1.Testing the reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index using Fitbit devices: a cross-sectional analysis
Si-Yeon LEE ; Ja-Eun CHOI ; Ji-Won LEE ; Yaeji LEE ; Jae-Min PARK ; Kyung-Won HONG
Korean Journal of Family Medicine 2025;46(1):42-47
		                        		
		                        			 Background:
		                        			Sleep disorders and insomnia are prevalent worldwide, with negative health outcomes. The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report assessment tool for evaluating sleep quality, comprising seven subdomains. The Korean version of the PSQI (PSQI-K) has been tested for reliability and validity in small sample sizes but lacks large-scale validation using objective measures. 
		                        		
		                        			Methods:
		                        			This study was conducted with 268 Korean adults attending health check programs. Participants completed the PSQI-K questionnaire and wore Fitbit devices (Fitbit Inc., USA) to ascertain sleep parameters. Reliability was analyzed using the Cronbach’s α coefficient, and construct validity was determined through factor analysis. Criteria validity was assessed by correlating their index scores with Fitbit sleep parameters. We identified the optimal cutoff for detecting sleep disorders. 
		                        		
		                        			Results:
		                        			The Cronbach’s α coefficient was 0.61, indicating adequate internal consistency. Factor analysis revealed three factors, explaining 48.2% of sleep quality variance. The index scores were negatively correlated with Fitbit sleep efficiency, total sleep time, and number of awakenings (P<0.05). The optimal cutoff point for identifying sleep disorder groups was ≥6. 
		                        		
		                        			Conclusion
		                        			The PSQI-K demonstrated good reliability and validity when correlated with Fitbit sleep parameters, offering a practical screening tool for identifying sleep disorders among Korean adults. Cutoff scores can help identify patients for sleep interventions. However, further large-scale studies are required to validate these findings. 
		                        		
		                        		
		                        		
		                        	
2.A comparison of the outcomes of families with children aged less than 2 who received universal versus sustained nurse home visiting services in Korea: a cross-sectional study
Yu-Mi KIM ; Sun Hwa PARK ; Kyung Ja JUNE ; Sung-Hyun CHO ; Ji Yun LEE ; Hong-Jun CHO ; Young-Ho KHANG
Epidemiology and Health 2025;47(1):e2025004-
		                        		
		                        			 OBJECTIVES:
		                        			This study aimed to compare maternal outcomes and the home environment between non‑vulnerable families with children under 2 receiving universal home visiting services and vulnerable families receiving sustained home visiting services. 
		                        		
		                        			METHODS:
		                        			This study was conducted in Seoul, Korea, where the country’s first nurse‑led early childhood home visiting program was introduced. A total of 551 mother‑child dyads participated in cross‑sectional surveys conducted at various child ages (6±2 weeks, 6±1 months, 12±1 months, and 24±1 months). Universal home visiting services were provided within six weeks postpartum to non‑vulnerable families, while vulnerable families received sustained services consisting of 25 visits over 24 months. Maternal knowledge of sudden infant death syndrome (SIDS) and childcare, maternal distress, and the Korean Infant‑Toddler Home Observation for Measurement of Environment (K‑IT‑HOME) were assessed. 
		                        		
		                        			RESULTS:
		                        			Overall, the universal home visitation group demonstrated higher levels of maternal knowledge regarding SIDS and childcare compared to the sustained home visitation group (all p-values <0.05), while the sustained home visitation group reported higher levels of maternal distress (p<0.001). The total K‑IT‑HOME score was 1.47 points higher in the universal home visitation group than in the sustained home visitation group (p<0.001). No significant differences were observed in the acceptance, organization, or involvement subscales of the K‑IT‑HOME (all p-values >0.05). 
		                        		
		                        			CONCLUSIONS
		                        			This study demonstrated that disparities in maternal outcomes and home environments persisted in early childhood between the sustained and universal home visitation groups. 
		                        		
