Antidiabetic effects of water extracts of mulberry (Morus alba L.) twig by inhibition of disaccharidase activity in streptozotocin-induced diabetic mice / 한국영양학회지

Purpose@#The prevalence of diabetes mellitus (DM) continues to increase worldwide, and blood glucose control may reduce mortality from diabetic complications and healthcare costs. Mulberry twig (MT) has been used as a herbal medicine in Asia, and its antidiabetic efficacy has recently been reported, but research in this area is still limited. This study examined the antidiabetic effects of water extracts of MT in diabetic animals. @*Methods@#Six weeks old male ICR mice were divided randomly into three groups; normal control (NC, n = 10), DM control (DC, n = 10), and MT (n = 10). Streptozotocin (STZ, 50 mg/ kg/day) was injected intraperitoneally into mice in the DC and MT groups for 5 consecutive days. After 10 days of the last STZ injection, the mice in the MT group were administered orally with MT water extracts (5 g/kg body weight) for 16 days. @*Results@#The MT water extracts ameliorated the swelling of the liver in the diabetic mice and reduced the elevated levels of fasting blood and plasma glucose, total cholesterol (T-CHO), low density lipoprotein-CHO, and the ratio of high density lipotrotein (HDL)-CHO/T-CHO. The liver triglyceride (TG) and glycogen contents were also significantly lower in the MT group mice than in the DC group. The small intestine disaccharidase activity was analyzed to understand the therapeutic effects and the mechanism of MT water extracts in diabetic animals. MT group mice showed reduced lactase and sucrase activity in the proximal part of the small intestine. On the other hand, body weight, plasma insulin, TG, HDL-CHO, and hepatic T-CHO levels were similar in the DC and MT groups. @*Conclusion@#These results suggest that MT water extracts have antidiabetic effects and can be developed as a functional source to reduce the postprandial blood glucose or to prevent DM incidence.

Quality of clinical nursing education for new graduate nurses: A concept analysis with a hybrid model / 한국간호교육학회지

Purpose@#The study aimed to examine the concept and attributes of the quality of clinical nursing education for new graduate nurses. @*Methods@#This study adopted a hybrid model introduced by Schwartz-Barcott and Kim. In the theoretical stage, the meaning and attributes of the quality of clinical nursing education for new graduate nurses were determined by analyzing eight articles. In the fieldwork stage, data were collected using semi-structured interviews with five new graduate nurses and seven experienced nurses. The data were analyzed by qualitative content analysis methods developed by Elo and Kyngӓs. In the final analysis, a final result was arrived at comparing, contrasting, and integrating the attributes of the concepts derived in the theoretical and field-work stages. @*Results@#The quality of clinical nursing education for new graduate nurses was identified as excellence or the standard of education for new graduate nurses that would support them in adapting to clinical settings and transitioning to professional nurses. The attributes of the quality of clinical nursing education were founded to possess three dimensions, six categories, and 18 attributes. The multidimensional attributes of the quality of clinical nursing education for new graduate nurses were confirmed as education resources, design, method, content, evaluation, interaction, and outcome under the three dimensions of input, process, and output. @*Conclusion@#The concept and nature of the quality of clinical nursing education observed in this study can be utilized as a basis for the future development, evaluation, and improvement of clinical nursing education for new graduate nurses in healthcare organizations.

Effects of Clinical Nurses Critical Reflection Competency, Professional Pride, and Person-Centered Care Practice on Patient Safety Management Activities / 중환자간호학회지

Purpose@#: This descriptive survey investigated the effects of clinical nurses’ critical reflection competency, professional pride, and person-centered care practices on patient safety management activities. @*Methods@#: The participants were 183 clinical nurses working at a tertiary hospital in South Korea. The questionnaires consisted of the Critical Reflection Competency Scale for Clinical Nurses Professional Pride the Person-Centered Nursing Assessment Tool and Patient Safety Management Activities. The collected data were analyzed using descriptive statistics, t-tests, ANOVA, Tukey’s HSD, Pearson’s correlation coefficient, and multiple regression using SPSS 29.0. @*Results@#: The mean score for patient safety management activities was 4.65±0.34 out of 5. There were significant differences in patient safety management activities according to age (F=3.90, p=.010), education level (t=-2.56, p=.013), total work experience (F=3.87, p=.010), and the number of healthcare accreditation system experiences (F=5.22, p=.006). Patient safety management activities were positively correlated with critical reflection competency (r=.337, p＜.001), professional pride (r=.271, p＜.001), and person-centered care practices (r=.399, p＜.001). The results indicated that person-centered care practices affected patient safety management activities (β=.358, p＜.001) with the explanatory power of 22.5%. @*Conclusion@#: To improve clinical nurses’ patient safety management activities, it is necessary to develop participatory educational programs that can integrate skills and attitudes based on conceptual knowledge of person-centered care. Intervention studies are needed to test the effect of person-centered care on patient safety when applied in clinical practice.

