• Korean Medical Education Review
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• v.24 no.3
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• pp.231-239
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• 2022

This study aimed to examine the influence of the coronavirus disease 2019 (COVID-19) pandemic on areas of Korean medical students' lives, assess concerns, and investigate the strategies they used to cope with stress due to the pandemic. An online survey with a total of 53 items on the impact of COVID-19, concerns, and coping strategies was sent to medical students, and responses were collected from April 27, 2021 to May 30, 2021. In total, 1,329 students were included in the study. Analysis was performed using the chi-square test, independent-sample t-test, and one-way analysis of variance, and the post-hoc Scheffé test or Games-Howell test was performed for multiple comparisons. The main negative impacts of the pandemic were on hobbies/leisure activities and mental health, and medical students expressed the highest levels of concern regarding restriction of movement, returning to everyday life, and risk of infection for family and friends. Female students more strongly agreed that COVID-19 had increased their depressed mood and anxiety (p<0.001 and p=0.003, respectively). Furthermore, the negative impacts of the pandemic on different areas of life significantly affected current levels of depressed mood and anxiety. To cope with pandemic-related stress, students used several strategies such as talking with family or friends (91.5%), sleeping (83.1%), exercising (72.8%), using social networking services (60.8%), drinking alcohol (37.8%), and practicing meditation/mindfulness (24.4%); the effectiveness of these strategies ranged from 3.45 to 4.19 on a 5-point Likert-type scale (1-5). The study findings suggest that COVID-19 has influenced the mental health of medical students and raised concerns in many areas of their lives. Students used various strategies to cope with the pandemic-related stress; since the effectiveness of frequently used approaches varied, it is essential to guide medical students to develop effective coping strategies.

• Archives of Plastic Surgery
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• v.48 no.4
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• pp.361-365
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• 2021

Background Pain in the postoperative body contouring patient has traditionally been managed with narcotic medication. In an effort to minimize side effects and prevent addiction, plastic surgeons are searching for novel ways to provide adequate analgesia, one of which is nerve blocks. This study was conducted with a meta-analysis that evaluates the efficacy of these blocks for patients who undergo breast surgery. Methods A search of the PubMed/MEDLINE database for articles including the terms "post-operative analgesia" OR "postoperative pain management" AND "in plastic surgery" OR "in cosmetic surgery" OR "in elective surgery" in February 2019 generated five studies on elective breast augmentation and reduction mammoplasty that reported pain scores and quantities of opioids consumed. Independent samples t-tests, one-way analysis of variance, and a random effects model were implemented for evaluation. Results A total of 317 patients were identified as having undergone body contouring of the breast, about half of which received a nerve block. Pain scores on a 1-10 scale and opioid dose-equivalents were calculated. Those who were blocked had an average score of 2.40 compared to 3.64 for those who did not (P<0.001), and required an average of 5.20 less narcotic doses (P<0.001). Pain relief following subpectoral augmentation was best achieved with type-II blocks as opposed to type-I and type-II with serratus plane (P<0.001). Conclusions The opioid epidemic has extended to all surgical specialties. Implementation of a nerve block seems to be an efficacious and cost-effective mechanism to not only help with post-operative pain, but also lower the need for narcotics, especially in subpectoral augmentation.

• Safety and Health at Work
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• v.11 no.4
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• pp.526-532
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• 2020

Background: The high incidence of work-related diseases and injuries among day-laborers and workers with no legal contracts (informal workers) has received the attention of the Thai authorities. Workers' low occupational health literacy (OHL) has been reasoned as one contributing factor. Absence of a valid tool has prevented assessment of informal workers' OHL. The aim of this study was to create a valid and reliable Occupational Health Literacy Scale within the context of Thai working culture (TOHLS-IF). Methods: This study used the mixed method approach to develop TOHLS-IF. Questions were generated using in-depth interviews and an extensive review of the literature. Experts' assessment confirmed the content validity of TOHLS-IF. The scales of its psychometric properties were assessed in a sample of 400 informal workers using cluster random sampling. Results: The final version of the TOHLS-IF comprises 38 items within 4 dimensions: Ability to Gain Access, Understanding, Evaluation, and Use of occupational health and safety information. Factor analysis identified items explaining 50.22% of the total variance. The final confirmatory analysis confirmed the model estimates were satisfactory for the construct. TOHLS-IF demonstrated a high internal consistency and satisfactory reliability (Cronbach's alpha = .98). Conclusion: The TOHLS-IF is a valid and reliable instrument to assess informal workers' OHL. The structural dimensions of this instrument are based on the concept of health literacy and Thai culture. Thai health professionals are encouraged to benefit from this instrument to assess their workers' OHL and apply findings as guidelines for effective occupational health and safety interventions.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.41.1-41.11
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• 2020

