BACKGROUND: Chronic kidney disease (CKD) is an independent risk factor for progression to an end-stage renal disease requiring dialysis or kidney transplantation. We investigated the association of lifestyle behaviors with the initiation of renal replacement therapy (RRT) among CKD patients using an employment-based health insurance claims database linked with specific health checkup (SHC) data. METHODS: This retrospective cohort study included 149,620 CKD patients aged 40-74 years who underwent a SHC between April 2008 and March 2016. CKD patients were identified using ICD-10 diagnostic codes and SHC results. We investigated lifestyle behaviors recorded at SHC. Initiation of RRT was defined by medical procedure claims. Lifestyle behaviors related to the initiation of RRT were identified using a Cox proportional hazards regression model with recency-weighted cumulative exposure as a time-dependent covariate. RESULTS: During 384,042 patient-years of follow-up by the end of March 2016, 295 dialysis and no kidney transplantation cases were identified. Current smoking (hazard ratio: 1.87, 95% confidence interval, 1.04─3.36), skipping breakfast (4.80, 1.98─11.62), and taking sufficient rest along with sleep (2.09, 1.14─3.85) were associated with the initiation of RRT. CONCLUSIONS Among CKD patients, the lifestyle behaviors of smoking, skipping breakfast, and sufficient rest along with sleep were independently associated with the initiation of RRT. Our study strengthens the importance of monitoring lifestyle behaviors to delay the progression of mild CKD to RRT in the Japanese working generation. A substantial portion of subjects had missing data for eGFR and drinking frequency, warranting verification of these results in prospective studies.
Aged ; Cohort Studies ; Databases, Factual ; Disease Progression ; Female ; Health Benefit Plans, Employee ; Humans ; Japan/epidemiology* ; Life Style ; Male ; Meals ; Middle Aged ; Proportional Hazards Models ; Renal Insufficiency, Chronic/therapy* ; Renal Replacement Therapy ; Retrospective Studies ; Sleep ; Smoking/epidemiology*

BACKGROUND: Regional disparities in the working conditions of medical doctors have not been fully assessed in Japan. We aimed to clarify these differences in hospital characteristics: doctors' workload, wages, and popularity among medical students by city population sizes. METHODS: We targeted 423 teaching hospitals certified by the Japanese Society of Internal Medicine and assessed the working conditions of physicians specializing in internal medicine. We calculated their workload (the annual number of discharged patients per physician) and retrieved data on junior residents' monthly wages from the Resinavi Book which is popular among medical students in Japan to know the teaching hospital's information and each hospital's website. Furthermore, we explored the interim matching rate of each hospital as its popularity among medical students. Next, we classified cities in which all hospitals were located into eight groups based on their population size and compared the characteristics of these hospitals using a one-way analysis of variance. RESULTS: The average workload was 110.3, while the average workload in hospitals located in most populated cities (≥ 2,000,000) was 88.4 (p < 0.05). The average monthly wage was 351,199 Japanese yen, while that in most populated cities was 305,635.1 Japanese yen. The average popularity (matching rate) was 101.9%, and the rate in most populated areas was 142.7%, which was significantly higher than in other areas. CONCLUSIONS Hospitals in most populated areas had significantly lower workloads and wages; however, they were more popular among medical students than those in other areas. This study was the first to quantify the regional disparities in physicians' working conditions in Japan, and such disparities need to be corrected.
Cities/statistics & numerical data* ; Geography ; Hospitals, Teaching/statistics & numerical data* ; Japan ; Physicians/statistics & numerical data* ; Population Density ; Salaries and Fringe Benefits/statistics & numerical data* ; Students, Medical/psychology* ; Workload/statistics & numerical data*

