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Background and Objectives@#It is well recognized that early detection and intervention are most important for the prevention of neonatal hearing loss. The national support policy in Korea for newborn hearing screening has been changed since October 2018; however, parent awareness of the change still needs to be increased. This study investigated how well parents, who have underwent national infant checkups of their children, were aware of the Korean national policy for neonatal and infant hearing loss in parents.Subjects and Method A survey of neonatal hearing tests and national support policies conducted for 353 parents was analyzed. The survey included questions about parent awareness of the neonatal hearing screening test period, confirmatory test period, national support for these expenses, and hearing aid support. Also evaluated were the necessity of national guidance and management system for neonatal hearing. @*Results@#The test time of neonatal hearing screening was correctly recognized by 82.2% of the parents. The percentage increased after the national insurance coverage started in October 2018 in Korea, and the rate was higher for parents who visited an otolaryngology clinic rather than a pediatric clinic. The test time of the confirmatory test was correctly recognized only by 20.4%. National support policy for neonatal hearing screening tests, confirmatory hearing tests, and hearing aids were acknowledged by 50.7%, 43.1%, and 56.1% of the parents, respectively. @*Conclusion@#These results indicate the necessity of efforts to increase the awareness of neonatal hearing tests and relevant support policies in Korea to ultimately achieve early hearing detection and intervention of neonates and infants in Korea.
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Purpose@#This study aims to determine the effectiveness of high physical activity (PA) on shoulder pain, functional recovery, and structural outcome in the early healing phase after arthroscopic rotator cuff repair (ARCR). @*Methods@#Forty-two patients were included in this study according to inclusion criteria. Subjects were classified into high PA (HPA) group (n=22) and low PA (LPA) group (n=20) according to the classification criteria. Differences between groups according to the PA level were analyzed by comparing visual analogue scale (VAS), range of motion (ROM), American Shoulder and Elbow Surgeons Shoulder Score (ASES), and isokinetic strength before and 6 weeks, 3, and 6 months after surgery. Structural outcome was analyzed by evaluating magnetic resonance imaging performed 6 months after ARCR. @*Results@#VAS, ROM, and ASES were significantly higher in the HPA group at 6 weeks and 3 months after ARCR with a significant interaction effect between time and group (p＜ 0.05). The isokinetic muscle strength was significantly higher in the HPA group at 3 months after surgery with a significant interaction effect on forward flexion and external rotation strength (p＜ 0.05). There was no significant difference in extension and internal rotation strength. In the structural outcome of 6 months after surgery, the retear rate was lower in the HPA group with a significant trend (p＜ 0.05). @*Conclusion@#In this study, higher PA levels in the early healing phase after ARCR were found to result in faster pain relief and restoration of shoulder function. In addition, higher PA level was associated with lower retear rates in structural outcomes related to tendon healing.
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Objective@#Incontrovertible disease markers are absent in delirium. This study investigated the usefulness of quantitative electroencephalography (qEEG) in diagnosing delirium. @*Methods@#This retrospective case-control study reviewed medical records and qEEG data of 69 age/sex-matched patients (delirium group, n=30; control group, n=39). The first minute of artifact-free EEG data with eyes closed was selected. Nineteen electrodes’ sensitivity, specificity, and correlation with delirium rating scale-revised-98 were analyzed. @*Results@#On comparing the means of absolute power by frontal, central, and posterior regions, the delta and theta powers showed significant differences (p<0.001) in all regions, and the magnitude of the absolute power was higher in the delirium group than in the control group; only the posterior region showed a significant (p<0.001) difference in beta power. The spectral power of theta at the frontal region (area under the curve [AUC]=0.84) and theta at the central and posterior regions (AUC=0.83) showed 90% sensitivity and 79% specificity, respectively, in differentiating delirious patients and controls. The beta power of the central region showed a significant negative correlation with delirium severity (R=-0.457, p=0.011). @*Conclusion@#Power spectrum analysis of qEEG showed high accuracy in screening delirium among patients. The study suggests qEEG as a potential aid in diagnosing delirium.
