A Systematic Review of Measurement Properties of Spirituality related Assessment Tools Published in Korean Journals / 기본간호학회지

Purpose@#The purpose of this study was to evaluate the measurement properties of spirituality-related assessment tools published in Korean journals. @*Methods@#The databases used to search the literature reporting use of the spirituality-related assessment tools were RISS, NDSL, DBpia, KoreaMed, and KISS. The quality of the measurement properties was evaluated based on the reported internal consistency, content validity, criterion validity, construct validity, reproducibility, responsiveness, floor-ceiling effects and interpretability based on the tools review criteria suggested by Terwee et al. @*Results@#Twenty-five assessment tools (including 7 original Korean versions) were identified from the 208 Korean studies published up to November, 2016. All of the 25 tools reported internal consistency and content validity; construct validity was reported in 21 tools while only six tools had reported on criterion validity. None of the studies reported on the reproducibility, responsiveness, and floor-ceiling effects. Among 25 spirituality-related assessment tools, the spiritual well-being scale was identified as the most commonly used tool for spirituality assessment. @*Conclusion@#Among 25 spirituality-related assessment tools used in Korean studies, all of them satisfied only three criteria out of the eight criteria for measurement properties, internal consistency, content validity, and interpretability. The results of this study provide evidence to develop reliable and valid tools that will satisfy the criteria for measurement properties. In addition, standardized, reliable, and valid assessment tools must be chosen for spirituality-related study.

Development and Validation of the New Version of Spirituality Assessment Scale

PURPOSE@#The purpose of this study was to develop a new version of Spirituality Assessment Scale (N-SAS) and verify its reliability and validity.@*METHODS@#The total of 59 preliminary items for the N-SAS were selected through a literature review, two rounds of experts' content validation, cognitive interviews, and pre-tests. Verification of its reliability and validity was divided into two phases. In Phase I, questionnaires were collected from 219 adults. Reliability was tested using Cronbach's alpha, validity with item analysis, and exploratory factor analysis. In Phase II, questionnaires developed based on the results of Phase I were collected from 225 adults. Reliability was tested using Cronbach's alpha, validity with confirmatory factor analysis, and criterion validity.@*RESULTS@#The final version of the N-SAS comprised two dimensions (vertical and horizontal), four domains (relationship with God; meaning of life and self-integration; self-transcendence; and relationship with others, neighborhoods, and nature), and 44 items were identified. Total Cronbach's α was .97; those of each subscale ranged from .79 to .98. N-SAS scores were positively correlated with the scores of Howden's Spiritual Assessment Scale (r=.81, p<.001).@*CONCLUSION@#Findings suggest that the N-SAS can be used to measure spirituality in adults. The use of N-SAS is expected to facilitate perceiving patient's spiritual needs and providing spiritual care.

Development and Validation of the New Version of Spirituality Assessment Scale / 간호학회지

PURPOSE: The purpose of this study was to develop a new version of Spirituality Assessment Scale (N-SAS) and verify its reliability and validity.METHODS: The total of 59 preliminary items for the N-SAS were selected through a literature review, two rounds of experts' content validation, cognitive interviews, and pre-tests. Verification of its reliability and validity was divided into two phases. In Phase I, questionnaires were collected from 219 adults. Reliability was tested using Cronbach's alpha, validity with item analysis, and exploratory factor analysis. In Phase II, questionnaires developed based on the results of Phase I were collected from 225 adults. Reliability was tested using Cronbach's alpha, validity with confirmatory factor analysis, and criterion validity.RESULTS: The final version of the N-SAS comprised two dimensions (vertical and horizontal), four domains (relationship with God; meaning of life and self-integration; self-transcendence; and relationship with others, neighborhoods, and nature), and 44 items were identified. Total Cronbach's α was .97; those of each subscale ranged from .79 to .98. N-SAS scores were positively correlated with the scores of Howden's Spiritual Assessment Scale (r=.81, p<.001).CONCLUSION: Findings suggest that the N-SAS can be used to measure spirituality in adults. The use of N-SAS is expected to facilitate perceiving patient's spiritual needs and providing spiritual care.