PURPOSE: Scholarly works have reported about the nurses' salary and its impact on job satisfaction, nurse turnover, retention, work condition, and provision of nursing care. However, studies are either focused on the nurses in government hospitals or nurses working outside the country. Thus, the study aims to explore and describe the lived experience of nurses employed in private hospitals in Albay province, the Philippines, and explicate the need for better pay. DESIGN: The study used a qualitative design, specifically a descriptive phenomenology approach. METHODS: Purposive sampling and in-depth interviews were conducted among seventeen (17) nurse informants. The audio-recorded interviews were transcribed verbatim and analyzed following the seven-stage process as described by Colaizzi (1978) for data coding and identifying themes. The same process of analysis performed among the responses or data gathered through electronic communication platforms. FINDINGS: Four themes and nine sub-themes were identified. The first theme is 'Over but under,' which includes three sub-themes: (1) Over-worked, underpaid working conditions, (2) Finding an additional source of income as a result of low-wages, (3) More nurses are produced, but less are staying in the country, (4) Required by law in the country but not permitted by low salary. The second theme is 'Same but different,' which includes three sub-themes: (1) The Nursing profession is akin to others, yet uncompensated, (2) Work demands are comparable to government hospitals. The third theme is 'Caring but uncared-for,' which includes two sub-themes: (1) Psychologically upsetting, (2) Stimulates nurses transition. The fourth theme is 'Selfless foresight,' which include only one sub-theme (1) Increasing the salary attracts nurses to stay in the country. CONCLLUSION AND RECOMMENDATIONS: The study results showed that nurses in private hospitals need better remuneration as they experience poor work conditions. Also, it described a low salary that impacts the nurses' workload, their physical and mental health, their socio-economic being, their ability to avail professional development, the retention or turnover, and the provision of nursing care. The study findings suggest data triangulation of the study in some other private hospitals outside the region and explore strategies for increasing nurses' retention and satisfaction. Nonetheless, these efforts will robust the empirical data about the need for better pay among nurses in the private sector.
Job Satisfaction ; Personnel Turnover ; Hospitals, Private ; Salaries and Fringe Benefits

health, especially sleep quality. This study aims to determine the relationship between DSE and sleep quality.METHODS: This study analyzed data of 50,250 wage workers from the fifth Korean Working Conditions Survey. Workers that did not respond or refused to answer any questions related to variables were excluded, and finally 36,709 participants were included in this study. A total of 2,287 workers (6.2%) were compared with non-DSE (34,422; 93.8%) workers, and multiple logistic regression analyses were applied.RESULTS: DSE status had a significant association with difficulty falling asleep (odds ratio [OR]: 1.331, 95% confidence interval [CI]: 1.178–1.504), difficulty maintaining sleep (OR: 1.279; 95% CI: 1.125–1.455), and extreme fatigue after waking up (OR: 1.331; 95% CI: 1.184–1.496). A multiple logistic regression of the variables for sleep quality in DSE showed a significant association with exposure to physical factors for all types of poor sleep quality as well as shift work for difficulty maintaining sleep with extreme fatigue after waking up. Long working hours and emotional labor were also associated with extreme fatigue after waking up.CONCLUSIONS: This study shows a significant association between DSE and poor sleep quality, especially when workers were exposed to physical risk factors (noise, vibration, abnormal temperature, etc.) and shift work.]]>
Accidental Falls ; Employment ; Fatigue ; Logistic Models ; Risk Factors ; Salaries and Fringe Benefits ; Vibration

OBJECTIVES: The purpose of this study was to investigate the job satisfaction level of the dental staff working at oral health centers for people with disabilities. METHODS: A questionnaire survey was conducted with 73 dentists and dental hygienists working at seven regional oral health centers for people with special needs and dental hospitals for people with disabilities in Seoul. The questionnaire consisted of seven questions across two subscales: general satisfaction (4 questions) and satisfaction with wage and welfare (3 questions). The internal consistency of the questionnaire items was assessed using Cronbach's alpha (0.80). The responses were analyzed using a t-test with SPSS (version 23.0). RESULTS: Of the 73 dental staff members, 50% were dentists, 64% were women, and participants' average age was 30 years. In total, 58% of the participants had up to five years of experience working with people with disabilities, 42% of them worked full-time, and each participant treated an average of 200 patients with disabilities per month. The participants reported that their salary was relatively low. Dental hygienists had higher satisfaction level than dentists in the institution's welfare work. The more full-time workers answered, the more suitable they are for their work. CONCLUSIONS: The job satisfaction level of most professionals working in oral health centers for people with disabilities was not very high but they felt rewarded by their welfare work. It was inferred that it is necessary to examine and improve institutional support aspects such as human resource support. Increasing the number of centers in the central region is also needed.
Dental Hygienists ; Dental Staff ; Dentists ; Disabled Persons ; Female ; Humans ; Job Satisfaction ; Oral Health ; Reward ; Salaries and Fringe Benefits ; Seoul

