Association Between Air Conditioning Use and Self-reported Symptoms During the 2018 Heat Wave in Korea / 예방의학회지

Objectives@#The purpose of this study was to investigate the health effects of air conditioning use during the 2018 heat wave in Korea, included the highest temperature ever recorded in the nation. @*Methods@#The participants in this study were 1000 adults aged 19 years and older recruited from across Korea. The participants were asked about their experience of symptoms of various diseases, disruptions of their daily lives, and use of air conditioning during the heat wave. The associations between air conditioning use during the heat wave and health outcomes were analyzed using the chi-square test and multiple logistic regression models. @*Results@#Among participants who lacked air conditioning in the main space where they spent time outside the home, 33.9%, 8.1%, 43.5%, and 19.4% experienced symptoms of heat-related, cardiovascular, nervous system diseases, and air-conditioningitis, respectively. In comparison, participants who did have air conditioning outside the home experienced the same symptoms at proportions of 21.0%, 1.9%, 26.8%, and 34.2%, respectively (p=0.027, 0.007, 0.007, and 0.023, respectively). Among participants who had no air conditioner at home, 10.0% were absent from school or work due to the heat wave. In contrast, among participants who had an air conditioner at home, only 3.7% were absent as a result of the heat wave (p=0.007). @*Conclusions@#When air conditioning was not used at home or in the main space where participants spent time outside the home during the 2018 heat wave, adverse health effects were more prevalent, but the risk of air-conditioningitis was reduced.

Introduction of Fall Risk Assessment (FRA) System and Cross-Sectional Validation Among Community-Dwelling Older Adults

OBJECTIVE: To predict the risk of falls, Fall Risk Assessment (FRA) system has been newly developed to measure multi-systemic balance control among community-dwelling older adults. The aim of this study was to examine the association between FRA and fall-related physical performance tests. METHODS: A total of 289 community-dwelling adults aged 65 years and older participated in this cross-sectional study. All participants underwent FRA test and physical performance tests such as Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), and Timed Up and Go Test (TUG). RESULTS: Participants who were younger, male, highly educated, living with family members, having high body mass index, having high appendicular lean mass index, and having no irritative lower urinary tract syndrome were more likely to have higher FRA scores. SPPB (β=1.012), BBS (β=0.481), and TUG (β=-0.831) were significantly associated with FRA score after adjusting for the variables (all p < 0.001). CONCLUSION: FRA composite score was closely correlated with SPPB, BBS, and TUG, suggesting that FRA is a promising candidate as a screening tool to predict falls among community-dwelling elderly people.

Text Network Analysis of Oncology Nursing Studies Published in the Journal of Asian Oncology Nursing

PURPOSE: The purpose of this study was to identify the knowledge structure of Asian Oncology Nursing (AON) from 2002 to 2018.METHODS: Abstracts from 382 studies were reviewed and analyzed using the text network analysis program, NetMiner 4.3. Keywords network trends were compared before and after 2012 when the journal title changed from Journal of Korean Oncology Nursing to Journal of Asian Oncology Nursing.RESULTS: ‘Cancer,’ ‘patient,’ ‘quality of life,’ ‘breast,’ ‘nurse,’ ‘depression,’ ‘health,’ ‘nursing,’ ‘pain,’ ‘family’ were the top 10 most frequent keywords, and ‘cancer,’ ‘patient,’ ‘quality of life,’ ‘health,’ ‘nursing,’ ‘family,’ ‘intervention,’ ‘effect,’ ‘hospital,’ and ‘therapy’ were the dominant keywords that ranked highest in co-appearance frequency. Core keywords changed before and after 2012. After 2012, depression, health, symptom and pain were the keywords ranked that replaced nursing, education, family, and intervention from before 2012. Four subtopic groups were identified: 1) cancer treatment, education and information, 2) chemotherapy and psychological adjustment, 3) psychosocial adjustment of cancer survivors, and 4) process of cancer intervention and support.CONCLUSION: This study provides a general overview of research trends of the Asian Oncology Nursing Society. Findings of this study may guide future research directions in Asian Oncology Nursing research.