Development and Validation of the New Version of Spirituality Assessment Scale

PURPOSE@#The purpose of this study was to develop a new version of Spirituality Assessment Scale (N-SAS) and verify its reliability and validity.@*METHODS@#The total of 59 preliminary items for the N-SAS were selected through a literature review, two rounds of experts' content validation, cognitive interviews, and pre-tests. Verification of its reliability and validity was divided into two phases. In Phase I, questionnaires were collected from 219 adults. Reliability was tested using Cronbach's alpha, validity with item analysis, and exploratory factor analysis. In Phase II, questionnaires developed based on the results of Phase I were collected from 225 adults. Reliability was tested using Cronbach's alpha, validity with confirmatory factor analysis, and criterion validity.@*RESULTS@#The final version of the N-SAS comprised two dimensions (vertical and horizontal), four domains (relationship with God; meaning of life and self-integration; self-transcendence; and relationship with others, neighborhoods, and nature), and 44 items were identified. Total Cronbach's α was .97; those of each subscale ranged from .79 to .98. N-SAS scores were positively correlated with the scores of Howden's Spiritual Assessment Scale (r=.81, p<.001).@*CONCLUSION@#Findings suggest that the N-SAS can be used to measure spirituality in adults. The use of N-SAS is expected to facilitate perceiving patient's spiritual needs and providing spiritual care.

A Study on the Relationship between the Spatial Cluster Patterns of Male Suicide Rate and the Regional Characteristics in South Korea / 보건행정학회지

BACKGROUND: Since 2003, Korea has consistently shown the highest suicide rate among the Organization for Economic Cooperation and Development countries, and suicide remains the major cause of death. In particular, men are 2–3 times more likely to commit suicide than women, which called the ‘gender paradox of suicide.’ The areas with frequent suicide have spatially clustered patterns because suicide with a social contagion spreads around the neighborhood. The purpose of this study was twofold. The first was to estimate the hotspot areas of age-standardized male suicide mortality from 2008 to 2015. The second was to analyze the relationship between the hotspot areas and the regional characteristics for study years. METHODS: The data was collected through the Korean Statistical Information Service. The study areas were 227 si · gun · gu administrative districts in Korea. The hotspot area was used as a dependent variable. Socio-demographic variables (number of marriages per 1,000 population, number of divorces per 1,000 population, and urbanization rate), financial variables (financial independence and social security budget), and health behaviors (EuroQol-5 dimension [EQ-5D], and depression experience rate) were used as independents variables. RESULTS: The hotspot areas were commonly located in Gangwon-do, Chungcheongnam-do, Gyeongsangbuk-do, and Chungceongbuk-do. According to the results of panel logit regression, the number of divorces per 1,000 population, social security budget, and EQ-5D were statistically significant variables. CONCLUSION: The results of hotspot analysis showed the need for establishing a prevention zone of suicide using hotspot areas. Also, medical resources could be considered to be preferentially placed in the prevention zone of suicide. This study could be used as basic data for health policymakers to establish a suicide-related policy.

Current Pharmacogenetic Approach for Oxaliplatin-induced Peripheral Neuropathy among Patients with Colorectal Cancer: A Systematic Review

PURPOSE: Peripheral neuropathy is common among colorectal cancer (CRC) patients who undergo oxaliplatin-based (OXL) chemotherapy. A pharmacogenetic approach can be used to identify patients at high-risk of developing severe neuropathy. This type of approach can also help clinicians determine the best treatment option and prevent severe neurotoxicity. The purpose of this study is to investigate the evidence of pharmacogenetic markers for OXL-induced peripheral neuropathy (OXIPN) in patients with CRC. METHODS: A systematic literature search was conducted using the following databases up to December 2017: Pubmed, EMBASE, and CINAHL. We reviewed the genetic risk factors for OXIPN in observational studies and randomized controlled clinical trials (RCTs). All processes were performed independently by two reviewers. RESULTS: Sixteen studies published in English between 2006 and 2017 were included in this review. A genome-wide association approach was used in one study and various candidate genes were tested, based on their functions (e.g., DNA damage or repair, ion channels, anti-oxidants, and nerve growth etc.). The genes associated with incidence or severity of OXIPN were ABCG2, GSTP1, XRCC1, TAC1, and ERCC1. CONCLUSION: This study highlighted the need and the importance of conducting pharmacogenetic studies to generate evidence of personalized OXIPN symptoms management. Additional studies are warranted to accelerate the tailored interventions used for OXIPN in patients with CRC (NRF-2014R1A1A3054386).

