BACKGROUND: We investigated the association between long workhours and marital status change from married to divorced or separated status that might have bad health effects. METHODS: A total of 40,654 participants with married status in 2014 were followed up in 2015. Weekly workhours were categorized into four groups: ≤ 40, 41–52, 53–60, and > 60 hours per week. Univariate and multivariate logistic regression analyses were performed to determine the relationship between groups of workhours and marital status change after adjusting for age, total monthly household income, working type, and depression with sex stratification. RESULTS: The study populations consisted of 8,346 (20.5%) females and 32,308 (79.5%) males. Odd ratios (ORs) of marital status change for females working for more than 60 hours per week was 4.26 (95% confidence interval [CI]: 1.25–14.5), when working less than or equal to 40 hours per week was used as reference in the crude model. ORs of working more than 60 hours per week was 4.57 (95% CI: 1.02–20.5) in female workers when considering age, total household earning per month, working type of daytime, and depression in a dose-response manner. However, for male workers, long workhours were not significantly related to change of marriage status. CONCLUSIONS: Long workhours for more than 60 hours per week had significantly higher risk of divorce or separation in females, but not in males. Further follow-up studies are needed to evaluate long term effects of long workhours on divorce risk.
Depression ; Divorce ; Family Characteristics ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Marital Status ; Marriage

OBJECTIVES: In recent decades, due to the high prevalence of divorce in numerous countries and the detrimental aftermath thereof, it has become increasingly important to study the components of marital stability. The current study explored fundamental protective factors in long-term marriage through a systematic review. METHODS: Searches for relevant publications were conducted in Embase, Web of Science, PubMed, Scopus, Science Direct, Magiran, and Scientific Information Database from their inception through January 30, 2019. Through the keyword search, 1,706 articles were found, of which 25 articles remained after screening based on the eligibility criteria. RESULTS: The extracted protective factors associated with marital stability in long-term marriage were classified as interpersonal and intrapersonal. Notable extracted factors included spirituality and religion, commitment, sexual relationship, communication, children, love and attachment, intimacy, and conflict resolution approach. These findings show that some aspects of relationships, such as commitment, act to preserve the pillars of marriage in critical situations, while other aspects, such as intimacy, help to construct marital identity and satisfaction. CONCLUSIONS: The identified components of marital stability are structures that enhance a couple’s identity and sense of togetherness. Identifying the specific aspects of marital relationships that contribute to marital stability may help specialists and researchers to target specific types of marital interaction that may enhance the happiness and longevity of relationships, thereby preventing avoidable divorces.
Child ; Divorce ; Happiness ; Humans ; Longevity ; Love ; Marriage ; Mass Screening ; Negotiating ; Prevalence ; Protective Factors ; Specialization ; Spirituality

BACKGROUND: Since 2003, Korea has consistently shown the highest suicide rate among the Organization for Economic Cooperation and Development countries, and suicide remains the major cause of death. In particular, men are 2–3 times more likely to commit suicide than women, which called the ‘gender paradox of suicide.’ The areas with frequent suicide have spatially clustered patterns because suicide with a social contagion spreads around the neighborhood. The purpose of this study was twofold. The first was to estimate the hotspot areas of age-standardized male suicide mortality from 2008 to 2015. The second was to analyze the relationship between the hotspot areas and the regional characteristics for study years. METHODS: The data was collected through the Korean Statistical Information Service. The study areas were 227 si · gun · gu administrative districts in Korea. The hotspot area was used as a dependent variable. Socio-demographic variables (number of marriages per 1,000 population, number of divorces per 1,000 population, and urbanization rate), financial variables (financial independence and social security budget), and health behaviors (EuroQol-5 dimension [EQ-5D], and depression experience rate) were used as independents variables. RESULTS: The hotspot areas were commonly located in Gangwon-do, Chungcheongnam-do, Gyeongsangbuk-do, and Chungceongbuk-do. According to the results of panel logit regression, the number of divorces per 1,000 population, social security budget, and EQ-5D were statistically significant variables. CONCLUSION: The results of hotspot analysis showed the need for establishing a prevention zone of suicide using hotspot areas. Also, medical resources could be considered to be preferentially placed in the prevention zone of suicide. This study could be used as basic data for health policymakers to establish a suicide-related policy.
Budgets ; Cause of Death ; Chungcheongnam-do ; Depression ; Divorce ; Female ; Gangwon-do ; Geographic Information Systems ; Gyeongsangbuk-do ; Health Behavior ; Humans ; Information Services ; Korea ; Male ; Marriage ; Mortality ; Organisation for Economic Co-Operation and Development ; Residence Characteristics ; Social Security ; Suicide ; Urbanization