		                        		
		                        		
		                        	
3.Testing the reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index using Fitbit devices: a cross-sectional analysis
Si-Yeon LEE ; Ja-Eun CHOI ; Ji-Won LEE ; Yaeji LEE ; Jae-Min PARK ; Kyung-Won HONG
Korean Journal of Family Medicine 2025;46(1):42-47
		                        		
		                        			 Background:
		                        			Sleep disorders and insomnia are prevalent worldwide, with negative health outcomes. The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report assessment tool for evaluating sleep quality, comprising seven subdomains. The Korean version of the PSQI (PSQI-K) has been tested for reliability and validity in small sample sizes but lacks large-scale validation using objective measures. 
		                        		
		                        			Methods:
		                        			This study was conducted with 268 Korean adults attending health check programs. Participants completed the PSQI-K questionnaire and wore Fitbit devices (Fitbit Inc., USA) to ascertain sleep parameters. Reliability was analyzed using the Cronbach’s α coefficient, and construct validity was determined through factor analysis. Criteria validity was assessed by correlating their index scores with Fitbit sleep parameters. We identified the optimal cutoff for detecting sleep disorders. 
		                        		
		                        			Results:
		                        			The Cronbach’s α coefficient was 0.61, indicating adequate internal consistency. Factor analysis revealed three factors, explaining 48.2% of sleep quality variance. The index scores were negatively correlated with Fitbit sleep efficiency, total sleep time, and number of awakenings (P<0.05). The optimal cutoff point for identifying sleep disorder groups was ≥6. 
		                        		
		                        			Conclusion
		                        			The PSQI-K demonstrated good reliability and validity when correlated with Fitbit sleep parameters, offering a practical screening tool for identifying sleep disorders among Korean adults. Cutoff scores can help identify patients for sleep interventions. However, further large-scale studies are required to validate these findings. 
		                        		
		                        		
		                        		
		                        	
4.Risk-adapted scoring model to identify candidates benefiting from adjuvant chemotherapy after radical nephroureterectomy for localized upper urinary tract urothelial carcinoma: A multicenter study
Sung Jun SOU ; Ja Yoon KU ; Kyung Hwan KIM ; Won Ik SEO ; Hong Koo HA ; Hui Mo GU ; Eu Chang HWANG ; Young Joo PARK ; Chan Ho LEE
Investigative and Clinical Urology 2025;66(2):114-123
		                        		
		                        			 Purpose:
		                        			Adjuvant chemotherapy (AC) is recommended for muscle-invasive or lymph node-positive upper urinary tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). However, disease recurrences are frequently observed in pT1 disease, and AC may increase the risk of overtreatment in pT2 UTUC patients. This study aimed to validate a risk-adapted scoring model for selecting UTUC patients with ≤pT2 disease who would benefit from AC. 
		                        		
		                        			Materials and Methods:
		                        			We retrospectively analyzed 443 ≤pT2 UTUC patients who underwent RNU. A risk-adapted scoring model was applied, categorizing patients into low- or high-risk groups. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were analyzed according to risk group. 
		                        		
		                        			Results:
		                        			Overall, 355 patients (80.1%) and 88 patients (19.9%) were categorized into the low- and high-risk groups, respectively, with the latter having higher pathological stages, concurrent carcinoma in situ, and synchronous bladder tumors. Disease recurrence occurred in 45 patients (10.2%), among whom 19 (5.4%) and 26 (29.5%) belonged to the low- and high-risk groups, respectively (p<0.001). High-risk patients had significantly shorter RFS (64.3% vs. 93.6% at 60 months; hazard ratio [HR] 13.66; p<0.001) and worse CSS (80.7% vs. 91.5% at 60 months; HR 4.25; p=0.002). Multivariate analysis confirmed that pT2 stage and the high-risk group were independent predictors of recurrence and cancer-specific death (p<0.001). Decision curve analysis for RFS showed larger net benefits with our model than with the T stage model. 
		                        		
