Validation of Cancer Diagnosis Based on the National Health Insurance Service Database versus the National Cancer Registry Database in Korea / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This study aimed to assess the feasibility of operational definitions of cancer patients in conducting cancer-related studies using the claims data from the National Health Insurance Service (NHIS). @*Materials and Methods@#Cancer incidence data were obtained from the Korean Central Cancer Registry, the NHIS primary diagnosis, and from the rare and intractable disease (RID) registration program. @*Results@#The operational definition with higher sensitivity for cancer patient verification was different by cancer type. Using primary diagnosis, the lowest sensitivity was found in colorectal cancer (91.5%; 95% confidence interval [CI], 91.7 to 92.0) and the highest sensitivity was found in breast cancer (97.9%; 95% CI, 97.8 to 98.0). With RID, sensitivity was the lowest in liver cancer (91.9%; 95% CI, 91.7 to 92.0) and highest in breast cancer (98.1%; 95% CI, 98.0 to 98.2). In terms of the difference in the date of diagnosis in the cancer registration data, > 80% of the patients showed a < 31-day difference from the RID definition. @*Conclusion@#Based on the NHIS data, the operational definition of cancer incidence is more accurate when using the RID registration program claims compared to using the primary diagnosis despite the relatively lower concordance by cancer type requires additional definitions such as treatment.

Brachytherapy utilization rate and effect on survival in cervical cancer patients in Korea / 부인종양

Objective@#External beam radiation therapy (EBRT) with concurrent chemotherapy followed by intracavitary brachytherapy is the standard treatment in locally advanced cervical cancer. This study examined the brachytherapy utilization rate and evaluated the effect of brachytherapy on survival in cervical cancer patients in Korea. @*Methods@#In this study, data from the Korea Central Cancer Registry and Korean National Health Insurance Service and data on mortality from Statistics Korea were linked and used. Patients with other cancers, distant metastasis at diagnosis, or unknown stage or who underwent hysterectomy were excluded. A total of 12,721 cervical cancer patients were analyzed in this study. @*Results@#The brachytherapy utilization rate (%) was calculated as the proportion of patients who received brachytherapy among those who received curative EBRT. The brachytherapy utilization rate decreased from 84% in 2005 to 78% in 2013 (p<0.001). Brachytherapy utilization rates varied by region, ranging from 72% to 100% except for in Jeju Island, where the rate was 56%. The brachytherapy utilization rate was lower in patients older than 80 years; patients with localized disease, non-squamous cell carcinoma, or Charlson comorbidity index 3 or more; patients diagnosed after 2010; patients from certain regions; patients receiving medical aid; and patients who underwent gynecologic procedures. Multivariable Cox regression analysis showed that brachytherapy when added to curative EBRT was independently associated with better cancer-specific survival (CSS) and overall survival (OS) than curative EBRT only. @*Conclusion@#The brachytherapy utilization rate decreased from 2005 to 2013 and varied by region in Korea. Brachytherapy use is independently associated with significantly higher CSS and OS in cervical cancer.

A Structural Equation Model for Happiness in Mothers with Young Children / 간호학회지

PURPOSE: This study aimed to develop and test a model of the happiness of mothers with young children based on the stress-coping-adaptation model of Lazarus and Folkman. METHODS: The data collection period was from May to July 2016. A self-report questionnaire was used to collect data from 210 mothers with children under 5 years of age living in Seoul, Gyeonggi, and Gangwon provinces. The exogenous variable was parenting stress, and the endogenous variables were parenting alliance, depression, optimism, ways of coping, and happiness. Data from 201 questionnaires were analyzed using the SPSS 22.0 and AMOS 20.0 programs. Data analyses included descriptive statistics, factor analysis, and structural equation modeling. RESULTS: The final modified model showed a reasonable fit to the data, and out of 25 paths, 13 were statistically significant. This model explained 78.4% of the variance in the happiness of mothers with young children and confirmed that depression, optimism, parenting alliance, and social support-focused coping have a direct effect on the subject's happiness. Parenting stress also influenced happiness through parenting alliance, depression, and optimism. CONCLUSION: In order to bolster the happiness of mothers with young children, positive psychological interventions that can minimize psychological vulnerabilities, such as depression, and that can enhance their strengths, such as optimism, may serve as effective ways of coping with and adapting to stress.