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Background@#Both medicolegal disputes and the incidence of cutaneous drug eruptions are increasing in Korea. We were unable to find research that surveyed the legal disputes involving drug eruption cases. @*Objective@#This study investigates medical litigation associated with drug eruption cases in Korea. @*Methods@#Judicial precedents on drug eruption cases were searched using the Supreme Court of South Korea’s Written Judgement Management System. General characteristics, results, suspected agents, and recognized negligence were analyzed. @*Results@#From the search results, 50 cases were selected. Of these, 34 cases had severe cutaneous adverse reactions, including Stevens-Johnson syndrome/toxic epidermal necrolysis (n=25, 50.0%), and drug rash with eosinophilia and systemic symptoms syndrome (n=9, 18.0%). Antimicrobial agents (n=17, 34.0%), non-steroidal anti-inflammatory drugs (n=6, 12.0%), and anticonvulsants (n=6, 12.0%) were the most common drugs implicated. Death was reported in 15 patients (30.0%). In this sample, 22 cases (47.0%) were awarded to the plaintiff, and violation of the duty to inform patients of risks was the most common legal issue cited. @*Conclusion@#Clinicians should be aware of and advise patients of the potential for severe adverse reactions that can lead to negative outcomes and medicolegal disputes.
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Objective@#Severe acute cholecystitis is an infectious disease that requires immediate gallbladder drainage. Although percutaneous transhepatic gallbladder drainage (PTGBD) is the most common method of gallbladder drainage, the optimal timing remains unclear. @*Methods@#This study is a retrospective analysis of patients diagnosed with severe acute cholecystitis who underwent PTGBD between July 2018 to June 2021. This study investigated the effect of time from emergency department arrival to PTGBD (tPTGBD) on patient prognosis. @*Results@#Totally, 48 patients were included in this study. Based on the cutoff value calculated using the Youden index, the group with tPTGBD of <5.93 hours had a shorter hospital stay (10 vs. 13.5 days, P=0.021), lower portion of progression (27:5 [15.6%] vs. 7:9 [56.3%], P=0.004), even they had a higher initial SOFA score (6 vs. 4.6, P=0.049). However, no statistical difference was obtained for the length of ICU stay between both groups (1 vs. 2, P=0.617). @*Conclusion@#Executing PTGBD to severe acute cholecystitis patients within 5.93 hours after presenting at the emergency department is associated with reduced progression and hospital stay.
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Quantitative and qualitative research explore various social phenomena using different methods. However, there has been a tendency to treat quantitative studies using complicated statistical techniques as more scientific and superior, whereas relatively few qualitative studies have been conducted in the medical and healthcare fields. This review aimed to provide a proper understanding of qualitative research. This review examined the characteristics of quantitative and qualitative research to help researchers select the appropriate qualitative research methodology. Qualitative research is applicable in following cases: (1) when an exploratory approach is required on a topic that is not well known, (2) when something cannot be explained fully with quantitative research, (3) when it is necessary to newly present a specific view on a research topic that is difficult to explain with existing views, (4) when it is inappropriate to present the rationale or theoretical proposition for designing hypotheses, as in quantitative research, and (5) when conducting research that requires detailed descriptive writing with literary expressions. Qualitative research is conducted in the following order: (1) selection of a research topic and question, (2) selection of a theoretical framework and methods, (3) literature analysis, (4) selection of the research participants and data collection methods, (5) data analysis and description of findings, and (6) research validation. This review can contribute to the more active use of qualitative research in healthcare, and the findings are expected to instill a proper understanding of qualitative research in researchers who review qualitative research reports and papers.
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Purpose@#The purpose of this study was to understand smartphone use guidance experiences of parents elementary school students. @*Methods@#Qualitative data were collected from 10 parents of elementary school students through individual in-depth interview from January 2022 to February 2022. Collected data were analyzed using the Colaizzi’s phenomenological method. @*Results@#The following four categories were derived from in-depth interviews: ‘Ambivalence on children's smartphone use’, ‘Limitations of guidance competence’, ‘Strategy for guidance’, and ‘New insights and challenges’. @*Conclusion@#This study confirmed that parents of elementary school students were experiencing insight and growth in the process of constantly thinking, trying new strategies, and struggling while guiding their children’s smartphone use. Parental education on elementary school students' smartphone use guidance should include comprehensive contents that could check awareness and principles of useful smartphone use and enable effective guidance tailored to the child's developmental characteristics.