		                        			Conclusions
		                        			The risk-adapted scoring model effectively predicts recurrence and identifies optimal candidates for AC post RNU in non-metastatic UTUC. 
		                        		
		                        		
		                        		
		                        	
5.A comparison of the outcomes of families with children aged less than 2 who received universal versus sustained nurse home visiting services in Korea: a cross-sectional study
Yu-Mi KIM ; Sun Hwa PARK ; Kyung Ja JUNE ; Sung-Hyun CHO ; Ji Yun LEE ; Hong-Jun CHO ; Young-Ho KHANG
Epidemiology and Health 2025;47(1):e2025004-
		                        		
		                        			 OBJECTIVES:
		                        			This study aimed to compare maternal outcomes and the home environment between non‑vulnerable families with children under 2 receiving universal home visiting services and vulnerable families receiving sustained home visiting services. 
		                        		
		                        			METHODS:
		                        			This study was conducted in Seoul, Korea, where the country’s first nurse‑led early childhood home visiting program was introduced. A total of 551 mother‑child dyads participated in cross‑sectional surveys conducted at various child ages (6±2 weeks, 6±1 months, 12±1 months, and 24±1 months). Universal home visiting services were provided within six weeks postpartum to non‑vulnerable families, while vulnerable families received sustained services consisting of 25 visits over 24 months. Maternal knowledge of sudden infant death syndrome (SIDS) and childcare, maternal distress, and the Korean Infant‑Toddler Home Observation for Measurement of Environment (K‑IT‑HOME) were assessed. 
		                        		
		                        			RESULTS:
		                        			Overall, the universal home visitation group demonstrated higher levels of maternal knowledge regarding SIDS and childcare compared to the sustained home visitation group (all p-values <0.05), while the sustained home visitation group reported higher levels of maternal distress (p<0.001). The total K‑IT‑HOME score was 1.47 points higher in the universal home visitation group than in the sustained home visitation group (p<0.001). No significant differences were observed in the acceptance, organization, or involvement subscales of the K‑IT‑HOME (all p-values >0.05). 
		                        		
		                        			CONCLUSIONS
		                        			This study demonstrated that disparities in maternal outcomes and home environments persisted in early childhood between the sustained and universal home visitation groups. 
		                        		
		                        		
		                        		
		                        	
6.A comparison of the outcomes of families with children aged less than 2 who received universal versus sustained nurse home visiting services in Korea: a cross-sectional study
Yu-Mi KIM ; Sun Hwa PARK ; Kyung Ja JUNE ; Sung-Hyun CHO ; Ji Yun LEE ; Hong-Jun CHO ; Young-Ho KHANG
Epidemiology and Health 2025;47(1):e2025004-
		                        		
		                        			 OBJECTIVES:
		                        			This study aimed to compare maternal outcomes and the home environment between non‑vulnerable families with children under 2 receiving universal home visiting services and vulnerable families receiving sustained home visiting services. 
		                        		
		                        			METHODS:
		                        			This study was conducted in Seoul, Korea, where the country’s first nurse‑led early childhood home visiting program was introduced. A total of 551 mother‑child dyads participated in cross‑sectional surveys conducted at various child ages (6±2 weeks, 6±1 months, 12±1 months, and 24±1 months). Universal home visiting services were provided within six weeks postpartum to non‑vulnerable families, while vulnerable families received sustained services consisting of 25 visits over 24 months. Maternal knowledge of sudden infant death syndrome (SIDS) and childcare, maternal distress, and the Korean Infant‑Toddler Home Observation for Measurement of Environment (K‑IT‑HOME) were assessed. 
		                        		
		                        			RESULTS:
		                        			Overall, the universal home visitation group demonstrated higher levels of maternal knowledge regarding SIDS and childcare compared to the sustained home visitation group (all p-values <0.05), while the sustained home visitation group reported higher levels of maternal distress (p<0.001). The total K‑IT‑HOME score was 1.47 points higher in the universal home visitation group than in the sustained home visitation group (p<0.001). No significant differences were observed in the acceptance, organization, or involvement subscales of the K‑IT‑HOME (all p-values >0.05). 
		                        		