The Effect of Nurse's Emotional Labor on Turnover Intention: Mediation Effect of Burnout and Moderated Mediation Effect of Authentic Leadership / 간호학회지

PURPOSE: To investigate the effect of nurses' emotional labor on their turnover intention that was mediated by burnout and to examine the moderated mediation effect of authentic leadership. METHODS: A total of 227 nurses working at two general hospitals in Seoul were recruited from March 21 to May 6 in 2016. Emotional labor including surface acting and deep acting; burnout factors such as emotional exhaustion and personal accomplishment; and turnover intention were assessed. The data were analyzed using SPSS 22.0 and SPSS PROCESS macro. RESULTS: Surface acting significantly increased emotional exhaustion and reduced personal accomplishment. Deep acting significantly increased personal accomplishment. Emotional exhaustion significantly increased turnover intention. Conversely, personal accomplishment significantly reduced turnover intention. Surface acting had an indirect effect on turnover intention that was mediated by emotional exhaustion. Deep acting had an indirect effect on turnover intention that was mediated by personal accomplishment. Authentic leadership had a moderated mediation effect on the relationship between surface acting and turnover intention that was mediated by emotional exhaustion. CONCLUSION: The findings of this study indicate that the establishment of strong authentic leadership by head nurses would help nurses reduce their burnout and turnover intention. Conducting intervention studies would be also important to promote better work environments that would enable nurses to fortify the positive aspect of emotional labor and to reduce their burnout levels.

A Structural Equation Model for Happiness in Mothers with Young Children

PURPOSE@#This study aimed to develop and test a model of the happiness of mothers with young children based on the stress-coping-adaptation model of Lazarus and Folkman.@*METHODS@#The data collection period was from May to July 2016. A self-report questionnaire was used to collect data from 210 mothers with children under 5 years of age living in Seoul, Gyeonggi, and Gangwon provinces. The exogenous variable was parenting stress, and the endogenous variables were parenting alliance, depression, optimism, ways of coping, and happiness. Data from 201 questionnaires were analyzed using the SPSS 22.0 and AMOS 20.0 programs. Data analyses included descriptive statistics, factor analysis, and structural equation modeling.@*RESULTS@#The final modified model showed a reasonable fit to the data, and out of 25 paths, 13 were statistically significant. This model explained 78.4% of the variance in the happiness of mothers with young children and confirmed that depression, optimism, parenting alliance, and social support-focused coping have a direct effect on the subject's happiness. Parenting stress also influenced happiness through parenting alliance, depression, and optimism.@*CONCLUSION@#In order to bolster the happiness of mothers with young children, positive psychological interventions that can minimize psychological vulnerabilities, such as depression, and that can enhance their strengths, such as optimism, may serve as effective ways of coping with and adapting to stress.

The Effect of Nurse's Emotional Labor on Turnover Intention: Mediation Effect of Burnout and Moderated Mediation Effect of Authentic Leadership

PURPOSE@#To investigate the effect of nurses' emotional labor on their turnover intention that was mediated by burnout and to examine the moderated mediation effect of authentic leadership.@*METHODS@#A total of 227 nurses working at two general hospitals in Seoul were recruited from March 21 to May 6 in 2016. Emotional labor including surface acting and deep acting; burnout factors such as emotional exhaustion and personal accomplishment; and turnover intention were assessed. The data were analyzed using SPSS 22.0 and SPSS PROCESS macro.@*RESULTS@#Surface acting significantly increased emotional exhaustion and reduced personal accomplishment. Deep acting significantly increased personal accomplishment. Emotional exhaustion significantly increased turnover intention. Conversely, personal accomplishment significantly reduced turnover intention. Surface acting had an indirect effect on turnover intention that was mediated by emotional exhaustion. Deep acting had an indirect effect on turnover intention that was mediated by personal accomplishment. Authentic leadership had a moderated mediation effect on the relationship between surface acting and turnover intention that was mediated by emotional exhaustion.@*CONCLUSION@#The findings of this study indicate that the establishment of strong authentic leadership by head nurses would help nurses reduce their burnout and turnover intention. Conducting intervention studies would be also important to promote better work environments that would enable nurses to fortify the positive aspect of emotional labor and to reduce their burnout levels.