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Purpose@#This descriptive study aimed to identify the effects of purposeful and timely nursing rounds on patients' perception of the quality of nursing services and nurses' perception of nursing rounds. @*Methods@#Intentional nursing rounds were conducted by communicating patients’ questions on pain, position, pump, potty, and possessions. A total of 144 nurses and 149 patients participated, and data were collected using self-report questionnaires. The independent t-test, x 2 test, and Wilcoxon’s rank-sum test were used to analyze the data with SPSS version 24.0. @*Results@#Although intentional nursing rounds improved the nurses’ perception of nursing rounds, there was no significant difference. The nurses’ benefit had the lowest score (3.36), and the benefit of communication with patients had the highest score (3.79).Intentional nursing rounds significantly improved the patients’ perception of the quality of nursing services in the intervention group. Among the factors of empathy (Z=4.98, p<.001) related to the quality of nursing services as perceived by the patient, assurance (Z=5.50, p<.001), reliability (Z=4.43, p<.001), and responsiveness (Z=5.02, p<.001) significantly increased. @*Conclusion@#Intentional nursing rounds positively affected patients’ perception of the quality of nursing service. It is important to improve intentional nursing rounds to enhance nurses’ perceptions of them.
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Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for managing advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of the limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: adenoma ≥10 mm in size; 3 to 5 (or more) adenomas; tubulovillous or villous adenoma; adenoma containing high-grade dysplasia; traditional serrated adenoma; sessile serrated lesion containing any grade of dysplasia; serrated polyp of at least 10 mm in size; and 3 to 5 (or more) sessile serrated lesions. More studies are needed to fully comprehend the patients who are most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.
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Background and Objectives@#Spermatogonial stem cells (SSCs) are the most primitive cells in spermatogenesis and are the only adult stem cells capable of passing on the genome of a given species to the next generation. SSCs are the only adult stem cells known to exhibit high Oct4 expression and can be induced to self-reprogram into pluripotent cells depending on culture conditions. Epigenetic modulation is well known to be involved in the induction of pluripotency of somatic cells. However, epigenetic modulation in self-reprogramming of SSCs into pluripotent cells has not been studied. @*Methods@#and Results: In this study, we examined the involvement of epigenetic modulation by assessing whether selfreprogramming of SSCs is enhanced by treatment with epigenetic modulators. We found that second-generation selective class I HDAC inhibitors increased SSC reprogramming efficiency, whereas non-selective HDAC inhibitors had no effect. @*Conclusions@#We showed that pluripotent stem cells derived from adult SSCs by treatment with small molecules with epigenetic modulator functions exhibit pluripotency in vitro and in vivo. Our results suggest that the mechanism of SSC reprogramming by epigenetic modulator can be used for important applications in epigenetic reprogramming research.
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Objective@#To investigate the effects of long-acting injectable 3-monthly paliperidone palmitate on the clinical and social functioning of patients with schizophrenia. @*Methods@#This study enrolled patients with schizophrenia receiving long-acting injectable 1-monthly paliperidone palmitate for at least 4 months and who subsequently received 3-monthly paliperidone palmitate. Accordingly, 418 patients were followed up for 24 weeks. Their clinical symptoms and social functioning were measured using the Clinical Global Impression-Severity of Illness and Personal and Social Performance scales. @*Results@#The Personal and Social Performance total score was significantly higher after 3-monthly paliperidone palmitate treatment than at baseline (baseline vs. week 24: 54.3 ± 18.0 vs. 61.0 ± 14.5 [mean ± standard deviation]; p ＜ 0.001; Wilcoxon signed-rank test); the proportion of patients in the mildly ill group (scores 71−100) also increased significantly (baseline vs. week 24: 16.5% vs. 20.6%; p＜ 0.001; McNemar-Bowker test). The mean Clinical Global Impression-Severity of Illness score decreased significantly (baseline vs. week 24: 3.7 ± 1.0 vs. 3.4 ± 0.9; p＜ 0.001; Wilcoxon signed-rank test), as did the proportion of patients in the severely ill group (baseline vs. week 24: 4.1% vs. 2.1%; p ＜ 0.001; McNemar-Bowker test). @*Conclusion@#Continuous 3-monthly paliperidone palmitate treatment significantly enhances the personal and social performance of patients with schizophrenia and reduces the proportion of those with severe illness. These findings suggest that long-acting injectable antipsychotic administration at intervals longer than 1 month might improve the social functioning of and promote return to activities of daily living in patients with schizophrenia.
