• Journal of Korean Neurosurgical Society
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• v.66 no.2
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• pp.190-198
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• 2023

Objective : Low back pain (LBP) is a global health problem that affects the productivity of the patients. Several factors such as individual, occupational, and psychosocial factors increase the risk of LBP. However, only a few studies investigated those factors, especially in middle adulthood in Indonesia. Indonesia is a country with a young population that has been rapidly developing in recent years. This study was conducted to find out the factors associated with LBP in middle adulthood. Methods : This study is a cross-sectional observational analytic study using a convenience sampling method with a total sample of 3005 respondents. Data were collected using a questionnaire which was then analyzed using the chi-square test, Kolmogorov-smirnov, Spearman's Rank, and logistic regression test. Results : From the result of this study, it was found that the 12-month prevalence of LBP in middle-aged adults was 44,29%. Female (odds ratio [OR], 1.3; 95% confidence interval [Cl], 1.098-1.545; p=0.002), lack of physical exercises (OR, 0.87; 95% Cl, 0.794-0.959; p=0.005), high body mass index (OR, 1.09; 95% Cl, 1.009-1.187; p=0.002), stress level (OR, 1.26; 95% Cl, 1.088-1.458; p=0.002), and years of work experience (OR, 1.1; 95% Cl, 1.001-1.225; p=0.047) were determined as risk factors that significantly associated with LBP. Conclusion : LBP is quite common among middle-aged adults in Indonesia. Female gender, higher body mass index, lack of physical activity, stress level, and years of work experience were all potential risk factors for LBP in middle-aged adults. Middle-aged adults in Indonesia should be aware of LBP and avoid disabilities by identifying risk factors that may worsen LBP in the future.

• Restorative Dentistry and Endodontics
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• v.46 no.2
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• pp.29.1-29.11
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• 2021

Objectives: This study was conducted to compare the post-fracture survival rate of endodontically treated molar endodontically treated teeth (molar ETT) restored with resin composites or crowns and to identify potential risk factors, using a retrospective cohort design. Materials and Methods: Dental records of molar ETT with crowns or composite restorations (recall period, 2015-2019) were collected based on inclusion and exclusion criteria. The incidence of unrestorable fractures was identified, and molar ETT were classified according to survival. Information on potential risk factors was collected. Survival rates and potential risk factors were analyzed using the Kaplan-Meier log-rank test and Cox regression model. Results: The overall survival rate of molar ETT was 87% (mean recall period, 31.73 ± 17.56 months). The survival rates of molar ETT restored with composites and crowns were 81.6% and 92.7%, reflecting a significant difference (p < 0.05). However, ETT restored with composites showed a 100% survival rate if only 1 surface was lost, which was comparable to the survival rate of ETT with crowns. The survival rates of ETT with composites and crowns were significantly different (97.6% vs. 83.7%) in the short-term (12-24 months), but not in the long-term (> 24 months) (87.8% vs. 79.5%). Conclusions: The survival rate from fracture was higher for molar ETT restored with crowns was higher than for ETT restored with composites, especially in the first 2 years after restoration. Molar ETT with limited tooth structure loss only on the occlusal surface could be successfully restored with composite restorations.

• Journal of East-West Nursing Research
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• v.29 no.2
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• pp.106-116
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• 2023

Purpose: The purpose of this study was to identify the impact of obesity on the incidence of diabetes mellitus in adults with pre-diabetes. Methods: This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study. This study used data from a sample of 3,693 adults with prediabetes who were followed every two years from 2001 to 2018. Statistical data analysis for frequency, number of cases per 1,000 person-years, log-rank test, Kaplan-Meier curve, and Cox's proportional hazards regression analysis was performed using IBM SPSS statistics version 26. Results: During the observation period, there were 1,309 (35.4%) patients with diabetes, and the total number of person-years was 35,342. The incidence of diabetes was higher in the obese group compared to the normal weight group (body mass index [BMI]: hazard ratio=1.57, 95% confidence interval [CI]=1.40~1.77, waist: hazard ratio=1.55, 95% CI=1.38~1.76, waist to hip ratio [WHR]: hazard ratio=1.53, 95% CI=1.24~1.89, body fat [BF] (%): hazard ratio=1.42, 95% CI=1.27~1.61). Conclusion: An increase in BMI, waist circumference, and WHR, which are indicators of obesity, can exacerbate the risk factors for diabetes. Thus, a decrease in BMI, waist circumference, and WHR is necessary to prevent pre-diabetes. In particular, health care professionals should provide individualized weight management program interventions, including adult obesity programs and obesity counseling in partnership with local health departments, to reduce BMI and waist circumference in people at high risk for diabetes.