PURPOSE: The purpose of this study was to investigate the frequency, patterns, and factors of reversals in decisions about life-sustaining treatment (LST) among older patients with terminal-stage chronic cardiopulmonary disease. METHODS: This was a retrospective correlational descriptive study based on medical chart review. De-identified patient electronic medical record data were collected from 124 deceased older patients with terminal-stage cardiopulmonary disease who had made reversals of LST decisions in an academic tertiary hospital in 2015. Data were extracted about the reversed LST decisions, LST treatments applied before death, and patients' demographic and clinical factors. Multivariate logistic regression analysis was used to identify the factors associated with the reversal to higher intensity of LST treatment. RESULTS: The use of inotropic agents was the most frequently reversed LST treatment, followed by cardiopulmonary resuscitation, intubation, ventilator therapy, and hemodialysis. Inconsistency between the last LST decisions and actual treatments occurred most often in hemodialysis. One-third of the reversals in LST decisions were made toward higher intensity of LST treatment. Patients who had lung diseases (vs. heart diseases); were single, divorced, or bereaved (vs. married); and had an acquaintance as a primary decision maker (vs. the patients themselves) were significantly more likely to reverse the LST decisions to higher intensity of LST treatment. CONCLUSION: This study demonstrated the complex and turmoil situation of the LST decision-making process among older patients with terminal-stage cardiopulmonary disease and suggests the importance of support for patients and families in their LST decision-making process.
Cardiopulmonary Resuscitation ; Decision Making ; Divorce ; Electronic Health Records ; Heart ; Humans ; Intubation ; Life Support Care ; Logistic Models ; Lung Diseases ; Renal Dialysis ; Retrospective Studies ; Terminal Care ; Tertiary Care Centers ; Ventilators, Mechanical

OBJECTIVE: The image of the wicked stepmother has created a prejudice against stepmothers, which makes it difficult for them to adjust to their stepfamilies. This study compared fairy tales from different cultures to reestablish the nature of stepmothers.METHODS: Grimms’ Fairy Tales (GFT) was used to represent Western culture, with stepmother characters appearing in 15 out of 210 tales. “The Collection of Korean Traditional Fairy Tales” (KFT) was used to represent Eastern culture, with stepmother characters featured in 14 out of 15,107 tales. We examined the relationships between stepmothers and stepchildren in GFT and KFT.RESULTS: Daughters were abused more often than sons in both genres. In GFT, jealousy spurred the abuse in 12 of 15 cases, while in KFT greed was predominant in 12 of 14 cases.CONCLUSION: The fairy tale portrayals of wicked stepmothers may be associated with the stigma children place on their stepmothers, which needs to be overcome.
Child ; Divorce ; Folklore ; Humans ; Jealousy ; Marriage ; Nuclear Family ; Parents ; Prejudice