Modified Criteria for Diagnosing “Cognitive Frailty”

The concept of cognitive frailty has recently been proposed by an International Consensus Group as the presence of physical frailty and cognitive impairment [defined using the Clinical Dementia Ratings (CDR)=0.5], without concurrent dementia. However, CDR is difficult to implement and not often available in epidemiologic studies or busy clinical settings, and an alternative to CDR is required. We suggest an alternative definition of cognitive frailty as: 1) physical frailty, 2) more than 1.5 standard deviation below the mean for age-, gender-, and education-adjusted norms on any cognitive function test (e.g., the Montreal Cognitive assessment test, the Alzheimer’s disease assessment scale-cognitive subscale, verbal learning test, Digit Span, Boston Naming Test, Trail Making Test, and Frontal Assessment Battery), and 3) no dependency in instrumental activities of daily living. The redefined criteria for cognitive frailty would be more feasible to implement and thus more applicable in epidemiologic studies and busy clinical settings.

Calf Circumference as a Simple Screening Marker for Diagnosing Sarcopenia in Older Korean Adults: the Korean Frailty and Aging Cohort Study (KFACS)

BACKGROUND: The purpose of this study was to explore the optimal cut-off point of calf circumference (CC) as a simple proxy marker of appendicular skeletal muscle mass (ASM) and sarcopenia in the Korean elderly and to test the criterion-related validity of CC by analyzing its relationships with the physical function. METHODS: The participants were 657 adults aged 70 to 84 years who had completed both dual energy X-ray absorptiometry (DXA) and physical function test in the first baseline year of the Korean Frailty and Aging Cohort Study. RESULTS: ASM and skeletal muscle mass index (SMI) were correlated positively with CC (male, ASM, r = 0.55 and SMI, r = 0.54; female, ASM, r = 0.55 and SMI, r = 0.42; all P < 0.001). Testing the validity of CC as a proxy marker for low muscle mass, an area under the curve (AUC) of 0.81 for males and 0.72 for females were found and their optimal cut-off values of CC were 35 cm for males and 33 cm for females. In addition, CC-based low muscle groups were correlated with physical functions even after adjusting for age and body mass index. Also, the cut-off value of CC for sarcopenia was 32 cm (AUC; male, 0.82 and female, 0.72). CONCLUSION: The optimal cut-off values of CC for low MM are 35 cm for males and 33 cm for females. Lower CC based on these cut-off values is related with poor physical function. CC may be also a good indicator of sarcopenia in Korean elderly.

Effects of Depressive Symptom and Health Status on Several Factors that Affect Suicidal Ideation among the Elderly Living Alone in Rural Area: The Fully Mediating Effect of Depressive Symptom

BACKGROUND: The study was performed to investigate effects of depression and health status on several factors of influencing suicidal ideation among living-alone elderly in rural area. And we assessed if depressive symptom mediates fully suicidal ideation among living-alone elderly in the rural area. METHODS: The subjects of this study used the survey data of elderly people living alone for the elderly mental health promotion project at the city health center. In the questionnaire, 200 people were interviewed by one of the public health center staffs directly. We analyzed a four step approach in which several logistic regression analyses were conducted and significance of the coefficients was examined at each step. RESULTS: The results from step 1 show that the total effect of health status(frailty) was significantly related to suicidal ideation(Exp(β)=2.198, P=0.042). In step 2, the direct effect of health status on depression was significant(Exp(β)=3.925, P<0.001) too. Step 3 analysis showed that the effect of depression on suicidal ideation was significant(Exp(β)=7.115, P=0.001). Step 4 showed that after controlling for depression, health status was not significant for suicidal ideation(P=0.322). Based on analysis results, the finding supports that suicidal ideation among living-alone elderly in the rural area was fully mediated by depressive symptom. CONCLUSIONS: Above findings imply that it is crucial to decrease depression in order to control suicidal ideation among living-alone elderly in rural area. To do that, early diagnosis and developing programs to decrease elderly depression and organizational approach according to characteristics of areas and elderly circunstances are needed.

