• Journal of Korean Academy of Nursing
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• v.37 no.2
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• pp.171-178
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• 2007

Purpose. To identify trends in patient satisfaction adjusted for sociodemographic factors and health status from 1989-2003. Methods. Five repeated cross-sectional surveys were used. The study sample included 290,534 household members 20 years of age and over from the five survey periods of 1989, 1992, 1995, 1999, and 2003. Satisfaction was measured using a five-point scale, ranging from "very satisfied" to "very dissatisfied." Crude satisfaction rates, representing the proportion of patients satisfied (very satisfied or satisfied), were calculated for each survey period. Satisfaction rates adjusted for age, sex, marital status, education, and self-rated health status were calculated for each of the five years. Results. Crude satisfaction rates increased from 15.4% in 1989 to 40.5% in 2003. The proportions of satisfaction and dissatisfaction were reversed after 15 years had passed. However, the satisfaction trend was not linear throughout the different years, with 1992 being the year with the lowest satisfaction rate (9.7%). These trends in crude rates did not change even after adjusting for patient characteristics. The odds of satisfaction in 1992 were 38% lower (odds ratio 0.62, 95% CI 0.60 to 0.64) than the odds in 1989. In 2003, the odds of satisfaction were 4.01 times (95% CI 3.89 to 4.13) the odds for 1989. Older, female, married, and less-educated people were more likely to be satisfied. Patients who rated their health as 'very good' had the highest satisfaction rate, and those with "neutral" health ratings had the lowest. General hospitals achieved substantial improvement whereas pharmacies became the lowest-rated of all institutions. Conclusions. The Korean health system has achieved better patient satisfaction rates over the past 15 years. Increased health expenditure, resources, and quality improvement efforts may have contributed to this progress.

• Phonetics and Speech Sciences
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• v.4 no.1
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• pp.99-108
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• 2012

Recent research has identified that self-reported voice problems are a risk indicator for voice disorders. However, previous studies concerning the general population did not take into account the influence of gender on self-reported voice problems. The purpose of the present cross-sectional study was to determine the gender differences in risk factors of self-reported voice problems in the Korean adult population using national survey data. This study utilized data from the Korea National Health and Nutritional Examination Survey 2008. Subjects inclued 3,622 people (1,508 male and 2,114 female) aged 19 years and older living in the community. Data were analyzed using t-test, one-way ANOVA, and multiple logistic regression. The prevalence of self-reported voice problems was 5.9% in males, and 8.1% in females Females had higher incidents of self-reported voice problems than males. Adjusting for covariates, in males, age (OR=2.47, 95% CI: 1.07-5.70), pain and discomfort during the last two weeks (OR=3.64, 95% CI: 2.20-6.01) were independently associated with self-reported voice problems (p<0.05). In women, age (OR=1.96, 95% CI: 1.18-3.26), education (OR=2.09, 95% CI: 1.06-4.12), smoking (OR=2.70, 95% CI: 1.48-4.93), thyroid disorders (OR=2.58, 95% CI: 1.47-4.53), pain and discomfort during the last two weeks (OR=1.75, 95% CI: 1.21-2.54) were independently associated with self-reported voice problem (p<0.05). Self-reported voice problems related risk factors differed according to gender. These findings suggest that there needs to be different program strategies that reflect gender differences in self-reported voice problems.

• Journal of Preventive Medicine and Public Health
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• v.50 no.3
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• pp.177-187
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• 2017

Objectives: Medical students represent a primary target for tobacco cessation training. This study assessed the prevalence of medical students' tobacco use, attitudes, clinical skills, and tobacco-related curricula in two countries, the US and Italy, with known baseline disparities in hopes of identifying potential corrective interventions. Methods: From September to December 2013, medical students enrolled at the University of Bologna and at Brown University were recruited via email to answer survey questions assessing the prevalence of medical students' tobacco use, attitudes and clinical skills related to patients' smoking, and elements of medical school curricula related to tobacco use. Results: Of the 449 medical students enrolled at Brown and the 1426 enrolled at Bologna, 174 Brown students (38.7%) and 527 Bologna students (36.9%) participated in this study. Italian students were more likely to smoke (29.5% vs. 6.1%; p<0.001) and less likely to receive smoking cessation training (9.4% vs. 80.3%; p<0.001) than their American counterparts, even though the majority of students in both countries desired smoking cessation training (98.6% at Brown, 85.4% at Bologna; p<0.001). Additionally, negative beliefs regarding tobacco usage, the absence of formal training in smoking cessation counseling, and a negative interest in receiving specific training on smoking cessation were associated with a higher risk of not investigating a patient's smoking status during a routine history and not offering tobacco cessation treatment to patients. Conclusions: Medical curricula on tobacco-related health hazards and on smoking cessation should be mandatory in order to reduce smoking among medical students, physicians, and patients, thereby improving tobacco-related global health.