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Chronic right ventricular (RV) pacing can exacerbate heart failure in patients with a low left ventricular ejection fraction (LVEF). Left bundle branch area pacing (LBBAP) has emerged as a novel physiological pacing technique; however, information remains limited on its use among patients with a low EF. This study investigated the safety and short-term clinical outcomes of LBBAP among patients with impaired left ventricular (LV) function. This retrospective analysis of pacemakers at Chosun University Hospital, South Korea, included all patients with impaired LV function (EF＜50%) who underwent pacemaker implantation for atrioventricular blockage from 2019-2022. Clinical characteristics, 12-lead electrocardiography findings, echocardiography findings, and laboratory parameters were evaluated. Composite outcomes were defined as all-cause mortality, cardiac death, and hospitalization due to heart failure during the 6-month follow-up. Altogether 57 patients (25 men; mean age, 77.4±10.8 y; LVEF, 41.5±3.8%) were divided into LBBAP (n=16), biventricular pacing (BVP; n=16), and conventional RV pacing (RVP; n=25) groups. In the LBBAP group, the mean paced QRS duration (pQRSd) was narrower (119.5±14.7 vs. 140.2±14.3 vs. 163.2±13.9; p＜0.001) and cardiac troponin I level was elevated post-pacing (1.14±1.29 vs. 0.20±0.29 vs.0.24±0.51, p=0.001). Lead parameters were stable. One patient was hospitalized, and four died (one patient each from heart failure admission, myocardial infarction, unexplained death, and pneumonia in RVP vs. one from intracerebral hemorrhage in BVP) during the follow-up period. In conclusion, LBBAP is feasible in patients with impaired LV function without acute or significant complications and provides a remarkably narrower pQRSd with a stable pacing threshold.
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Purpose@#The treatment of male breast cancer (MBC) has been extrapolated from female breast cancer (FBC) because of its rarity despite their different clinicopathologic characteristics. We aimed to investigate the distribution of intrinsic subtypes based on immunohistochemistry, their clinical impact, and treatment pattern in clinical practice through a multicenter study in Korea. @*Materials and Methods@#We retrospectively analyzed clinical data of 248 MBC patients from 18 institutions across the country from January 1995 to July 2016. @*Results@#The median age of MBC patients was 63 years (range, 25 to 102 years). Among 148 intrinsic subtype classified patients, 61 (41.2%), 44 (29.7%), 29 (19.5%), and 14 (9.5%) were luminal A, luminal B, human epidermal growth factor receptor 2, and triple-negative breast cancer, respectively. Luminal A subtype showed trends for superior survival compared to other subtypes. Most hormone receptor-positive patients (166 patients, 82.6%) received adjuvant endocrine treatment. Five-year completion of adjuvant endocrine treatment was associated with superior disease-free survival (DFS) in patients classified with an intrinsic subtype (hazard ratio [HR], 0.15; 95% confidence interval [CI], 0.04 to 0.49; p=0.002) and in all patients (HR, 0.16; 95% CI, 0.05 to 0.54; p=0.003). @*Conclusion@#Distribution of subtypes of MBC was similar to FBC and luminal type A was most common. Overall survival tended to be improved for luminal A subtype, although there was no statistical significance. Completion of adjuvant endocrine treatment was associated with prolonged DFS in intrinsic subtype classified patients. MBC patients tended to receive less treatment. MBC patients should receive standard treatment according to guidelines as FBC patients.