OBJECTIVES: Many of the patients with type 2 diabetes are associated with sleep problems, and the rate of insomnia is known to be higher in the general population. The aims of this study were to know the frequency and clnical characteristics of insomnia, and related variables to insomnia in patients diagnosed with type 2 diabetes. METHODS: For 99 patients from 18 to 80 years of age (65 males and 34 females) with type 2 diabetes, interviews were performed. Total sleep time and sleep latency was evaluated. Insomnia was evaluated using the Korean Version of the Insomnia Severity Index (ISI-K). Severity of depressive symptoms were evaluted using the Korean version of the Hamilton Depression Scale (K-HDRM). According to the cutoff score of 15.5 on the ISI-K, subjects were divided into the group of type 2 diabetics with insomnia (N=34) and those without insomnia (N=65) at first, and then statistically analyzed. RESULTS: TInsomnia could be found in 34.34% of type 2 diabetics. Type 2 diabetics with insomnia had significantly more single or divorced (respectively 11.8%, p<0.05), higher total scores of the K-HDRS (11.76±5.52, p<0.001), shorter total sleep time (5.35±2.00 hours, p<0.001), and longer sleep latency (50.29±33.80 minutes, p<0.001). The all item scores of the ISI-K in type 2 diabetics with insomnia were significantly higher than those in type 2 diabetics without insomnia, that is, total (18.38±2.69), A1 (Initial insomnia) (2.97±0.76), A2 (Middle insomnia) (3.06±0.69), A3 (Terminal insomnia) (2.76±0.61), B (Satisfaction) (3.18±0.72), C (Interference) (2.09±0.97), D (Noticeability) (2.12±1.09) and E (Distress) (2.21±0.81) (respectively p<0.001). Variables associated with insomnia in type 2 diabetics were as following. Age had significant negative correlation with A3 items of the ISI-K (β=−0.241, p<0.05). Total scores of the K-HDRS had significant positive correlation, while total sleep time had significant negative correlation with all items of the ISI-K (respectively p<0.05). Sleep latency had significant positive correlation with total,, A1, B and E item scores of the ISI-K (respectively p<0.05). CONCLUSIONS: Insomnia was found in about 1/3 of type 2 diabetics. According to the presence of insomnia, clinical characteristics including sleep quality as well as quantity seemed to be different. Because depression seemed to be correlated with insomnia, clinicians should pay attention to early detection and intervention of depression among type 2 diabetics
Depression ; Divorce ; Humans ; Male ; Sleep Initiation and Maintenance Disorders

OBJECTIVES: This study examined the factors associated with suicidal behavior in psychiatric inpatients. METHODS: The medical records of 208 psychiatric inpatients were reviewed retrospectively. The factors related to suicide attempts and ideation at the time of admission, and during outpatient follow-up, were investigated. RESULTS: In total, 120 patients (57.7%) with a history of at least one suicide attempt, and 163 patients (78.4%) who reported active suicide ideation (e.g., a suicide plan or intention to commit suicide) at the time of admission were reviewed. Being unmarried or divorced, substance abuse, impulsivity, and a poor social support system were associated with a history of suicide attempts. The suicidal ideation group had significantly higher rates of coexisting depression, severe depressive symptoms, hopelessness, and impulsivity, as well as a lower incidence of moral objection to suicide and high religiosity. In total, 15 out of 193 patients (7.8%) who were followed-up at outpatient clinics attempted suicide after discharge. Patients who attempted suicide or reported suicidal ideation at the outpatient clinic after discharge were significantly more likely to have a history of previous suicide attempts, or have had active suicide ideation at the time of admission. Good social support and high responsibility to family were inversely associated with suicidal ideation as an outpatient. CONCLUSION: A history of suicide attempts and ideation at the time of hospital admission were the risk factors for future outpatient suicidal behavior. Further study is warranted to develop a checklist and assessment measures of the various risk and protective factors associated with suicidal behavior.
Ambulatory Care Facilities ; Checklist ; Depression ; Divorce ; Follow-Up Studies ; Humans ; Impulsive Behavior ; Incidence ; Inpatients ; Intention ; Medical Records ; Outpatients ; Protective Factors ; Retrospective Studies ; Risk Factors ; Single Person ; Substance-Related Disorders ; Suicidal Ideation ; Suicide ; Suicide, Attempted