• Health Policy and Management
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• v.8 no.1
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• pp.52-96
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• 1998

To find causal factors and improvement plans of organizational commitment of public servants in urban health centers, a hypothetical causal model, which included 2 endogenous variables(organizational commitment & organizational satisfaction) and 15 exogenous variables, was constructed. Exogenous variables consisted of individual factors (sex, age, education, job-grade, and annual salary), psychological variables(pride for organization, extrinsic motivation, intrinsic motivation and support of supervisor) ad structural variables(formalization, centralization, communication, job-conflict, job-decision, and workload). In the hypothetical causal model, organizational commitment was supposed to be effect variable, and organizational satisfaction was presumed to be intervening variable to mediate between organizational commitment and exogenous variables. For data collection, cross-sectional self-administered questionnaire survey was conducted to 1,295 public servants from 32 urban health centers nationwide. The survey responses were from 934, 72.1% of subjects. But 756 responses(58.4%) were analyzed because of excluding ones with missing values. The hypothetical causal model was fitted by covariance structural analysis with maximum likelihood method. Main results were as follows: (1) The fitted causal model accounted for 33 and 55 percent of total variance of organizational commitment and organizational satisfaction of public servants, respectively. (2) In order of effect size, pride for organization, supervisor support, communication, extrinsic motivation and centralization had an indirect effect effect on organizational commitment through organizational satisfaction. However, the effect of centralization was negative. (3) Pride for organiztion, intrinsic motivation, organizational satisfaction, job-conflict, supervisor support, communication, age, centralization, annual salar and extrinsic motivation had indirect or direct effects on organizational commitment in order of effect size. Among them, effects of job-conflict and centraldization were negative. In conclusion, these results suggested that organizational commitment of public servants in urban health centers could be enhanced by pride for organization, intrinsic and extrinsic motivations, prevention of job-conflict and excess centralization, supervisor support and active communication. Especially, pride for organization and intrinsic motivation were expected to play the most important role.

• Journal of muscle and joint health
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• v.21 no.3
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• pp.195-205
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• 2014

Purpose: This study was conducted to identify factors that influence health-related quality of life in older adults with osteoarthritis. Methods: This study used a cross-sectional design with secondary analysis of the Korean National Health and Nutrition Examination Survey 2011. A total of 362 participants aged 65 years and older who had osteoarthritis were selected. Health-related quality of life using EQ-5D, perceived health status, body mass index, numbers of chronic illness, smoking and alcohol use, exercise, activity limitation, joint pain and stiffness, depression, and perceived stress were measured. Descriptive statistics, $x^2$-test, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression were conducted with SPSS/WIN 21.0. Results: The mean score of EQ-5D was 0.77 in older adults with osteoarthritis. The results of multiple regression analysis showed that age, income, subjective health status, restriction of activity, knee joint stiffness, depressive mood, and perceived stress significantly predicted health-related quality of life in older adults with osteoarthritis, explaining 42% of the variance. Conclusion: Older adults with osteoarthritis have low health-related quality of life. In oder to improve health-related quality of life in older adults with osteoarthritis, it is important not only to enhance physical function but also to provide emotional support.

• Korean Journal of Community Nutrition
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• v.16 no.3
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• pp.364-374
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• 2011

There is a great public concern that higher consumption of eggs may increase the risk of chronic disease due to high levels of cholesterol in eggs. In contrast to this concern, limited studies have examined this relationship, and the study results have been inconsistent. This study was to evaluate the cross-sectional associations between egg consumption, blood markers and metabolic syndrome in Korean adults. We analyzed data from the combined 2007-2008 Korean National Health and Nutrition Examination Survey (KNHANES). Egg intakes were assessed using a food frequency questionnaire. Metabolic syndrome was ascertained using criteria of the NCEP ATP III (2001) and abdominal obesity criteria of the WHO. In 5,548 subjects, 937 subjects were defined as having metabolic syndrome. In linear regression models, subjects reporting one or more egg consumption per day had significantly lower levels of triglyceride, fasting blood glucose and blood pressure, and a higher level of HDL cholesterol, compared to those who rarely consumed eggs (P-trends < 0.05). After adjustments for potential confounding factors, the associations were no longer significant except for total cholesterol, showing higher levels with frequent egg consumption. More frequent intakes of egg (1 egg or more/day) were associated with lower risk of metabolic syndrome in a logistic regression model (OR: 0.69, 95% CI: 0.50-0.96), but this association also became insignificant after adjustments for multiple confounding factors (OR: 1.05, 95% CI: 0.71-1.57). In healthy Korean adults, frequent intakes of eggs did not adversely affect the risk of metabolic syndrome. Further studies are needed to confirm this finding.