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BACKGROUND/OBJECTIVES@#Probiotics have been suggested as potent modulators of agerelated disorders in immunological functions, yet little is known about sex-dependent effects of probiotic supplements. Therefore, we aimed to investigate sex-dependent effects of probiotics on profiles of the gut microbiota and peripheral immune cells in healthy older adults. @*SUBJECTS/METHODS@#In a randomized, double-blind, placebo-controlled, multicenter trial, healthy elderly individuals ≥ 65 yrs old were administered probiotic capsules (or placebo) for 12 wk. Gut microbiota was analyzed using 16S rRNA gene sequencing and bioinformatic analyses. Peripheral immune cells were profiled using flow cytometry for lymphocytes (natural killer, B, CD4 + T, and CD8 + T cells), dendritic cells, monocytes, and their subpopulations. @*RESULTS@#Compared with placebo, phylum Firmicutes was significantly reduced in the probiotic group in women, but not in men. At the genus level, sex-specific responses included reductions in the relative abundances of pro-inflammatory gut microbes, including Catabacter and unclassified_Coriobacteriales, and Burkholderia and unclassified Enterobacteriaceae, in men and women, respectively. Peripheral immune cell profiling analysis revealed that in men, probiotics significantly reduced the proportions of dendritic cells and CD14 + CD16 - monocytes; however, these effects were not observed in women. In contrast, the proportion of total CD4 + T cells was significantly reduced in women in the probiotic group. Additionally, serum lipopolysaccharide-binding protein levels showed a decreasing tendency that were positively associated with changes in gut bacteria, including Catabacter (ρ = 0.678, P < 0.05) and Burkholderia (ρ = 0.673, P < 0.05) in men and women, respectively. @*CONCLUSIONS@#These results suggest that probiotic supplementation may reduce the incidence of inflammation-related diseases by regulating the profiles of the gut microbiota and peripheral immune cells in healthy elders in a sex-specific manner.
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BACKGROUND/OBJECTIVES@#Obesity is a major risk factor for metabolic syndrome, a global public health problem. Mentha canadensis (MA), a traditional phytomedicine and dietary herb used for centuries, was the focus of this study to investigate its effects on obesity.MATERIALS/METHODS: Thirty-five male C57BL/6J mice were randomly divided into 2 groups and fed either a normal diet (ND, n = 10) or a high-fat diet (HFD, n = 25) for 4 weeks to induce obesity. After the obesity induction period, the HFD-fed mice were randomly separated into 2 groups: one group continued to be fed HFD (n = 15, HFD group), while the other group was fed HFD with 1.5% (w/w) MA ethanol extract (n = 10, MA group) for 13 weeks. @*RESULTS@#The results showed that body and white adipose tissue (WAT) weights were significantly decreased in the MA-supplemented group compared to the HFD group.Additionally, MA supplementation enhanced energy expenditure, leading to improvements in plasma lipids, cytokines, hepatic steatosis, and fecal lipids. Furthermore, MA supplementation regulated lipid-metabolism-related enzyme activity and gene expression, thereby suppressing lipid accumulation in the WAT and liver. @*CONCLUSIONS@#These findings indicate that MA has the potential to improve diet-induced obesity and its associated complications, including adiposity, dyslipidemia, hepatic steatosis, and inflammation.
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Background@#Orthotopic liver transplantation is the only option for patients with end-stage liver disease and hepatocellular carcinoma. Post-transplant immunosuppressive therapy is important to prevent graft failure. We investigated the effectiveness of tacrolimus (FK506) and their mechanisms for liver transplant immune tolerance in an outbred rat LT model. @*Results@#To investigate the therapeutic effect of the FK506 on outbred rat LT model, FK506 and postoperative therapy were administered subcutaneously once or twice daily to transplanted rats. Histopathological and immunohistochemical analyses were conducted for all groups. The regulation of inflammatory cytokine signaling in the spleen was analyzed by flow cytometry. FK506 attenuated allograft rejection and increased survival in rat orthotopic liver transplantation models. The FK506-treated group had reduced serum levels of alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase. Furthermore, FK506 decreased the expression of inflammatory cytokines and the activation of pathogenic Th1 and Th17 cells in the liver. @*Conclusions@#Taken together, we revealed that FK506 ameliorated strong allograft rejection in outbred liver transplantation model by anti-inflammatory effect and inhibitory peroperty of pathogenic T cells.
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We experienced a case of disseminated Staphylococcus aureus infection with bacterial pericarditis that progressed to septic shock and multiorgan failure despite pericardiocentesis and surgical removal of the original abscess with intensive antibiotic therapy. We report this case because of the patient’s very rare and remarkable echocardiographic findings and highly turbid pericardial effusion.