BACKGROUND: Discrimination is a representative social determinant of health. Presenteeism is defined as presenting to work despite of illness and is an indicator of group health. We investigated the association of discrimination and presenteeism with cardiovascular disease using Korean data. METHODS: This study used the fourth Korea Working Conditions Survey (2014) data of 27,662 wage workers (employees). Presenteeism and discrimination related to age, sex, education, birth region, and employment type were ascertained. Self-reported cardiovascular disease was also assessed using the survey questionnaire. General and occupational characteristics found to be significant in univariate analyses were entered into a multivariate logistic regression analysis of the association of discrimination and presenteeism with cardiovascular disease. We also calculated the odds ratios of multiple discriminations and/or presenteeism for cardiovascular disease. RESULTS: In the univariate analyses, sex, age, education, monthly income, employment type, occupation, hours worked per week, workplace scale, and shift work were significantly associated with cardiovascular disease. A multivariate logistic regression analysis adjusted for general and occupational characteristics showed that discrimination and presenteeism were significantly associated with cardiovascular disease. Finally, the association with cardiovascular disease was strongest when both multiple discriminations and presenteeism were present. CONCLUSIONS: Discrimination and presenteeism are associated with cardiovascular disease, and this association was stronger in the presence of multiple types of discrimination and presenteeism.
Cardiovascular Diseases ; Discrimination (Psychology) ; Education ; Employment ; Korea ; Logistic Models ; Occupations ; Odds Ratio ; Parturition ; Presenteeism ; Salaries and Fringe Benefits

BACKGROUND: Workers spend most of their social lives at work and have relationships of varying nature with people in the workplace. Direct supervisors, in particular, have a direct and lasting impact on workers, which may influence workers' mental health. Depression is very prevalent worldwide, and social concern about the disease is on the rise. The aim of this study is to investigate the effect of direct supervisors' behavior on the depressive mood of Korean wage workers. METHODS: We used data from the 4th Korean Working Conditions Survey held in 2014; 22,212 participants were included in the analysis. The quality of a direct supervisor's behavior was categorized from 0 (= lowest) to 5 (= highest) points. The degree of depressive mood was measured on a scale from “normal mood” to “likely depression” based on the 5-item World Health Organization Well-Being Index (WHO-5) questionnaire. Multiple logistic regression was used to analyze the association between the quality of the direct supervisor's behavior and the depressive mood of wage workers. RESULTS: After multivariable adjustment, significantly increased odds ratio (OR) for likely depression was found in the 4, 3, 2, 1, and 0 points of the quality of the direct supervisor's behavior compared to 5 points. After stratification for the level of satisfaction with working conditions, the OR of the unsatisfied groups was higher than that of the satisfied groups. CONCLUSIONS: Likely depression was found to be significantly associated with a low quality of direct supervisor's behavior. This association was stronger in workers who were not satisfied with their working conditions. This study suggests that proper management of the direct supervisor's behavior is needed to reduce the risk of depression among Korean wage workers.
Depression ; Logistic Models ; Mental Health ; Odds Ratio ; Salaries and Fringe Benefits ; World Health Organization

OBJECTIVES: This study conducted to investigate work-related factors in relation to smoking among women working in call centers in Gwangju, South Korea. METHODS: From 56 call centers (7320 employees), we selected 10 and conducted a survey using a structured questionnaire by randomly selecting 10% of workers from each center. A total of 387 subjects participated in this survey We analyzed for 375 respondents, after excluding men and those with missing responses. We analyzed the relationships of work-related factors such as emotional labor, workplace violence, employment type, annual salary, working hours, employment period with smoking, using multiple logistic regression analysis. Emotional labor and workplace violence were measured using the Korean Emotional Labor Scale (K-ELS) and Korean Workplace Violence Scale (K-WVS). RESULTS: The prevalence of current smoking among call center female workers was 13.6%. Univariate analysis showed that “Emotional disharmony and hurt”, “Experience of psychological and sexual violence from supervisors and co-workers” among items of K-ELS and K-WVS, working hours, annual salary correlated with smoking. After adjusting for emotional labor, workplace violence, employment type, annual salary, working hours, employment period, and age, only working hours show a significant association with smoking. Women who worked 40–49 h had 3.50 times (95% CI = 1.04–11.80) and worked more than 50 h had 8.68 times (95% CI = 1.89–39.78) greater odds of smoking as compared with women who worked less than 40 h. CONCLUSIONS: Smoking was associated with working hours among female workers in call center. However, emotional labor and workplace violence did not show significant relationships with smoking.
Cross-Sectional Studies ; Employment ; Female ; Gwangju ; Humans ; Korea ; Logistic Models ; Male ; Prevalence ; Salaries and Fringe Benefits ; Sex Offenses ; Smoke ; Smoking ; Surveys and Questionnaires ; Workplace Violence