Factors Influencing Depression and Suicide Attempts among South Korean Juvenile Victims of Violence: Secondary Data Analysis from the 11(th) Korea Youth Risk Behavior Web-based Survey / 정신간호학회지

PURPOSE: The aim of this study was to examine factors influencing depression and suicide attempts among South Korean adolescent victims of violence. METHODS: This secondary data analysis was based on the 11th (2015) Korea Youth Risk Behavior Web-based survey. The study sample comprised of 1,565 students who were victims of violence and subsequently required medical treatment during the past 12 months. Descriptive statistics and logistic regression analyses were completed. RESULTS: Factors associated with adolescent depression due to violence were residence type, perceived happiness, sleep satisfaction, perceived stress, perceived health, gender, lifetime smoking habits, number of violent experiences, and lifetime alcohol consumption habits. Factors associated with adolescent suicide attempts were perceived health, residence type, number of violent experiences, lifetime smoking habits, and gender. CONCLUSION: Our study findings show that different factors affect depression and suicide attempts among Korean juvenile victims of violence. Therefore, considering these factors, it is necessary to prepare intervention strategies that include family-centered support systems, improvement in coping ability of the individual and counselors who have experience with juvenile victims of violence.

Erratum to: Therapeutic Consideration of Periappendiceal Abscess: an Evaluation of Non-surgical Treatment Followed by Minimally Invasive Interval Appendectomy

Authors requested to change the name of the hospital to proper name.

Do Eosinophilic Polyps Act as a Reliable Predictor of Olfactory Dysfunction and Postoperative Recovery in Chronic Rhinosinusitis? / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was 1) to assess differences in categories of olfactory dysfunction according to the pathological classification of chronic rhinosinusitis with nasal polyp (CRSwNP) patients; 2) to identify the degree of olfaction recovery after endoscopic sinus surgery (ESS); and 3) to identify the factors that predict the changes in olfactory status. SUBJECTS AND METHOD: The sample of the study consisted of patients with CRSwNP who underwent ESS with biopsy from January 2012 to September 2014. Seventy five patients were classified into eosinophilic CRS (ECRS) and non-ECRS groups. During an approximately five-month follow-up, the Korean Version of Sniffin' Sticks test II (KVSS II) was conducted on each patient to examine the difference between the preoperative and postoperative states of olfactory function. RESULTS: The ECRS group showed a statistical significant increase in the postoperative KVSS II scores when compared to the preoperative scores, while the non-ECRS group did not show any statistically significant change. For the anosmia category by KVSS II, the ECRS group showed significantly improved olfactory function test scores for the threshold, discrimination, and identification tests. CONCLUSION: ECRS and preoperative olfactory function status (anosmia) could be predictable factors of postoperative olfactory function.

Prevalence of Allergic Disease in Korean Adults: Results from the Korea National Health and Nutrition Examination Survey (2010–2012) / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In this study, we evaluated differences in the prevalence of allergic rhinitis, asthma, atopic dermatitis and specific immunoglobuline E (IgE) value for some respiratory antigens in Korean adults. SUBJECTS AND METHOD: The study was conducted using data from the 5th National Health and Nutrition Survey (2010-2012). All subjects who were aged 19 years or older completed questionnaires on asthma, atopic dermatitis and allergic rhinitis. The subjects were first divided into male and female, and then into age groups of 19-29, 30-39, 40-49, 50-59, 60-69, ≥70 each. The lifetime and current prevalence rates for allergic rhinitis, asthma, and atopic dermatitis were calculated for each age group. The total and specific IgE level for Dermatophagoides farinae (DF), cockroach, and dog dander were also calculated. RESULTS: Final participants of 17542 were analyzed for the prevalence rate among the total of 25534 participants. The mean IgE level was calculated from 2028 subjects from the final participants. In asthma, the lifetime prevalence and current prevalence increased with age, but decreased with atopic dermatitis and allergic rhinitis. Total IgE level increased with age, but IgE level of DF reached its peak at 20-29 years, and then decreased rapidly thereafter. There was no clear trend for cockroach and dog dander. CONCLUSION: The prevalence of allergic diseases in adults varies widely by age group. Asthma has a low prevalence after age 20 and gradually increases after age 50. Atopic dermatitis and allergic rhinitis are the most prevalent in their 20s and gradually decrease thereafter.