An analysis of the educational needs priorities for clinical nurse educators: Utilizing the Borich needs assessment and the locus for focus model / 한국간호교육학회지

Purpose@#This study used a descriptive investigative design to compare the educational needs and priorities of education-dedicated nurses and preceptors regarding clinical nurse educator competency. @*Methods@#A survey was conducted from March to April 2023 with 308 participants, including 140 education-dedicated nurses and 168 preceptors. The collected data were analyzed using descriptive statistics and a paired t-test with the IBM SPSS 26.0 program. For the purpose of analyzing educational needs, we further analyzed data through the Borich needs assessment and the locus for focus model. @*Results@#Among the clinical nurse educator competency, both education-dedicated nurses and preceptors identified “new theory and practice” as the highest priority educational need. Additionally, education-dedicated nurses prioritized “teaching design ability,” “teaching evaluation ability,” and “evidence-based nursing/practice and research,” while preceptors prioritized “clinical nursing knowledge” and “professional development ability” as their educational needs. @*Conclusion@#While both education-dedicated nurses and preceptors responded that education is necessary for all the competency areas required of clinical nurse educators, variations were observed in their reported educational needs and priorities. Thus, it is imperative to develop and implement a differentiated education program for enhancing the competency of clinical nurse educators that considers the distinct requirements of education-dedicated nurses and preceptors.

Developing a Nursing Needs Assessment Scale and Patient Classification System based on Nursing Activities in Comprehensive Nursing Care Units / 기본간호학회지

Purpose@#This study was done to develop and validate a scale for assessing nursing needs on comprehensive nursing care units and to derive a patient classification system based on nursing needs. @*Methods@#In this methodological study, the initial items were identified through a review of the literature and surveys from nursing staff regarding the nursing needs on comprehensive nursing care units. Content validity was evaluated by nine nursing staff members from comprehensive nursing care units. To evaluate the concurrent validity and derive a patient classification system, nursing needs scores, perceived nursing needs and perceived patient severity for 216 patient cases were evaluated by five nurses. These data were analyzed using Pearson‘s correlation coefficients, one-way ANOVA with Scheffépost hoc tests and K-means clustering. @*Results@#After evaluating content validity, the developed scale contained 64 activities in two domains: nursing intervention and assistance of daily living. Concurrent validity was verified by analyzing the differences in the nursing needs scores according to each group of perceived nursing needs and severity (p<.001) and by analyzing the correlation between the score of the developed scale and the National Health Insurance Service nursing need assessment scale (r=.68, p<.001). Based on the score of the developed scale, a patient classification system that classified nursing needs into four stages was derived. @*Conclusion@#The developed scale represented nursing activities in comprehensive nursing care units. It also provided specific data regarding the time spent on nursing activities. Therefore, it is expected to contribute toward establishing appropriate nurse staffing strategies to provide quality patient care.

The Effects of Clinical Practice Stress and Resilience on Nursing Students’ Academic Burnout / 의학교육논단

The high degree of academic burnout experienced during academic life indicates that job skill levels during the first year following graduation are low, and the correlation with turnover intention is high. We investigated the effects of clinical practice stress and resilience on nursing students’ burnout, and searched for factors that can prevent or control burnout. We recruited a convenience sample of 202 nursing students. Academic burnout, general characteristics, clinical practice stress, and resilience were assessed via self-reported questionnaires. The mean total score of academic burnout was 44.0 points; exhaustion was the highest at 18.5 points, inefficacy was 15.9 points, and cynicism was 9.6 points. High levels of clinical practice stress affected academic burnout (β=0.194, p=0.003), while high resilience was a factor that lowered the degree of academic burnout (β=-0.449, p<0.001). Based on our results, factors affecting students’ experiences of academic burnout were clinical practice stress and resilience. We therefore propose the implementation of a new curriculum aimed at increasing satisfaction with the major, reducing clinical practice stress, and increasing resilience, including an efficient peer mentoring program for clinical practice.