		                        			CONCLUSIONS
		                        			This study demonstrated that disparities in maternal outcomes and home environments persisted in early childhood between the sustained and universal home visitation groups. 
		                        		
		                        		
		                        		
		                        	
7.Testing the reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index using Fitbit devices: a cross-sectional analysis
Si-Yeon LEE ; Ja-Eun CHOI ; Ji-Won LEE ; Yaeji LEE ; Jae-Min PARK ; Kyung-Won HONG
Korean Journal of Family Medicine 2025;46(1):42-47
		                        		
		                        			 Background:
		                        			Sleep disorders and insomnia are prevalent worldwide, with negative health outcomes. The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report assessment tool for evaluating sleep quality, comprising seven subdomains. The Korean version of the PSQI (PSQI-K) has been tested for reliability and validity in small sample sizes but lacks large-scale validation using objective measures. 
		                        		
		                        			Methods:
		                        			This study was conducted with 268 Korean adults attending health check programs. Participants completed the PSQI-K questionnaire and wore Fitbit devices (Fitbit Inc., USA) to ascertain sleep parameters. Reliability was analyzed using the Cronbach’s α coefficient, and construct validity was determined through factor analysis. Criteria validity was assessed by correlating their index scores with Fitbit sleep parameters. We identified the optimal cutoff for detecting sleep disorders. 
		                        		
		                        			Results:
		                        			The Cronbach’s α coefficient was 0.61, indicating adequate internal consistency. Factor analysis revealed three factors, explaining 48.2% of sleep quality variance. The index scores were negatively correlated with Fitbit sleep efficiency, total sleep time, and number of awakenings (P<0.05). The optimal cutoff point for identifying sleep disorder groups was ≥6. 
		                        		
		                        			Conclusion
		                        			The PSQI-K demonstrated good reliability and validity when correlated with Fitbit sleep parameters, offering a practical screening tool for identifying sleep disorders among Korean adults. Cutoff scores can help identify patients for sleep interventions. However, further large-scale studies are required to validate these findings. 
		                        		
		                        		
		                        		
		                        	
8.A comparison of the outcomes of families with children aged less than 2 who received universal versus sustained nurse home visiting services in Korea: a cross-sectional study
Yu-Mi KIM ; Sun Hwa PARK ; Kyung Ja JUNE ; Sung-Hyun CHO ; Ji Yun LEE ; Hong-Jun CHO ; Young-Ho KHANG
Epidemiology and Health 2025;47(1):e2025004-
		                        		
		                        			 OBJECTIVES:
		                        			This study aimed to compare maternal outcomes and the home environment between non‑vulnerable families with children under 2 receiving universal home visiting services and vulnerable families receiving sustained home visiting services. 
		                        		
		                        			METHODS:
		                        			This study was conducted in Seoul, Korea, where the country’s first nurse‑led early childhood home visiting program was introduced. A total of 551 mother‑child dyads participated in cross‑sectional surveys conducted at various child ages (6±2 weeks, 6±1 months, 12±1 months, and 24±1 months). Universal home visiting services were provided within six weeks postpartum to non‑vulnerable families, while vulnerable families received sustained services consisting of 25 visits over 24 months. Maternal knowledge of sudden infant death syndrome (SIDS) and childcare, maternal distress, and the Korean Infant‑Toddler Home Observation for Measurement of Environment (K‑IT‑HOME) were assessed. 
		                        		
		                        			RESULTS:
		                        			Overall, the universal home visitation group demonstrated higher levels of maternal knowledge regarding SIDS and childcare compared to the sustained home visitation group (all p-values <0.05), while the sustained home visitation group reported higher levels of maternal distress (p<0.001). The total K‑IT‑HOME score was 1.47 points higher in the universal home visitation group than in the sustained home visitation group (p<0.001). No significant differences were observed in the acceptance, organization, or involvement subscales of the K‑IT‑HOME (all p-values >0.05). 
		                        		