Therapeutic Consideration of Periappendiceal Abscess: an Evaluation of Non-surgical Treatment Followed by Minimally Invasive Interval Appendectomy

PURPOSE: Periappendiceal abscess (PAA) is a severe complicated appendicitis with high morbidity. Non-surgical treatment followed by interval appendectomy (IA) is associated with lower complication rate compared with emergency surgery (ES) and minimally invasive surgery (MIS) can be done more often. The purpose of this study is to assess the incidence and factors predictive of complications of surgery for PAA and to evaluate the clinical effectiveness of IA as a treatment policy to increase MIS. METHODS: Retrospectively, we reviewed 171 patients undergoing surgery for PAA between 2011 and 2016 at Ulsan University Hospital. The incidence and influence of different factors were assessed by univariate and multivariate analyses. RESULTS: In 171 patients, 28 (16.4%) developed postoperative complications, which included; wound complications (7.6%), intra-abdominal abscess (4.1%) and ileus (2.9%). In both analyses, only ES was independently associated with postoperative complications; (Relative risk, 15.0; 95% Confidence interval, 2.4~92.5). Comparing the IA and ES groups revealed that operative time, complication rate, laparoscopic approach, postoperative hospitalization, postoperative antibiotic use and bowel resection rate were significantly different. The postoperative complication rate of patients with PAA in ES group was 28.7%, which was statistically higher than that of IA group (3.6%). Especially, MIS rate was more than 9-times greater in the IA group (98.8% vs. 10.3%, p<0.001). Although the IA group required additional hospitalization, there was no statistical difference between the two groups in total length of hospital stay. CONCLUSION: Morbidity was high for patients who had emergency surgery for PAA. ES was the only factor associated with postoperative morbidity. IA can reduce the postoperative complication rate and allowed MIS to be used more often as a useful treatment policy for PAA.

Factors Influencing Family-function in Families of Pathological Gamblers / 정신간호학회지

PURPOSE: This study was done to identify levels of family function, codependency, depression, and self-esteem, and to identify factors influencing family function in families pathological gamblers. METHODS: A cross-sectional survey design was used. Participants in the survey for this study were 103 families pathological gamblers from gambling counseling G center in Gyung-gi province. Data were collected from January to December, 2012 using self-report structured questionnaires. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients and Stepwise regression with SAS program. RESULTS: Codependency, depression, self-esteem and family function showed strong correlations (p<.001). Family status, type of housing tenure, codependency and self-esteem were identified as factors influencing family function in families pathological gamblers. These variables explained 27% of family function. CONCLUSION: Findings of this study suggest that these variables should be considered in developing nursing intervention programs to improve family function in families pathological gamblers.

A Simple and Rapid Method Based on Liquid Chromatography-Tandem Mass Spectrometry for the Measurement of alpha-L-Iduronidase Activity in Dried Blood Spots: An Application to Mucopolysaccharidosis I (Hurler) Screening

BACKGROUND: We developed an analytical method to measure alpha-L-iduronidase (IDUA) activity in dried blood spots. This was achieved by using liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) with electrospray ionization in the positive ion mode. METHODS: Chromatographic separation was completed using mobile phase involving water-formic acid and acetonitrile-formic acid over 2.8 min of run time on a column with a Kinetex XB-C18 (Phenomenex, USA). The detection of column effluent was performed using a Xevo TQ-S triple quadrupole mass spectrometer (Waters, USA) in the multiple-reaction monitoring mode. This method was verified with blank and control samples at four activity levels: base, low, medium, and high. Control materials were provided from Centers for Disease Control and Prevention (CDC). RESULTS: Intra- and inter-day precisions were between 2.6% and 16.5% and between 7.9% and 17.0%, respectively. A correlative regression study on the IDUA activity in CDC-control samples performed to assess the validity of the developed method showed a highly significant linear association (r2=0.9976) between the calculated and CDC-reported values and an obvious difference in activity among the four levels. This reliable analytical method was applied to mucopolysaccharidosis I (Hurler) screening of patients under treatment (n=4) and in normal controls (n=129). IDUA activity ranged from 8.98 to 77.12 micromol/hr/L) in normal controls, and patients undergoing medical treatment showed low IDUA activity. CONCLUSIONS: This method had advantages of simplicity, rapid sample preparation, and liquid chromatographic separation, which efficiently inhibited ionization suppression induced by matrix effects in mass spectrometric detection.