Prevalence of Sleep Disturbance in Korean University Students: A Systematic Review and Meta-Analysis

Background@#This systematic review and meta-analysis aimed at investigating the current status and prevalence of sleep disturbance in Korean university students and provide evidence to develop appropriate strategies for improving sleep disturbance. @*Methods@#Pooled prevalence of sleep disturbance in Korean university students was assessed using PubMed, CINAHL, Research Information Sharing Service, National Assembly Library, Korean studies Information Service System, and Korea Citation Index databases. A total of 1,843 studies were retrieved from the literature search, and 14 studies were included in the analysis. Statistical analysis was performed using comprehensive meta-analysis software. @*Results@#The overall pooled prevalence was 48.9% (95% confidence interval [CI], 41.6-56.3%). Subgroup analyses revealed that the pooled prevalence rates were 59.2% (95% CI, 38.8-50.7%) in the Pittsburgh Sleep Quality Index (PSQI)-based and 26.0% (95% CI, 19.5-33.9%) in non-PSQI-based studies, 23.2% (95% CI, 15.6-33.1%) in low-quality and 56.9% (95% CI, 49.3-64.2%) in moderate-quality studies, 35.6% (95% CI, 33.4-37.8%) in studies published before 2010 and 51.4% (95% CI, 42.9-59.8%) in studies published since 2011. @*Conclusions@#The prevalence of sleep disturbance is higher in university students. Therefore, further studies are needed to identify sleep problems of university students and gain future-oriented insights to develop mediation strategies.

Using the Angoff method to set a standard on mock exams for the Korean Nursing Licensing Examination / 보건의료교육평가

Purpose@#This study explored the possibility of using the Angoff method, in which panel experts determine the cut score of an exam, for the Korean Nursing Licensing Examination (KNLE). Two mock exams for the KNLE were analyzed. The Angoff standard setting procedure was conducted and the results were analyzed. We also aimed to examine the procedural validity of applying the Angoff method in this context. @*Methods@#For both mock exams, we set a pass-fail cut score using the Angoff method. The standard setting panel consisted of 16 nursing professors. After the Angoff procedure, the procedural validity of establishing the standard was evaluated by investigating the responses of the standard setters. @*Results@#The descriptions of the minimally competent person for the KNLE were presented at the levels of general and subject performance. The cut scores of first and second mock exams were 74.4 and 76.8, respectively. These were higher than the traditional cut score (60% of the total score of the KNLE). The panel survey showed very positive responses, with scores higher than 4 out of 5 points on a Likert scale. @*Conclusion@#The scores calculated for both mock tests were similar, and were much higher than the existing cut scores. In the second simulation, the standard deviation of the Angoff rating was lower than in the first simulation. According to the survey results, procedural validity was acceptable, as shown by a high level of confidence. The results show that determining cut scores by an expert panel is an applicable method.

Factors Related to Persistent Postoperative Pain after Cardiac Surgery: A Systematic Review and Meta-Analysis

Purpose@#This study aimed at identifying factors related to persistent postoperative pain after cardiac surgery and estimating their effect sizes. @*Methods@#The literature search and selection was conducted in four different databases (CINAHL, Cochrane Library, PubMed, and PQDT) using the Preferred Reporting Items for Systematic Review and Meta-Analysis Statement. A total of 14 studies met the inclusion criteria and were systematically reviewed. For the meta-analysis, R was used to analyze 30 effect sizes of for both individual and operative factors as well as publication biases from a total of nine studies. @*Results@#The meta-analysis revealed that persistent postoperative pain after cardiac surgery was related to one individual factor (gender) and two operative factors (acute postoperative pain and use of the internal mammary artery). Operative factors (OR=5.26) had a larger effect size than individual factors (OR=1.53). @*Conclusion@#Female gender, acute pain after surgery, and use of the internal mammary artery are related factors to persistent postoperative pain. The development of interventions focusing on modifiable related factors, such as acute postoperative pain, may help to minimize or prevent PPP after cardiac surgery.