• Korean Journal of Community Nutrition
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• v.25 no.5
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• pp.396-405
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• 2020

Objectives: This study was conducted to compare the nutrient intake of normal healthy adults with those having hypercholesterolemia. Methods: We analyzed data from the 6th Korea National Health and Nutrition Examination Survey (KNHANES VI). A total of 12,636 adults (5,223 males and 7,413 females) aged 19 or older were included in the study. Results: Males with hypercholesterolemia were older and had a higher waist circumference, body mass index, fasting blood sugar levels (FBS) and serum triglyceride (TG) concentrations compared to the normal group. Females with hypercholesterolemia were older and had higher FBS levels and serum TG concentrations compared to the normal group. While comparing nutrient intake by the 24-hour recall method, the male normal group showed a higher intake of fat, saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), vitamin A and thiamin compared to the hypercholesterolemic group. However, the male normal group had a lower intake of iron and vitamin C compared to the hypercholesterolemic group. The female normal group had a higher intake of energy, protein, fat, SFA, MUFA, polyunsaturated fatty acids, cholesterol, riboflavin, and niacin compared to the hypercholesterolemic group, but had a lower intake of iron compared to the hypercholesterolemic group. A comparison of nutrient intake by food frequency questionnaire (FFQ) showed the following: There was no significant difference in nutrient intake between the normal men and women and those with hypercholesterolemia. After adjustment for confounding factors, nutrient intake by FFQ of the male normal group showed higher levels of n-3 fatty acid and vitamin C compared to the group with hypercholesterolemia. However, there was no significant difference in nutrient intake between the two groups of women. Conclusions: The average intake of n-3 fatty acids and vitamin C of the male group with hypercholesterolemia was lower than that of the normal group. However, since KNHANES is a cross-sectional study, prospective cohort studies are required to analyze the risk factors of hypercholesterolemia.

• Child Health Nursing Research
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• v.21 no.3
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• pp.253-260
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• 2015

Purpose: Child Health nurse practitioners (CHNPs) in Korea have important roles in disease management and health promotion for children and adolescents. Yet, practices of CHNPs licensed and employed in hospitals have not been adequately identified. Thus, in this study the scope of practice by CHNPs and job satisfaction and stress were investigated and compared according to the CHNPs' position in the working place. Methods: A descriptive cross-sectional survey design was used. All 53 licensed CHNPs participated in the mail survey which included a 71-item questionnaire on job performance and job satisfaction and a job contents questionnaire. Descriptive statistics, ${\chi}^2$ test, independent t-test and Mann-Whitney U test were used to compare CHNPs employed as nurse practitioner (NP) and CHNPs employed as staff nurses. Results: Compared to CHNPs employed as staff nurses, CHNPs employed as NPs more frequently provided education, environment management, coordination and research in their practice areas. No significant difference was found in job satisfaction between the two groups except for the administration and income subdomains. Only the physical exertion subdomain in job stress was stressful to CHNP employed as staff nurse. Conclusions: Job performance of CHNPs in Korea needs to be revised to include more practical practice in education, coordination, and research related areas.

• Safety and Health at Work
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• v.11 no.2
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• pp.159-164
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• 2020

Background: This study aimed to examine the association between educational level and unable to work due to ill-health (UWdIH) among 30- to 79-year-old South Koreans. Methods: A cross-sectional nationwide survey of the 2010-2016 Korea National Health and Nutritional Evaluation Survey was used for analyses. A total of 29,930 participants aged ≥30 and < 80 years, who do not have any disability in their daily life because of health problems, were included. Educational level and reason for nonworking are self-reported with multiple choices. Multivariate logistic regression was used to examine an association between education level and UWdIH by setting those who graduated college as their final education (n = 6,997) as a baseline while controlling for potential confounding factors. Results: In the age-stratified result, the ratio of UWdIH was increased as age increases in 3 educational groups (p < .0001). There was a tendency that low-level educated [International Standard Classification of Education (0-2)] participants showed higher ratio of UWdIH than high-level educated [International Standard Classification of Education (5≤)] participants in both sexes (odds ratio: 2.54, 95% confidence interval: 2.12-3.05). Conclusion: There is a clear link between educational level and UWdIH; the less the educated, the more likely to be UWdIH. Policy priority should be given to plans that can help this vulnerable social group to work and enjoy healthy lives.

• Journal of Digital Convergence
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• v.14 no.11
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• pp.27-35
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• 2016

The study was conducted to identify related risk factor of elderly's suicidal ideation. This study used a cross-sectional design with secondary analysis of the $6^{th}$ 2013 Korea National Health and Nutrition Examination Survey (KNHANES). Data for 1,201 elderlies who aged over 65 years old from the KNHANES were included. Suicidal ideation, general characteristics, physical health, psychological health, EuroQoL, and health behavior were measured. Chi-square test, t-test, and multiple logistic regression were used to analyze this data through the SPSS win 22.0 program. In the results, 7.7% of the elderly had suicidal ideation. The odds ratios of suicidal ideation were significantly higher among those with restriction of activity (OR=1.31, CI=1.40~3.82), those with depression (OR=4.44, CI=1.66~7.40), and those with high levels of stress (OR=9.24, CI=3.48~24.5). Therefore, the activity level, depression level, and stress level need to be regularly assessed in order to prevent suicidal ideation among the elderly.