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Objective@#Cine magnetic resonance imaging (MRI) has emerged as a noninvasive method to quantitatively assess bowel motility. However, its accuracy in measuring various degrees of small bowel motility has not been extensively evaluated. We aimed to draw a quantitative small bowel motility score from cine MRI and evaluate its performance in a population with varying degrees of small bowel motility. @*Materials and Methods@#A total of 174 participants (28.5 ± 7.6 years; 135 males) underwent a 22-second-long cine MRI sequence (2-dimensional balanced turbo-field echo; 0.5 seconds per image) approximately 5 minutes after being intravenously administered 10 mg of scopolamine-N-butyl bromide to deliberately create diverse degrees of small bowel motility. In a manually segmented area of the small bowel, motility was automatically quantified using a nonrigid registration and calculated as a quantitative motility score. The mean value (MV) of motility grades visually assessed by two radiologists was used as a reference standard. The quantitative motility score’s correlation (Spearman’s ρ) with the reference standard and performance (area under the receiver operating characteristics curve [AUROC], sensitivity, and specificity) for diagnosing adynamic small bowel (MV of 1) were evaluated. @*Results@#For the MV of the quantitative motility scores at grades 1, 1.5, 2, 2.5, and 3, the mean ± standard deviation values were 0.019 ± 0.003, 0.027 ± 0.010, 0.033 ± 0.008, 0.032 ± 0.009, and 0.043 ± 0.013, respectively. There was a significant positive correlation between the quantitative motility score and the MV (ρ = 0.531, P < 0.001). The AUROC value for diagnosing a MV of 1 (i.e., adynamic small bowel) was 0.953 (95% confidence interval, 0.923–0.984). Moreover, the optimal cutoff for the quantitative motility score was 0.024, with a sensitivity of 100% (15/15) and specificity of 89.9% (143/159). @*Conclusion@#The quantitative motility score calculated from a cine MRI enables diagnosis of an adynamic small bowel, and potentially discerns various degrees of bowel motility.
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Background and Objectives@#Inherited arrhythmia (IA) is a more common cause of sudden cardiac death in Asian population, but little is known about the genetic background of Asian IA probands. We aimed to investigate the clinical characteristics and analyze the genetic underpinnings of IA in a Korean cohort. @*Methods@#This study was conducted in a multicenter cohort of the Korean IA Registry from 2014 to 2017. Genetic testing was performed using a next-generation sequencing panel including 174 causative genes of cardiovascular disease. @*Results@#Among the 265 IA probands, idiopathic ventricular fibrillation (IVF) and Brugada Syndrome (BrS) was the most prevalent diseases (96 and 95 cases respectively), followed by long QT syndrome (LQTS, n=54). Two-hundred-sixteen probands underwent genetic testing, and 69 probands (31.9%) were detected with genetic variant, with yield of pathogenic or likely pathogenic variant as 6.4%. Left ventricular ejection fraction was significantly lower in genotype positive probands (54.7±11.3 vs. 59.3±9.2%, p=0.005). IVF probands showed highest yield of positive genotype (54.0%), followed by LQTS (23.8%), and BrS (19.5%). @*Conclusions@#There were significant differences in clinical characteristics and genetic yields among BrS, LQTS, and IVF. Genetic testing did not provide better yield for BrS and LQTS. On the other hand, in IVF, genetic testing using multiple gene panel might enable the molecular diagnosis of concealed genotype, which may alter future clinical diagnosis and management strategies.
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Purpose@#The objective of this study was to develop a structural model to assess and forecast the quality of life in climacteric women, focusing the concept of salutogenesis. @*Methods@#Participants were sourced from two urban locations through convenience sampling. Data collection involved questionnaires, analyzed using SPSS 21.0 and AMOS 20.0. Assessment instruments comprised the Menopause Rating Scale, New General Self-Efficacy Scale, Sense of Coherence Scale, and the Korean version of the WHOQOL-BREF. @*Results@#The fit indices of the proposed model met recommended standards. The sense of coherence, menopausal symptoms, and self-efficacy accounted for 58% of the quality of life variance, with sense of coherence emerging as the most significant predictor. Menopausal symptoms directly and negatively affected quality of life (β=-0.30, p<0.001), and had an indirect influence through self-efficacy and integration (β=-0.30, p<0.001). Self-efficacy positively influenced quality of life directly (β=0.27, p<0.001) and indirectly through integration (β=0.14, p=0.001). Integration positively affected quality of life directly (β=0.36, p<0.001). @*Conclusion@#Interventions to bolster sense of coherence are crucial for enhancing the quality of life among climacteric women.