A Novel Simultaneous Determination of Sarpogrelate and its Active Metabolite (M-1) in Human Plasma, Using Liquid Chromatography-Tandem Mass Spectrometry: Clinical Application

BACKGROUND: This study describes a novel analytical method for simultaneously determining sarpogrelate and its metabolite (M-1) in human plasma, using liquid chromatography coupled with tandem mass spectrometry, with electrospray ionization in the positive ion mode. METHODS: Sarpogrelate, M-1, and labeled internal standard (d3-sarpogrelate) were extracted from 50 microL of human plasma by simple protein precipitation. Chromatographic separation was performed by using a linear gradient elution of a mobile phase involving water-formic acid (99.9:0.1, v/v) and acetonitrile-formic acid (99.9:0.1, v/v) over 4 min of run time on a column, with a core-shell-type stationary phase (Kinetex C18, 50 mm x 2.1 mm i.d., 2.6-microm particle size, Phenomenex, USA). Detection of the column effluent was performed by using a triple-quadruple mass spectrometer in the multiple-reaction monitoring mode. RESULTS: The developed method was validated in human plasma, with lower limits of quantification of 10 ng/mL for sarpogrelate and 2 ng/mL for M-1. The calibration curves of sarpogrelate and M-1 were linear over the concentration ranges of 10-2,000 and 2-400 ng/mL, respectively (R2>0.99). The carry-over effect, precision, accuracy, and stability of the method met the criteria for acceptance. CONCLUSIONS: A simple, fast, robust, and reliable analytical method was successfully developed and applied to the high-throughput determination of sarpogrelate and its metabolite in real plasma samples in a pharmacokinetic study of healthy subjects.

Mesh Encircling Total Extraperitoneal (TEP) Repair of Inguinal Hernia without a Fixation Material or Preformed Mesh: Overlay Closure of Slit Without Additional Mesh

PURPOSE: Mesh non-fixation in TEP is associated with lower cost and shorter operative time, and it is safe and recommended when performed by an experienced surgeon. In performance of TEP surgery using a non-fixation mesh, particularly by a non-experienced surgeon, prevention of mesh migration is an important issue for mesh application. The aim of this study was to report on a fixation method using a non-preformed mesh encircling a cord structure without the use of tacks, staples, or fibrin sealants in TEP surgery. METHODS: A total of 41 patients who had undergone mesh-encircling TEP without fixation from December 2008 (first case of surgery) to June 2012 were analyzed. RESULTS: The mean follow-up period was 23.2 months (12~35 months). Three patients complained of scrotal discomfort, and one patient complained of scrotal edema, but they were resolved with conservative management. There was no recurrence during the follow up period. CONCLUSION: The method of mesh-encircling TEP without fixation material and no additional mesh in which the slit of the mesh is wrapped around the cord structure using an overlay suture is a simple and safe technique without compromising recurrence or chronic pain.

A Study on the Maternal Cultural and Emotional Factors Influencing the Children's Mental Health in Multicultural Families / 정신간호학회지

PURPOSE: This study investigated the current mental health status of school-age children from multicultural families and explored the maternal factors influencing their mental health. METHODS: The subjects consisted of 70 pairs of elementary students and their mothers who were registered at Global Children Center in A City and Support Center for Multicultural Families in H County. One of the dependent variables was the children's mental health measured using the Korea Child Behavior Checklist, and the predictors were the maternal factors measured using the Korean General Health Questionnaire, modified East Asian Acculturation Measure, modified Acculturation Stress Scale for International Students, and reformulated Social Support Scale. RESULTS: 14.7% of the children were within the clinical range for total social competence, and 8.7% showed elevated total behavior problems. Maternal acculturation stress, marginalization, and depression were the predictors of the total social competence, explaining 25.0% of the latter. One of the contributors to the total behavior problems was the maternal mental health, explaining 18.0% of such. CONCLUSION: The findings indicated that promoting the mental health of children from multicultural families requires comprehensive support for positive acculturation and the promotion of mental health in interracial married women.