The Spatial Accessibility of Women in Childbearing Age for Delivery Services in Gangwon-do / 보건행정학회지

BACKGROUND: This study purposed to analyze the spatial accessibility of women in childbearing age to the healthcare organizations (HCOs) providing delivery services in Gangwon-do. METHODS: Network analysis was applied to assess the spatial accessibility based on the travel time and road travel distance. Travel time and travel distance were measured between the location of HCOs and the centroid of the smallest administrative areas, eup, myeon, and dong in Gangwon-do. Korean Transport Database Center provided road network GIS (Geographic Information System) Database in 2015 and it was used to build the network dataset. Two types of network analysis, service area analysis and origin-destination (OD)-cost matrix analysis, applied to the created network dataset. Service area analysis defined all-accessible areas that are within a specified time, and OD-cost matrix analysis measured the least-cost paths from the HCOs to the centroids. The visualization of the number of the HCOs and the number of women in childbearing age on the Ganwon-do map and network analysis were performed with ArcGIS ver. 10.0 (ESRI, Redlands, CA, USA). RESULTS: Twenty HCOs were providing delivery services in Gangwon-do in 2016. Over 50% of the women in childbearing age were aged more than 35 years. Service area analysis found that 89.56% of Gangwon-do area took less than 60 minutes to reach any types of HCOs. For tertiary hospitals, about 74.37% of Gangwon-do area took more than 60 minutes. Except Wonju-si and Hoengseonggun, other regions took more than 60 minutes to reach the tertiary hospital. Especially, Goseong-gun, Donghae-si, Samcheok-si, Sokcho-si, Yanggu-gun, Cheorwon-gun, and Taebaek-si took more than 100 minutes to the tertiary hospital. CONCLUSION: This study provided that the accessibility toward the tertiary hospital was limited and it may cause problems in high-risk delivery patients such as over 35 years. Health policy makers will need to handle the obstetric accessibility issues in Gangwon-do.

The Spatial Accessibility of Women in Childbearing Age for Delivery Services in Gangwon-do / 보건행정학회지

BACKGROUND: This study purposed to analyze the spatial accessibility of women in childbearing age to the healthcare organizations (HCOs) providing delivery services in Gangwon-do. METHODS: Network analysis was applied to assess the spatial accessibility based on the travel time and road travel distance. Travel time and travel distance were measured between the location of HCOs and the centroid of the smallest administrative areas, eup, myeon, and dong in Gangwon-do. Korean Transport Database Center provided road network GIS (Geographic Information System) Database in 2015 and it was used to build the network dataset. Two types of network analysis, service area analysis and origin-destination (OD)-cost matrix analysis, applied to the created network dataset. Service area analysis defined all-accessible areas that are within a specified time, and OD-cost matrix analysis measured the least-cost paths from the HCOs to the centroids. The visualization of the number of the HCOs and the number of women in childbearing age on the Ganwon-do map and network analysis were performed with ArcGIS ver. 10.0 (ESRI, Redlands, CA, USA). RESULTS: Twenty HCOs were providing delivery services in Gangwon-do in 2016. Over 50% of the women in childbearing age were aged more than 35 years. Service area analysis found that 89.56% of Gangwon-do area took less than 60 minutes to reach any types of HCOs. For tertiary hospitals, about 74.37% of Gangwon-do area took more than 60 minutes. Except Wonju-si and Hoengseonggun, other regions took more than 60 minutes to reach the tertiary hospital. Especially, Goseong-gun, Donghae-si, Samcheok-si, Sokcho-si, Yanggu-gun, Cheorwon-gun, and Taebaek-si took more than 100 minutes to the tertiary hospital. CONCLUSION: This study provided that the accessibility toward the tertiary hospital was limited and it may cause problems in high-risk delivery patients such as over 35 years. Health policy makers will need to handle the obstetric accessibility issues in Gangwon-do.