Background: Orthognathic surgery such as bilateral sagittal split ramus osteotomy (BSSRO) for the treatment of mandibular deformities is one of the most common procedures in maxillofacial operations that may lead to neurosensory disturbance. In this study, we aimed to evaluate the effectiveness of low-level laser therapy (LLLT) on augmenting recovery of neurosensory disturbance of inferior alveolar nerve (IAN) in patients who underwent BSSRO surgery. Methods: A comprehensive literature search was conducted by two independent authors in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Embase, and Google Scholar electronic databases. Besides, a manual search of all textbooks and relevant articles were conducted. Searches took place in August 2020 and were limited to published and peer-reviewed articles from 2000 to 2020. All analysis was performed using the comprehensive meta-analysis (CMA) and the STATA MP (version:16) software. The weighted mean difference (WMD) using the inverse variance method and the standard mean difference (SMD) was considered for continuous variables. Results: Seventy-four papers were retrieved after removing duplicate studies and finally, eight studies were assessed for qualitative synthesis and five for meta-analysis. Totally, 94 patients were included in the meta-analysis. Based on the meta-analysis, it was shown that LLLT was not effective in a short interval (0 to 48 h) after surgery, but in a period of more than 1 month after surgery, the positive results of treatment can be observed strikingly. Also, LLLT side/group showed no significant difference in some aspects of neurosensory recovery such as thermal sensation compared to the placebo side/group. Conclusions: The meta-analysis of randomized controlled trials revealed that LLLT generally improves IAN sensory disturbance caused by BSSRO. Further high-quality clinical trials with longer follow-up periods and larger sample sizes are recommended.

• Journal of Korean Academy of Nursing
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• v.52 no.1
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• pp.52-65
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• 2022

Purpose: This study was conducted to develop a scale to measure spiritual distress in cancer patients. Methods: A total of 69 preliminary items for the spiritaul distress assessment tool (SDAT) were compiled, based on a literature review, selection of empirically relevant items through concept analysis of hybrid models, confirmation of content validity by experts, cognitive interviews, and a pretest. Self-administered questionnaires were collected between April 1 and July 31, 2018, from 225 cancer patients at four medical institutions and one nursing home. The data were analyzed using item analysis, exploratory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity. Reliability was tested by Cronbash's α coefficient. Results: The final version of the SDAT consisted of 20 items. Five-factors, loss of peace, burden of family, avoidance of confronting death, guilt and remorse, regret for not being able to apololgize and forgive were extracted, and showed 62.8% of total variance. The factors were confirmed through convergent and discriminant validity. Criterion validity was confirmed by functional assessment chronic illness therapy spiritual well-being scale 12 (FACIT-Sp12). The overall Cronbach's α was .91, and the coefficients of each subscale ranged from .78~.83. Conclusion: The SDAT for cancer patients is valid and reliable. It is suggested that the tool can be used to measure spiritual distress in cancer patients.

• Korean Medical Education Review
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• v.25 no.1
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• pp.45-54
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• 2023

We investigated the work-life balance of clinical professors in charge of patient care, research, and education at medical schools and the demand for work-life balance support according to position (professor, associate professor, or assistant professor). In total, 163 clinical professors completed the consent form and participated in the study. They filled out an online survey consisting of questions about essential characteristics, a work-life balance test, stress, burnout, work-life satisfaction, and work-life balance support needs. We analyzed the results by analysis of variance and cross-tabulation using IBM SPSS ver. 23.0. Differences were found in work-life balance, stress, burnout, and satisfaction with life and work by position. The requirements for support for work-life balance also varied by professional status. Professors had a higher balance between life and work than associate professors or assistant professors. The specific requirements for work-life balance support were also slightly different for each position. Overall, there was a high demand for work process simplification and efficiency for work support, flexible working hours and sabbatical years for family and leisure, and career management consulting and training support for growth. Assistant professors and associate professors had a lower level of work-life balance than professors, as well as higher levels of stress and burnout. Professors' job satisfaction was also higher than that of the other groups. Based on the results of this study, we hope that a healthy work environment can be established through work-life balance support suitable for clinical professors' positions.