Nurses and Nursing Students' Recognition of Good Instruction

PURPOSE@#The purpose of this study was to identify and assess from nursing students and nurses in the clinical field what constitute good instruction, through the review of nursing students' opinions and clinical field demands.@*METHODS@#The study design was used Creswell's exploratory sequential design by collecting and analyzing qualitative data obtained from interviews and then analysis of quantitative data. The participations were 79 seniors in nursing schools and 85 nurses with less than three years of clinical experience. The data were collected through individual interviews and analyzed based on Elo and Kyngäs's content analysis method. The quantitative data were collected using the questionnaire developed based on qualitative results and analyzed by SPSS 23.0 program and Importance Performance Analysis (IPA).@*RESULTS@#The results showed that IPA extracted seven items with high importance but low satisfaction: “nursing fads and trends,”“teacher-learner communication and reflection,”“materials used in clinical settings such as monitoring results and test results,”“special presentations by experienced practitioners,”“instruction assures learners' comprehension,”“accurate and detailed evaluation standards” and “feedback on homework and exam.”@*CONCLUSION@#The factors comprising good instruction were verified, and the necessity for additional efforts to improve high importance and low performance factors was noted. Therefore, this study can serve as a guide for nursing education facilities and educators in developing of a thorough education system with excellent instruction designed to achieve an ideal nursing education.

Nurses and Nursing Students' Recognition of Good Instruction / 간호학회지

PURPOSE: The purpose of this study was to identify and assess from nursing students and nurses in the clinical field what constitute good instruction, through the review of nursing students' opinions and clinical field demands.METHODS: The study design was used Creswell's exploratory sequential design by collecting and analyzing qualitative data obtained from interviews and then analysis of quantitative data. The participations were 79 seniors in nursing schools and 85 nurses with less than three years of clinical experience. The data were collected through individual interviews and analyzed based on Elo and Kyngäs's content analysis method. The quantitative data were collected using the questionnaire developed based on qualitative results and analyzed by SPSS 23.0 program and Importance Performance Analysis (IPA).RESULTS: The results showed that IPA extracted seven items with high importance but low satisfaction: “nursing fads and trends,” “teacher-learner communication and reflection,” “materials used in clinical settings such as monitoring results and test results,” “special presentations by experienced practitioners,” “instruction assures learners' comprehension,” “accurate and detailed evaluation standards” and “feedback on homework and exam.”CONCLUSION: The factors comprising good instruction were verified, and the necessity for additional efforts to improve high importance and low performance factors was noted. Therefore, this study can serve as a guide for nursing education facilities and educators in developing of a thorough education system with excellent instruction designed to achieve an ideal nursing education.

Nurses and Nursing Students' Recognition of Good Instruction

PURPOSE@#The purpose of this study was to identify and assess from nursing students and nurses in the clinical field what constitute good instruction, through the review of nursing students' opinions and clinical field demands.@*METHODS@#The study design was used Creswell's exploratory sequential design by collecting and analyzing qualitative data obtained from interviews and then analysis of quantitative data. The participations were 79 seniors in nursing schools and 85 nurses with less than three years of clinical experience. The data were collected through individual interviews and analyzed based on Elo and Kyngäs's content analysis method. The quantitative data were collected using the questionnaire developed based on qualitative results and analyzed by SPSS 23.0 program and Importance Performance Analysis (IPA).@*RESULTS@#The results showed that IPA extracted seven items with high importance but low satisfaction: “nursing fads and trends,”“teacher-learner communication and reflection,”“materials used in clinical settings such as monitoring results and test results,”“special presentations by experienced practitioners,”“instruction assures learners' comprehension,”“accurate and detailed evaluation standards” and “feedback on homework and exam.”@*CONCLUSION@#The factors comprising good instruction were verified, and the necessity for additional efforts to improve high importance and low performance factors was noted. Therefore, this study can serve as a guide for nursing education facilities and educators in developing of a thorough education system with excellent instruction designed to achieve an ideal nursing education.