		                        			CONCLUSIONS
		                        			This study demonstrated that disparities in maternal outcomes and home environments persisted in early childhood between the sustained and universal home visitation groups. 
		                        		
		                        		
		                        		
		                        	
9.Testing the reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index using Fitbit devices: a cross-sectional analysis
Si-Yeon LEE ; Ja-Eun CHOI ; Ji-Won LEE ; Yaeji LEE ; Jae-Min PARK ; Kyung-Won HONG
Korean Journal of Family Medicine 2025;46(1):42-47
		                        		
		                        			 Background:
		                        			Sleep disorders and insomnia are prevalent worldwide, with negative health outcomes. The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report assessment tool for evaluating sleep quality, comprising seven subdomains. The Korean version of the PSQI (PSQI-K) has been tested for reliability and validity in small sample sizes but lacks large-scale validation using objective measures. 
		                        		
		                        			Methods:
		                        			This study was conducted with 268 Korean adults attending health check programs. Participants completed the PSQI-K questionnaire and wore Fitbit devices (Fitbit Inc., USA) to ascertain sleep parameters. Reliability was analyzed using the Cronbach’s α coefficient, and construct validity was determined through factor analysis. Criteria validity was assessed by correlating their index scores with Fitbit sleep parameters. We identified the optimal cutoff for detecting sleep disorders. 
		                        		
		                        			Results:
		                        			The Cronbach’s α coefficient was 0.61, indicating adequate internal consistency. Factor analysis revealed three factors, explaining 48.2% of sleep quality variance. The index scores were negatively correlated with Fitbit sleep efficiency, total sleep time, and number of awakenings (P<0.05). The optimal cutoff point for identifying sleep disorder groups was ≥6. 
		                        		
		                        			Conclusion
		                        			The PSQI-K demonstrated good reliability and validity when correlated with Fitbit sleep parameters, offering a practical screening tool for identifying sleep disorders among Korean adults. Cutoff scores can help identify patients for sleep interventions. However, further large-scale studies are required to validate these findings. 
		                        		
		                        		
		                        		
		                        	
10.Motherhood as Experienced by Women in a Prenatal and Early-Childhood Home Visitation Program, and Associated Factors
Ji Yun LEE ; Young-Ho KHANG ; Yu-Mi KIM ; Kyung Ja JUNE ; Sung-Hyun CHO ; Hong-Jun CHO
Journal of the Korean Society of Maternal and Child Health 2024;28(1):22-31
		                        		
		                        			 Purpose:
		                        			This study is intended to examine the difficulties facing mothers of young children (early childhood) and to understand the associated factors.Method: We analyzed 1,003 data items of women with children under age 2 who participated in a prenatal and early-childhood home visitation program in Seoul from 2016 to 2019. For our research, we used self-administered registration and service monitoring data. The difficulties the women faced as mothers were measured using the “Being a Mother Scale” (BaM-13). This analysis considered covariates including maternal and infant ages, their number of children, economic conditions, presence of disabilities, single motherhood, multicultural migration background, employment status, unintended pregnancy, instrumental and emotional support, and depression scores. 
		                        		
		                        			Results:
		                        			The average score for being a mother was 14.45 (standard deviation=6.61), and higher scores were recorded for women with spouses, Korean women (as opposed to multicultural immigrant women), women whose pregnancies were unplanned, women without instrumental support, and severely depressed women. 
		                        		
		                        			Conclusion
		                        			Motherhood poses great difficulties to women with children under age two. To help women transition from motherhood, it is important to understand their situations in relation to their social and psychological characteristics, as well as the cultural, social, and contextual perspectives they bring to motherhood. 
		                        		
		                        		
		                        		
		                        	
            
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