Trends in Nursing Research in Korea: Research Trends for Studies Published from the Inaugural Issue to 2010 in the Journal of Korean Academy of Nursing and the Journals Published by Member Societies under Korean Academy of Nursing Science

PURPOSE: The purpose of this study was to identify trends for studies published in the Journal of Korean Academy of Nursing and journals published by member societies from inaugural issues to 2010. METHODS: A total of 6890 studies were analyzed using descriptive statistics. RESULTS: Quantitative studies accounted for 83.6% while qualitative studies accounted for 14.4%. Most frequently used research designs were quasi-experimental (91.1%) for experimental research and survey (85.2%) for non-experimental research. Most frequent study participants were healthy people (35.8%), most frequent nursing interventions, nursing skills (53.5%), and 39.8% used knowledge, attitude and behavior outcomes for dependent variables. Most frequently used keyword was elderly. Survey studies decreased from 1991 to 2010 by approximately 50%, while qualitative studies increased by about 20%. True experimental research (1.2%) showed no significant changes. Studies focusing on healthy populations increased from 2001-2005 (37.5%) to 2006-2010 (41.0%). From 1970 to 2010, studies using questionnaire accounted for over 50% whereas physiological measurement, approximately 5% only. Experimental studies using nursing skill interventions increased from 1970-1980 (30.4%) to 2006-2010 (64.0%). No significant changes were noted in studies using knowledge, attitude and behavior (39.9% ) as dependent variables. CONCLUSION: The results suggest that further expansion of true experimental, qualitative studies and physiological measurements are needed.

Comparison of abdominal and perineal procedures for complete rectal prolapse: an analysis of 104 patients

PURPOSE: Selecting the best surgical approach for treating complete rectal prolapse involves comparing the operative and functional outcomes of the procedures. The aims of this study were to evaluate and compare the operative and functional outcomes of abdominal and perineal surgical procedures for patients with complete rectal prolapse. METHODS: A retrospective study of patients with complete rectal prolapse who had operations at a tertiary referral hospital and a university hospital between March 1990 and May 2011 was conducted. Patients were classified according to the type of operation: abdominal procedure (AP) (n = 64) or perineal procedure (PP) (n = 40). The operative outcomes and functional results were assessed. RESULTS: The AP group had the younger and more men than the PP group. The AP group had longer operation times than the PP group (165 minutes vs. 70 minutes; P = 0.001) and longer hospital stays (10 days vs. 7 days; P = 0.001), but a lower overall recurrence rate (6.3% vs. 15.0%; P = 0.14). The overall rate of the major complication was similar in the both groups (10.9% vs. 6.8%; P = 0.47). The patients in the AP group complained more frequently of constipation than of incontinence, conversely, in the PP group of incontinence than of constipation. CONCLUSION: The two approaches for treating complete rectal prolapse did not differ with regard to postoperative morbidity, but the overall recurrence tended to occur frequently among patients in the PP group. Functional results after each surgical approach need to be considered for the selection of procedure.

Effects of a Psychological Adaptation Improvement Program for International Marriage Migrant Women in South Korea

PURPOSE: This study was conducted to develop and evaluate the Psychological Adaptation Improvement Program (PAIP) for international marriage migrant women in South Korea. METHODS: A total of 43 international marriage migrant women who were enrolled in six rural multicultural family support centers in South Korea were included in this study. They were randomly assigned to the intervention group (n = 21) or to the control group (n = 22). The intervention group received 10 sessions of PAIP, 1 or 2 sessions per week for 8 weeks. The dependent variables were self-esteem, depression and social problem solving ability. The data were analyzed by Fisher's exact test, t test, and repeated measures analysis of variance using SAS program. RESULTS: PAIP was effective in increasing self-esteem and reducing depression, and partially showed significant positive effects on participants' social problem solving ability, suggesting increased levels of positive problem orientation and decreased avoidance style in the social problem solving ability subscales. CONCLUSION: PAIP might be used as an effective intervention to improve psychological adaptation among international marriage migrant women in the rural community of South Korea.

Effects of a Family Education Program for Families of Pathological Gamblers

PURPOSE: This study was done to examine the intervention effects on the family of a family education program for pathological gamblers based on Community Reinforcement and Family Training (CRAFT). METHODS: A quasi-experimental, nonequivalent control group pretest-posttest design was used. The participants were 44 families of pathological gamblers from G center in Gyung-gi Province and 5 Gam-Anon groups in Seoul City and Gyung-gi Province. The experimental group (n=22) attended the 6 weekly 2 hour-long CRAFT family education program. The control group (n=22) attended the 12-step program of Gam-Anon. Data were collected from November, 2011 to May, 2012. RESULTS: Compared with the control group, the experimental group showed significant decrease in depression (p=.001) and state anger (p=.039). There were no significant differences between groups in the level of interpersonal communication, trait anger, the mode of anger expression and self-esteem. CONCLUSION: Findings from this study suggest that the CRAFT family education program is effective in decreasing depression and state anger in families of pathological gamblers.