Development of Handoff Education Program using SBAR for Nursing Students and Its Effect on Self-efficacy, Communication Ability and Clinical Performance Ability / 기본간호학회지

PURPOSE: This study was conducted to develop a handoff education program for nursing students and examine the effects of it on nursing students'self-efficacy, communication ability, and clinical performance ability. METHODS: A quasi-experimental design was used with a nonequivalent control group pretest-posttest method. The experimental group (n=31) received handoff education using SBAR; the control group (n=31) received non-SBAR handoff education. Self-efficacy, communication ability, clinical performance ability were measured to evaluate the effects of the program. RESULTS: The experimental group showed significant improvements in self-efficacy (p<.001), and communication ability (p=.025) compared to the control group. However, there was no significant difference in the clinical performance ability between the groups (p=.618). CONCLUSION: The results indicate that the handoff education program using SBAR is effective in improving nursing students'self-efficacy and communication ability.

Survey on the Education System for New Graduate Nurses in Hospitals: Focusing on the Preceptorship / 의학교육논단

The purpose of this study was to identify the current status of the new graduate nurses' education system, to establish guidelines for the education of new graduate nurses, and to provide dates for the improvement of the education system. Eighty-nine hospitals participated in the survey from July to August 2018. The questionnaires consisted of 24 items including general characteristics, new graduate nurses' education system, operation of nursing education teams, and preceptorship programs. The average duration of education/training for new graduate nurses was 57.3 days, and 26.6%–58.5% of general hospitals, hospitals, and long-term care hospitals had less than 30 days of new graduate nurses education/training, which is shorter than the education/training period of tertiary hospitals. There were new nursing education guidelines in 88.8% of all medical institutions and 58.6% of them had nursing education teams. Most of the personnel in charge of nursing education were not dedicated to education. A total of 87.6% of the all participating medical institutions had preceptorship programs, while 23.1%–33.3% of hospitals and long-term care hospitals did not. The breakdown of preceptorship programs showed 68.4% as “preceptor and preceptee are in charge of one team, and preceptor is teaching preceptee,” and 19.7% were “preceptor and preceptee are in charge of each team, and preceptor is teaching preceptee at the same time.” These results show that standardization and management of new graduate nurses' education programs is necessary. For the standardization and management of new graduate nurses' education programs, joint efforts of nurses' associations and support from the government should be encouraged.

Work-related Characteristics and Sleep Quality of Nurses in Comprehensive Nursing Care Units of Small-medium Sized Hospitals / 기본간호학회지

PURPOSE@#The purpose of this study was to examine the sleep quality of nurses in the comprehensive nursing care units of small-medium sized hospitals, and general and work-related characteristics associated with sleep quality of nurses.@*METHODS@#Participants were 312 nurses in comprehensive nursing care units of eight small and medium hospitals. The data were collected between June and August, 2018. A survey questionnaire including, sleep quality, general, and work-related characteristics of nurses was used. The data were analyzed using SPSS/WIN 23.0 program with descriptive statistics, independent t-test, and χ² test. Logistic regression analyses were used to identify factors associated with sleep quality.@*RESULTS@#The average score for sleep quality was 8.58±3.18 (0~21). Using a cut-off point of 8.5, 51.9% were poor sleepers. Sleep quality was associated with age (Odds Ratio [OR]=0.93, 95% Confidence Interval [CI]=0.88~0.99).@*CONCLUSION@#Age was identified as a factor associated with sleep quality among nurses in the comprehensive nursing care units at small and medium sized hospitals. Researchers and nurse administrators need to develop and provide strategies to improve young nurses' sleep quality.

The Relationship among Attitudes toward the Withdrawal of Life-sustaining Treatment, Death Anxiety, and Death Acceptance among Hospitalized Elderly Cancer Patients

PURPOSE: The purpose of this study was to identify the relationship between attitudes toward the withdrawal of life-sustaining treatment, death anxiety and death acceptance among hospitalized cancer patients who were at least 65 years old. METHODS: This study adopted a descriptive study design. Data were collected from 128 patients diagnosed with cancer. The instruments used were the Attitudes toward Life-sustaining Treatment Scale, Death Anxiety Scale and modified versions of the Death Attitude Profile-Revised (DAP-R) questionnaire. RESULTS: The mean score for the subjects' attitudes toward the withdrawal of life-sustaining treatment was 3.48±0.50 out of 5. Death anxiety was reported at 2.53±0.54 out of 4. Death acceptance was reported at 4.10±1.20 out of 7. There was a significant negative correlation between the subjects' attitudes toward the withdrawal of life-sustaining treatment and death anxiety (r=−.21, p=.018), however there was no statistically significant correlation between the subjects' attitude towards the withdrawal of life-sustaining treatment and death acceptance (r=−.07, p=.462) CONCLUSION: The more positive elderly cancer patients are about the withdrawal of life-sustaining treatment, the lower their death anxiety is. This finding can help nurses with patient care towards the end of life by considering the relationship between death anxiety and their attitudes toward the withdrawal of life-sustaining treatment.