• Health Policy and Management
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• v.33 no.1
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• pp.40-54
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• 2023

Background: Based on the increase in the needs for convalescent rehabilitation medical services in Korea, this study aims to calculate the needs for rehabilitation services and examine its determinants for 229 regions. Methods: Claim data from the Health Insurance Review and Assessment Service were used to estimate patients who need to receive rehabilitation services, and data from various sources were also used for analysis. The number of cases and incidence rates of hospitalization related to convalescent rehabilitation were calculated to estimate the needs for services by region, and the results were visualized via a map. Multivariate regression and fixed effects regression using panel data were performed to identify the determinants of regional variation of the incidence rate. Results: First, the incidence rate of rural areas such as Jeolla-do, Gyeongsang-do, and Chungcheong-do was higher than urban areas (metropolitan cities). Second, the population, proportion of the elder, medical aid recipients, financial independence, traffic deaths, smoking, diabetes rate, and medical infrastructure correlated significantly with the incidence rate. Third, 'rho' values which mean the fraction of variance due to individual terms in panel data regression models were 0.965 and 0.976, respectively. Conclusion: The incidence rate of hospitalizations was correlated with most independent variables in this study and there is a gap between urban and rural areas. These regional disparities are fixed in our society. An improved regional convalescent rehabilitation system is suggested to cover the entire area including rural areas with a high rate of aging.

• Korea Trade Review
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• v.42 no.6
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• pp.131-154
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• 2017

In international trade, transportation generally has the largest and direct impact on freight costs. However, it is also sensitive to external factors such as global economic conditions, global trade volume and exchange rate. Therefore, it is necessary to examine the relationship and influence of international trade in terms of external factors that affect the change of imports and exports by marine and air transportation through empirical analysis. In particular, the analysis of the impact of these external factors on marine and air transportation is an important topic when recent exchange rate changes are significant, and it is also necessary to analyze what transportation means are more sensitive to exchange rate changes. In this study, we use the Vector Error Correction Model to analyze the dynamic effects of changes in exchange rate and domestic and international economic conditions on marine and air transportation from January 2000 to March 2017. Respectively. Alos, Impulse response function and variance decomposition were examined.

• Journal of Korean Academy of Nursing
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• v.53 no.6
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• pp.652-665
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• 2023

Purpose: This study aimed to develop a nursing clinical judgment scale (NCJS) and verify its validity and reliability in assessing the clinical judgment of nurses. Methods: A preliminary instrument of the NCJS comprising 38 items was first developed from attributes and indicators derived from a literature review and an in-depth/focus interview with 12 clinical nurses. The preliminary tool was finalized after 7 experts conducted a content validity test based on a data from a preliminary survey of 30 hospital nurses in Korea. Data were collected from 443 ward, intensive care unit, emergency room nurses who voluntarily participated in the survey through offline and online for the verification of the construct validity and reliability of the scale. Results: The final scale comprised 23 items scored on a 5-point Likert scale. Six factors - integrated data analysis, evaluation and reflection on interventions, evidence on interventions, collaboration among health professionals, patient-centered nursing, and collaboration among nurse colleagues - accounted for 64.9% of the total variance. Confirmatory factor analysis supported the fit of the measurement model, comprising six factors (root mean square error of approximation = .07, standardized root mean square residual = .04, comparative fit index = .90). Cronbach's α for all the items was .92. Conclusion: The NCJS is a valid and reliable tool that fully reflects the characteristics of clinical practice, and it can be used effectively to evaluate the clinical judgment of Korean nurses. Future research should reflect the variables influencing clinical judgment and develop an action plan to improve it.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.2
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• pp.65-76
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• 2024

Purpose : This study aimed to develop and validate a reliable tool, the Korean physical therapists' work environment scale (K-PTWES), for assessing the work environment of Korean physical therapists. The study also sought to examine the validity and reliability of the instrument. Methods : This methodological study involved the development and testing of the measurement tool. The conceptual framework was established through a literature review and in-depth interviews with clinical physical therapists. A total of 40 meaningful statements emerged from this process, leading to the generation of 29 primary items. Following a content validity test, 29 items were selected for the preliminary tool. Data were collected from 220 physical therapists across various job roles and unit types, such as outpatient and inpatient physical therapy rooms in domestic hospitals, with more than one year of experience. The final analysis included data from all 220 physical therapists. Results : Varimax rotated principal component analysis was employed for validities, revealing four factors: organizational support, working system, sustainable development, and relationship with coworkers, explaining a total variance of 54.97 %. The Cronbach's α coefficient for the final tool was .939, indicating high reliability. Conclusion : In this study, we developed a measurement tool reflecting the characteristics of the Korean physical therapists' work environment scale (K-PTWES). Our findings highlight the tool demonstrated both validity and reliability. Utilizing this tool is expected to contribute to understanding the work environment of Korean physical therapists and fostering a healthy work environment. Based on our findings, we recommend, firstly, conducting research on the work environment and related factors of physical therapists working in diverse settings using the K-PTWES. Secondly, future studies should focus on validating the tool's criterion-related validity, as it was not addressed in this research.