• The Journal of Korean Academic Society of Nursing Education
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• v.30 no.1
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• pp.49-60
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• 2024

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has had significant physical and psychological impacts on registered nurses (RNs). This study aimed to identify long COVID symptoms and their associated factors specifically among RNs. Methods: This descriptive correlational study's sample comprised 189 nurses (31.57±5.98 years, 93.7% female) in Korea. Self-reported long COVID symptoms were assessed using the COVID-19 Yorkshire Rehabilitation Scale. Data were collected from December 31, 2022, to January 13, 2023, using the online survey method and were analyzed using independent t-test, Wilcoxon signed-rank test, one-way ANOVA, Pearson's correlation, and a multiple linear regression analysis with the IBM SPSS Statistics 26.0 program. Results: A total of 179 participants (94.7%) experienced one or more long COVID symptoms. The most prevalent symptoms were weakness (77.8%), fatigue (68.3%), breathlessness (67.7%), cough/throat sensitivity/voice change (50.3%), and sleep problems (50.3%). The factors related to long COVID symptoms were marital status, type of institution, working time, acute COVID-19 symptoms, and vaccination status. The quarantine period (β=.26, p<.001) and the nursing workforce after COVID-19 (β=-.17, p=.018) were significantly associated with long COVID symptoms (Adjusted R² =.33). Conclusion: Providing comprehensive recognition is necessary for the understanding of long COVID symptoms and their associated factors among nurses and could promote a long COVID symptom management education program targeted at nurses. Moreover, it could facilitate effective nursing care and education plans for long COVID patients.

• Journal of Korean Academy of Nursing
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• v.54 no.1
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• pp.18-31
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• 2024

Purpose: This study aimed to investigate the impact of anthropometric indices of obesity (body mass index [BMI], waist circumference, waist hip ratio, and body fat percentage) on the incidence of hypertension in adults with prehypertension. Methods: A longitudinal study design using secondary data form the Korean Genome and Epidemiology Study was employed. The study included 1,838 adults with prehypertension tracked every two years from 2001 to 2018. Statistical analyses, including frequency assessments, number of cases per 1,000 person-years, log-rank tests, Kaplan-Meier curves, and Cox's proportional hazards regression, were conducted using SPSS version 25. Results: Over the observation period (15,783.6 person-years), 1,136 individuals developed hypertension. The incidence of hypertension was significantly higher in the obesity groups defined by BMI (hazard ratio [HR] = 1.33), waist circumference (HR = 1.34), waist hip ratio (HR = 1.29), and body fat percentage (HR = 1.31) compared to the non-obese group. These findings indicate an increased risk of hypertension associated with obesity as measured by these indices. Conclusion: The study underscores the importance of avoiding obesity to prevent hypertension in individuals with prehypertension. Specifically, BMI, waist circumference, waist hip circumference, and body fat percentage were identified as significant risk factors for hypertension. The results suggest the need for individualized weight control interventions, emphasizing the role of health professionals in addressing the heightened hypertension risk in this population.