OBJECTIVES: In recent decades, due to the high prevalence of divorce in numerous countries and the detrimental aftermath thereof, it has become increasingly important to study the components of marital stability. The current study explored fundamental protective factors in long-term marriage through a systematic review.METHODS: Searches for relevant publications were conducted in Embase, Web of Science, PubMed, Scopus, Science Direct, Magiran, and Scientific Information Database from their inception through January 30, 2019. Through the keyword search, 1,706 articles were found, of which 25 articles remained after screening based on the eligibility criteria.RESULTS: The extracted protective factors associated with marital stability in long-term marriage were classified as interpersonal and intrapersonal. Notable extracted factors included spirituality and religion, commitment, sexual relationship, communication, children, love and attachment, intimacy, and conflict resolution approach. These findings show that some aspects of relationships, such as commitment, act to preserve the pillars of marriage in critical situations, while other aspects, such as intimacy, help to construct marital identity and satisfaction.CONCLUSIONS: The identified components of marital stability are structures that enhance a couple's identity and sense of togetherness. Identifying the specific aspects of marital relationships that contribute to marital stability may help specialists and researchers to target specific types of marital interaction that may enhance the happiness and longevity of relationships, thereby preventing avoidable divorces.
Child ; Divorce ; Happiness ; Humans ; Longevity ; Love ; Marriage ; Mass Screening ; Negotiating ; Prevalence ; Protective Factors ; Specialization ; Spirituality

BACKGROUND: The aims of this study were to determine the extent of workplace bullying perceptions among the employees of a Faculty of Medicine, evaluating the variables considered to be associated, and determining the effect of workplace bullying perceptions on their psychological symptoms evaluated by the Brief Symptom Inventory (BSI). METHODS: This cross-sectional study was performed involving 355 (88.75%) employees. RESULTS: Levels of perceived workplace bullying were found to increase with the increasing scores for BSI and BSI sub-dimensions of anxiety, depression, negative self, somatization, and hostility (all p < 0.001). One point increase in the workplace bullying perception score was associated with a 0.47 point increase in psychological symptoms evaluated by BSI. Moreover, the workplace bullying perception scores were most strongly affected by the scores of anxiety, negative self, depression, hostility, and somatization (all p < 0.05). CONCLUSION: The present results revealed that young individuals, divorced individuals, faculty members, and individuals with a chronic disease had the greatest workplace bullying perceptions with our study population. Additionally, the BSI, anxiety, depression, negative self, somatization, and hostility scores of the individuals with high levels of workplace bullying perceptions were also high.
Anxiety ; Bullying* ; Chronic Disease ; Cross-Sectional Studies ; Depression ; Divorce ; Hostility

OBJECTIVES: The aim of this study was to investigate the variables influencing acceptability and perception towards suicide among the elderly in Bucheon city, South Korea. METHODS: A total of 1099 elderly over 65 years old participated in this study. The subjects completed a self-questionnaire including their demographic characteristics, psychiatric characteristics, factor 1 and 4 of the Attitudes Towards Suicide-20, and Geriatric Depression Scale Short Form Korea Version. One-way analysis of variance was performed to identify the variables associated with the acceptability and perception towards suicide. RESULTS: As result of this study, the demographic characteristics (older age, lower education level, lower economic state, bereavement, divorce or separated marital status, and life without spouse) and psychiatric characteristics (psychiatric past history, treatment history, and suicidal attempt history) were found to be associated with a more acceptable attitude toward suicide. In addition, a lower education level, no psychiatric history, and no psychiatric treatment history influenced the lack of perception to suicide. CONCLUSION: For public services to prevent suicide of the elderly population who lack spontaneity and accessibility to suicidal evaluations, it would be important to focus on the variables identified in this study for enhancing the effectiveness of the services.
Aged* ; Bereavement ; Depression ; Divorce ; Education ; Gyeonggi-do* ; Humans ; Korea ; Marital Status ; Suicide*