Association between Objectively Measured Sleep Quality and Obesity in Community-dwelling Adults Aged 80 Years or Older: A Cross-sectional Study

The purpose of this study was to examine the association between objective measures of sleep quality and obesity in older community-dwelling people. This cross-sectional study included 189 community-dwelling adults aged > or = 80 yr (83.4 +/- 2.5 yr [age range, 80-95 yr]). Participants wore an accelerometer (ActiGraph GT3X+) on their non-dominant wrist 24 hr per day for 7 consecutive nights. Sleep parameters measured included total sleep time, sleep efficiency, and wake after sleep onset (WASO) during the night. Associations between sleep parameters and obesity were investigated by using multivariate logistic regression analysis. In multivariate models, those with sleep efficiency lower than 85% had a 2.85-fold increased odds of obesity, compared with those with sleep efficiency of 85% or higher. Similarly, those with WASO of > or = 60 min (compared with or = 80 yr, even after controlling for potential confounding factors, including daily physical activity.

Association between Objectively Measured Sleep Quality and Obesity in Community-dwelling Adults Aged 80 Years or Older: A Cross-sectional Study

The purpose of this study was to examine the association between objective measures of sleep quality and obesity in older community-dwelling people. This cross-sectional study included 189 community-dwelling adults aged > or = 80 yr (83.4 +/- 2.5 yr [age range, 80-95 yr]). Participants wore an accelerometer (ActiGraph GT3X+) on their non-dominant wrist 24 hr per day for 7 consecutive nights. Sleep parameters measured included total sleep time, sleep efficiency, and wake after sleep onset (WASO) during the night. Associations between sleep parameters and obesity were investigated by using multivariate logistic regression analysis. In multivariate models, those with sleep efficiency lower than 85% had a 2.85-fold increased odds of obesity, compared with those with sleep efficiency of 85% or higher. Similarly, those with WASO of > or = 60 min (compared with or = 80 yr, even after controlling for potential confounding factors, including daily physical activity.

Structural Equation Modeling of Quality of Work Life in Clinical Nurses based on the Culture-Work-Health Model

PURPOSE: The purpose of this study was to construct and test a structural equation model of quality of work life for clinical nurses based on Peterson and Wilson's Culture-Work-Health model (CWHM). METHODS: A structured questionnaire was completed by 523 clinical nurses to analyze the relationships between concepts of CWHM-organizational culture, social support, employee health, organizational health, and quality of work life. Among these conceptual variables of CWHM, employee health was measured by perceived health status, and organizational health was measured by presenteeism. SPSS21.0 and AMOS 21.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factors affecting quality of work life among clinical nurses. RESULTS: The goodness-of-fit statistics of the final modified hypothetical model are as follows: chi2=586.03, chi2/df=4.19, GFI=.89, AGFI=.85, CFI=.91, TLI=.90, NFI=.89, and RMSEA=.08. The results revealed that organizational culture, social support, organizational health, and employee health accounted for 69% of clinical nurses' quality of work life. CONCLUSION: The major findings of this study indicate that it is essential to create a positive organizational culture and provide adequate organizational support to maintain a balance between the health of clinical nurses and the organization. Further repeated and expanded studies are needed to explore the multidimensional aspects of clinical nurses' quality of work life in Korea, including various factors, such as work environment, work stress, and burnout.

Predictors of Clinical Nurses' Presenteeism / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to identify factors affecting clinical nurses' presenteeism. METHODS: A descriptive cross-sectional design was used in which participants completed self-report questionnaires that consisted of measures for nurses' job satisfaction, job stress, professionalism and presenteeism. 267 nurses working in general hospital participated in this study. Logistic regression analysis was used to estimate predictors of the presenteeism in clinical nurses. RESULTS: 250 nurses experienced one or more health problems last one month. The group who experienced presenteeism during the last one year had significant differences in professionalism and perceived productivity. Predictors of sickness presenteeism in clinical nurses included work experience, total health problem and last 1 year absenteeism. Last 1 year absenteeism and total health problem were strongly related to presenteeism in clinical nurses. CONCLUSION: Major findings of this study indicated that in dealing with nurses' presenteeism, not only managing nurses' job stress and job satisfaction but also providing flexible work schedule and increasing staffing level as an organizational approach are necessary to be considered. Further repeated and expanded research is needed to explore the multidimensional aspects of nurses' presenteeism including a broad range of work setting and the influence of Korean nurses' organizational culture on presenteeism.