BACKGROUND: Most of the school meal service workers in Korea are middle-aged individuals. They have high workload, which increases their incidence of musculoskeletal disorders. This study aimed to evaluate the prevalence and risk factors of subjective musculoskeletal symptoms, presumptive diagnosis, medical care use, and sick leave among female school meal workers. METHODS: We analyzed the results of musculoskeletal disease screening of 1581 female school meal workers. The screening consisted of self-administered questionnaire, history taking by occupational physicians, and physical examination. The prevalence of subjective musculoskeletal symptoms, presumptive diagnosis after initial examination by occupational physicians, use of medical care for more than 7 days, and sick leave due to musculoskeletal diseases during the past year were evaluated in this study. The relative risk of four outcome indicators of musculoskeletal disorders was compared with respect to potential factors, such as age, subjective physical loading, present illness, injury experience, and type of school, using log-binomial regression. RESULTS: The prevalence of subjective musculoskeletal symptom was 79.6%; presumptive diagnosis, 47.6%; hospital visits over 7 days, 36.4%; and sick leave, 7.3%. The relative risk of musculoskeletal symptoms by age (≥50 years vs < 50 years) was 1.04 (95% confidence interval (CI): 1.00–1.09); presumptive diagnosis of musculoskeletal disease, 1.17 (95% CI: 1.06–1.30); hospital visits over 7 days, 1.26 (95% CI: 0.85–1.85); and sick leave, 1.17 (95% CI: 1.02–1.34). The relative risk of musculoskeletal symptoms due to subjective physical loading (very hard vs low) was 1.45 (95% CI: 1.33–1.58); presumptive diagnosis, 2.92 (95% CI: 2.25); hospital visits over 7 days, 1.91 (95% CI: 1.02–3.59); and sick leave, 2.11 (95% CI: 1.63–2.74). CONCLUSIONS: Subjective physical loading was a more important factor in musculoskeletal disorders than the age of female school meal workers.
Diagnosis ; Female ; Humans ; Incidence ; Korea ; Mass Screening ; Meals ; Musculoskeletal Diseases ; Physical Examination ; Prevalence ; Risk Factors ; Sick Leave

PURPOSE: This study aimed to investigate the factors affecting general hospital nurses' intention to stay in their jobs. METHODS: A descriptive research design was used with a convenience sample of 286 nurses. Data were collected from March 15 to April 14, 2017using self-reported questionnaires and analyzed by descriptive statistics, t-test, analysis of variance, Pearson's correlation coefficient, and multiple regression analysis using the SPSS/WIN 21.0 program. RESULTS: The mean scores for intention to stay, resilience, and emotional labor were 5.28 out of 8, 57.40 out of 100, and 3.23 out of 5, respectively. Intention to stay was positively correlated with overall career (r=.30), workplace (r=.18), shift work (r=−.20), position (r=.28), salary (r=.13), job satisfaction (r=.51), hospital satisfaction (r=.46), and resilience (r=.41). Factors influencing the intention to stay were job satisfaction and resilience, which explained 28% of the variance. CONCLUSION: Overall career, job satisfaction, and resilience are critical factors affecting general hospital nurses' intention to stay. Based on the findings of this study, efforts to improve nurses' job satisfaction and resilience should be implemented to mitigate the loss of this expert group among healthcare professionals.
Delivery of Health Care ; Hospitals, General ; Intention ; Job Satisfaction ; Research Design ; Salaries and Fringe Benefits