The Effects of Insurance Types on the Medical Service Uses for Heart Failure Inpatients: Using Propensity Score Matching Analysis / 보건행정학회지

BACKGROUND: This study aims to analyze the effects of insurance types on the medical service uses for heart failure inpatients using propensity score matching (PSM). METHODS: 2014 National inpatient sample based on health insurance claims data was used in the analysis. PSM was applied to control factors influencing the service uses except insurance types. Negative binomial regression was used after PSM to analyze factors that had influences on the service uses among inpatients. Subjects were divided by health insurance type, national health insurance (NHI) and medical aid (MA). Total charges and length of stay were used to represent the medical service uses. Covariance variables in PSM consist of sociodemographic characteristics (gender, age, Elixhauser comorbidity index) and hospital characteristics (hospital types, number of beds, location, number of doctors per 50 beds). These variables were also used as independent variables in negative binomial regression. RESULTS: After the PSM, length of stay showed statistically significant difference on medical uses between insurance types. Negative binomial regression provided that insurance types, Elixhauser comorbidity index, and number of doctors per 50 beds were significant on the length of stay. CONCLUSION: This study provided that the service uses, especially length of stay, were differed by insurance types. Health policy makers will be required to prepare interventions to narrow the gap of the service uses between NHI and MA.

Relationship between reactive oxygen species and autophagy in dormant mouse blastocysts during delayed implantation / 대한생식의학회지

OBJECTIVE: Under estrogen deficiency, blastocysts cannot initiate implantation and enter dormancy. Dormant blastocysts live longer in utero than normal blastocysts, and autophagy has been suggested as a mechanism underlying the sustained survival of dormant blastocysts during delayed implantation. Autophagy is a cellular degradation pathway and a central component of the integrated stress response. Reactive oxygen species (ROS) are produced within cells during normal metabolism, but their levels increase dramatically under stressful conditions. We investigated whether heightened autophagy in dormant blastocysts is associated with the increased oxidative stress under the unfavorable condition of delayed implantation. METHODS: To visualize ROS production, day 8 (short-term dormancy) and day 20 (long-term dormancy) dormant blastocysts were loaded with 1-microM 5-(and-6)-chloromethyl-2', 7'-dichlorodihydrofluorescein diacetate, acetyl ester (CM-H2DCFDA). To block autophagic activation, 3-methyladenine (3-MA) and wortmannin were used in vivo and in vitro, respectively. RESULTS: We observed that ROS production was not significantly affected by the status of dormancy; in other words, both dormant and activated blastocysts showed high levels of ROS. However, ROS production was higher in the dormant blastocysts of the long-term dormancy group than in those of the short-term group. The addition of wortmannin to dormant blastocysts in vitro and 3-MA injection in vivo significantly increased ROS production in the short-term dormant blastocysts. In the long-term dormant blastocysts, ROS levels were not significantly affected by the treatment of the autophagy inhibitor. CONCLUSION: During delayed implantation, heightened autophagy in dormant blastocysts may be operative as a potential mechanism to reduce oxidative stress. Further, ROS may be one of the potential causes of compromised developmental competence of long-term dormant blastocysts after implantation.

The Role of Major Donors in Health Aid to the Democratic People's Republic of Korea / 예방의학회지

We investigated the major trends in health aid financing in the Democratic People's Republic of Korea (DPRK) by identifying the primary donor organizations and examining several data sources to track overall health aid trends. We collected gross disbursements from bilateral donor countries and international organizations toward the DPRK according to specific health sectors by using the Organization for Economic Cooperation and Development creditor reporting system database and the United Nations Office for the Coordination of Humanitarian Affairs financial tracking service database. We analyzed sources of health aid to the DPRK from the Republic of Korea (ROK) using the official records from the ROK's Ministry of Unification. We identified the ROK, United Nations Children's Fund (UNICEF), World Health Organization (WHO), United Nations Population Fund (UNFPA), and The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) as the major donor entities not only according to their level of health aid expenditures but also their growing roles within the health sector of the DPRK. We found that health aid from the ROK is comprised of funding from the Inter-Korean Cooperation Fund, private organizations, local governments, and South Korean branches of international organizations such as WHO and UNICEF. We also distinguished medical equipment aid from developmental aid to show that the majority of health aid from the ROK was developmental aid. This study highlights the valuable role of the ROK in the flow of health aid to the DPRK, especially in light of the DPRK's precarious international status. Although global health aid from many international organizations has decreased, organizations such as GFATM and UNFPA continue to maintain their focus on reproductive health and infectious diseases.