Research Trend Analysis of Do-Not-Resuscitate Decision: Based on Text Network Analysis

PURPOSE: The purpose of this study was to identify a research trend of studies related to the Do-Not-Resuscitate (DNR) decision making process in Korea. METHODS: Assessing through five computerized databases, 889 studies were reviewed and of these 32 were included. An integrative literature review and text network analysis were applied to examine the research. The keywords from each article's abstracts were extracted by using a program, KrKwic. RESULTS: The number of studies on DNR decision has been increasing, especially since 2011. A descriptive study design (59%) was most commonly used in the research. In relation to factors affecting DNR decision, 97% of the studies stated patient factors and 66% stated family factors. 'Patient', 'DNR', 'decision', 'treatment', 'life', 'family' were the major keywords, and 'patient' and 'care' were dominant keywords that ranked high in coappearance frequency. CONCLUSION: Studies related to DNR decision have been increasing, and themes of the studies have also been broader. Further research is required to investigate factors affecting DNR decision in specific populations such as cancer patients, the elderly, patients with end-stage of chronic diseases etc. Moreover, a comparative study is necessary to define differences of research trends related to DNR decision making process between Korea and other countries.

Is habitual sedentary behaviour time associated with lower extremity performance independent of moderate- to vigorous-intensity physical activity in older adults? −Cross-sectional analysis using uniaxial accelerometer– / 体力科学

Habitual moderate- to vigorous-intensity physical activity positively impacts lower extremely performance in older adults. However, little is known whether habitual sedentary behaviour time independently impacts lower extremity performance. The purpose of this cross-sectional study was to identify whether sedentary behaviour time is associated with lower extremity performance independent of moderate- to vigorous-intensity physical activity time in older adults. Eight-hundred-and-two community-dwelling older Japanese adults (72.5 ± 5.9 years) participated in this study. Sedentary behavioir time and moderate- to vigorous-intensity physical activity time were assessed using a uniaxial accelerometer. Lower extremity performance was assessed by repeated chair stand, single leg stance, and timed up and go tests. Jonckheere terpstra trend test and Spearman rank correlation coefficient were used to identify the single relation between sedentary behaviour time and lower extremity performance. A hierarchical multiple regression analysis was used to identify whether sedentary behaviour time is associated with lower extremity performance independent of moderate- to vigorous-intensity physical activity time. Results of single relation analysis showed there were negative associations between sedentary behaviour time and all lower extremity performance tests. Multivariable analysis indicated that sedentary behaviour time was not significantly associated with any lower extremity performances but moderate- to vigorous-intensity physical activity time was positively associated with all lower extremity performance tests. In conclusion, sedentary behaviour time would be less useful than moderate- to vigorous-intensity physical activity time as an indicator for modifying habitual behavior to maintain good lower extremity performance in community-dwelling older adults.

Cross-sectional association between body mass index and muscle strength, and mobility limitation in community-dwelling older women / 体力科学

This study aimed to examine the association between body mass index (BMI) and muscle strength, and mobility limitation (ML). A cross-sectional analysis was conducted on data from 570 community-dwelling older Japanese women aged 65-91 years [mean age, 73.9 ± 5.8 (SD) years]. Muscle strength was assessed by hand-grip strength (HGS). ML was assessed using self-reported difficulty level in walking 400 m and ascending 10 steps without resting. BMI and muscle strength were divided into tertiles (high: BMI ≧ 25.1 kg/m², HGS ≧ 22.5 kg; middle: BMI 22.4-25.0 kg/m², HGS 18.8-22.4 kg; low: BMI ≦ 22.3 kg/m², HGS ≦ 18.7 kg) respectively, and logistic regression analysis was used to determine the association between BMI and muscle strength with ML. 256 participants (44.9%) were identified as having ML. Adjusted odds ratios of BMI for ML were 1.64 (95% confidence interval (CI): 1.00-2.68) in the middle group and 1.89 (95% CI: 1.15-3.12) in the high group when compared to the low group. Adjusted odds ratios of muscle strength for ML were 1.25 (95% CI: 0.77-2.04) in the middle group and 1.85 (95% CI: 1.11-3.09) in the low group when compared to the high group. Compared to the low BMI plus high muscle strength group, adjusted odds ratio for ML was significantly higher in the high BMI plus low muscle strength group (2.65, 95% CI: 1.02-6.87) and the high BMI plus middle muscle strength group (3.09, 95% CI: 1.25-7.61). Our findings indicate that the combination of overweight plus muscle weakness is more predictive for having ML than overweight or muscle weakness alone.