• Korean Journal of Radiology
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• v.21 no.5
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• pp.561-571
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• 2020

Objective: To evaluate the clinical utility of ultrafast dynamic contrast-enhanced (DCE)-MRI compared to conventional DCE-MRI by studying lesion conspicuity and size according to the level of background parenchymal enhancement (BPE). Materials and Methods: This study included 360 women (median age, 54 years; range, 26-82 years) with 361 who had undergone breast MRI, including both ultrafast and conventional DCE-MRI before surgery, between January and December 2017. Conspicuity was evaluated using a five-point score. Size was measured as the single maximal diameter. The Wilcoxon signed-rank test was used to compare median conspicuity score. To identify factors associated with conspicuity, multivariable logistic regression was performed. Absolute agreement between size at MRI and histopathologic examination was assessed using the intraclass correlation coefficient (ICC). Results: The median conspicuity scores were 5 at both scans, but the interquartile ranges were significantly different (5-5 at ultrafast vs. 4-5 at conventional, p < 0.001). Premenopausal status (odds ratio [OR] = 2.2, p = 0.048), non-mass enhancement (OR = 4.1, p = 0.001), moderate to marked BPE (OR = 7.5, p < 0.001), and shorter time to enhancement (OR = 0.9, p = 0.043) were independently associated with better conspicuity at ultrafast scans. Tumor size agreement between MRI and histopathologic examination was similar for both scans (ICC = 0.66 for ultrafast vs. 0.63 for conventional). Conclusion: Ultrafast DCE-MRI could improve lesion conspicuity compared to conventional DCE-MRI, especially in women with premenopausal status, non-mass enhancement, moderate to marked BPE or short time to enhancement.

• Korean Journal of Radiology
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• v.23 no.10
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• pp.998-1008
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• 2022

Objective: The present study aimed to assess the relationship between incidental abnormalities on thoracic computed tomography (CT) and mortality in a general screening population using a long-term follow-up analysis. Materials and Methods: We retrospectively collected the medical records and CT images of 840 participants (mean age ± standard deviation [SD], 58.5 ± 6.7 years; 564 male) who underwent thoracic CT at a single health promotion center between 2007 and 2010. Two thoracic radiologists independently reviewed all CT images and evaluated any incidental abnormalities (interstitial lung abnormality [ILA], emphysema, coronary artery calcification [CAC], aortic valve [AV] calcification, and pulmonary nodules). Kaplan-Meier analysis with log-rank and z-tests was performed to assess the relationship between incidental CT abnormalities and all-cause mortality in the subsequent follow-up. Cox proportional hazards regression was performed to further identify risk factors of all-cause mortality among the incidental CT abnormalities and clinical factors. Results: Among the 840 participants, 55 (6%), 171 (20%), 288 (34%), 396 (47%), and 97 (11%) had findings of ILA, emphysema, CAC, pulmonary nodule, and AV calcification, respectively, on initial CT. The participants were followed up for a mean period ± SD of 10.9 ± 1.4 years. All incidental CT abnormalities were associated with all-cause mortality in univariable analysis (p < 0.05). However, multivariable analysis further revealed fibrotic ILA as an independent risk factor for all-cause mortality (hazard ratio, 2.52 [95% confidence interval, 1.02-6.22], p = 0.046). ILA were also identified as an independent risk factor for lung cancer or respiratory disease-related deaths. Conclusion: Incidental abnormalities on screening thoracic CT were associated with increased mortality during the long-term follow-up. Among incidental CT abnormalities, fibrotic ILA were independently associated with increased mortality. Appropriate management and surveillance may be required for patients with fibrotic ILA on thoracic CT obtained for general screening purposes.

• Journal of Hospice and Palliative Care
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• v.27 no.1
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• pp.11-20
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• 2024

Purpose: Advance directives (ADs) are legal documents that outline a person's preferences or decisions regarding end-of-life care ahead of time. In Korea, there is insufficient awareness and knowledge about ADs among patients undergoing hemodialysis. This study explored the relationship between perceptions of a good death, knowledge about ADs, and attitudes toward ADs in this patient population. Methods: This cross-sectional survey enrolled 119 hemodialysis patients from a secondary hospital in 2021. The participants completed a self-administered questionnaire, and the data were analyzed using the t-test, analysis of variance, Pearson correlation coefficients, Spearman rank correlation coefficients, and multiple regression analysis. Results: The average score for perceptions of a good death among hemodialysis patients was 2.80 out of 4, with clinical symptoms identified as the most critical factor. The average scores for knowledge about ADs and attitudes toward ADs were 5.69 out of 9 and 2.79 out of 4, respectively. There was a positive correlation between perceptions of a good death and attitudes toward ADs (r=0.34, P<0.001), as well as between knowledge about Ads and attitudes toward ADs (r=0.19, P=0.037). Factors influencing attitudes toward Ads included employment status (β=0.22, P=0.011), education level (β=0.22, P=0.013), and perceptions of a good death (β=0.29, P=0.001), which accounted for 24.8% of the variance in attitudes toward ADs. Conclusion: A positive perception of a good death among patients undergoing hemodialysis was associated with a positive attitude toward ADs. Educational programs are needed to improve individuals' understanding of a good death and encourage the development of end-of-life care plans.

• Journal of Hospice and Palliative Care
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• v.14 no.4
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• pp.212-217
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• 2011

Purpose: Since 2005, the Ministry of Health & Welfare has provided financial support to promote palliative care for terminal cancer patients. We analyzed how palliative care facilities used the funding between 2006 and 2010. Methods: Frequency analysis was conducted by the item of expenditure based on fiscal reports of the palliative care facilities. Linear regression analysis was performed to examine a trend over time. Kruskal-Wallis test and Wilcoxon rank-sum test were used to compare expenditure items, the number of provision of financial support and type of palliative care units. Results: About a half of the fund was spent to pay care givers salary, improve facilities and purchase equipment regardless of the year, the number of financial support provided or facility type. By year, the operation cost for palliative care program and the education cost for health care workers have significantly increased in linear regression analysis (P<0.01). However, the amount of financial support for the low income group has decreased over years (P=0.024). This trend was affected by evaluation criteria and weight. Conclusion: The government aid for palliative care units has been used to improve facilities and equipment. Moreover, desirable changes were noted such as a higher portion of expenses for program operation and care giver training to enhance the quality of care. However, the evaluation criteria need to be adjusted to prevent any further decrease in the support provided to the low income group.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.2055-2060
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• 2015

Purpose: To present information about prognostic factors of gastric cancer patients treated in our Erzurum center including age, gender, tumour location, pathological grade, stage and the effect of treatment on survival. Materials and Methods: This retrospective study was performed on patients who applied to our clinic and diagnosed as gastric cancer. Age and gender of the patients, primary location, histopathological characteristics, TNM stage of the gastric cancers (GCs), treatment applied, oncological treatment modalities and survival outcomes were studied. A univariate analysis of potential prognostic factors was performed with the log-rank test for categorical factors and parameters with a p value < 0.05 at the univariate step were included in the multivariate regression. Results: A total of 228 patients with a confirmed diagnosis of gastric cancer were included in the study with a male/female ratio of 1.47. Median follow-up period was estimated as 22.3 (range, 3 to 96) months. When diagnosis of the patients at admission was analysed, stage III patients were most frequently encountered (n=147; 64.5%). One hundred and twenty-six (55.3%) underwent surgical treatment, while 117 (51.3%) were given adjuvant chemotherapy. Median overall survival time was 18.0 (${\pm}1.19$) months. Mean overall survival rates for 1, 2, 3 and 5 years were $68{\pm}0.031%$, $36{\pm}0.033%$, $24{\pm}0.031%$and $15.5{\pm}0.036%$, respectively. Univariate variables found to be significant for median OS in the multivariate analysis were evaluated with Cox regression analysis. A significant difference was found among TNM stage groups, location of the tumour and postoperative adjuvant treatment receivers (p values were 0.011, 0.025 and 0.001, respectively). Conclusions: This study revealed that it is possible to achieve long-term survival of gastric cancer with early diagnosis. Besides, in locally advanced GC patients, curative resection followed by adjuvant concomitant chemoradiotherapy based on the McDonald regimen was an independent prognostic factor for survival.