Effects of Academic Resilience and Interpersonal Competence on the Happiness of Nursing Students / 의학교육논단

The purpose of this study was to investigate the effects of academic resilience and interpersonal competence on the happiness of nursing students. A descriptive design was used to study 158 nursing students in nursing school through convenience sampling. IBM SPSS ver. 23.0 (IBM Corp., Armonk, NY, USA) was used to analyze data for descriptive statistics, t-test, analysis of variance, Tukey post hoc test, Pearson's correlations, and multiple regressions. The results showed that the level of nursing students' happiness was lower than that of college students in other majors, but academic resilience and interpersonal competence among nursing students were relatively high. Nursing students' happiness was positively correlated with academic resilience and interpersonal competence. The factors affecting happiness were academic resilience (β=0.459, p < 0.001), satisfaction with major (β=0.272, p=0.006), perceived subjective health status (β=0.223, p=0.013), and interpersonal competence (β=0.185, p=0.003). Explained variance for happiness was 56.4%, and academic resilience was the most influential factor in the happiness of nursing students. Nursing students are caring human beings and should be able to pursue a happy life; therefore, it is necessary to improve satisfaction levels with the nursing major, guide students to excel in their academic achievement, prepare health education programs, and design curriculum that inspires confidence in interpersonal relationships.

Individual and School Factors Affecting Critical Thinking Ability among Nursing Students / 의학교육논단

The purpose of this study was to investigate factors associated with the critical thinking ability of nursing students at the individual and school levels. The study adopted a descriptive design and recruited 465 nursing students from four nursing schools from November 2014 to September 2015 through convenience sampling. The Clinical Critical Thinking Skill Test was used to measure critical thinking ability, and the data were analyzed with the SAS ver. 9.4 program (SAS Institute Inc., Cary, NC, USA) for descriptive statistics, t-test, analysis of variance, and multi-level model. The results showed that clinical practicum experience (β=−0.72, p=0.025), taking critical thinking courses (β=0.63, p=0.010), and taking simulation courses (β=0.56, p=0.035) improved critical thinking ability in the individual level model. In the school level model, the interaction effect between the years of clinical practice done by the student and the presence of full-time clinical instructors was significant (β=1.29, p=0.011). These results suggest that critical thinking ability improves with the more years of clinical practice individual nursing students have, and this improvement is greater with the presence of full-time clinical instructors in the school. Therefore, it is recommended that nursing students undergo critical thinking and simulation courses to develop their critical thinking ability, and dedicated clinical instructors in nursing schools should play a vital role.

Depression in Patients with Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis

BACKGROUND: Symptoms of subclinical hypothyroidism include depression, memory loss, myocardial contractility disorder, lipid metabolic disorder, and atherosclerosis. However, the relationship between subclinical hypothyroidism and depression has not been consistent. Therefore, the purpose of this study was to provide the scientific evidence for the relationship between subclinical hypothyroidism and depression. METHODS: This study was a meta-analysis of depression in subjects with subclinical hypothyroidism. The search engine of PubMed, EBSCO, ScienceDirect, and RISS was used to search the studies published since the 1990s. A total of 176 documents were retrieved from the literature search, and finally 10 studies were included in the analysis. Statistical analysis of effect sizes was performed using Comprehensive Meta-Analysis software version 2.2.064. RESULTS: Of the 10 studies, five studies reported that depression was associated with subclinical hypothyroidism. Two of these studies were on women and two were on the elderly. The effect size of depression in patients with subclinical hypothyroidism was 3.46 (95% confidence interval 0.20–0.74, P=0.001), and the subclinical hypothyroidism was significantly associated with depression. CONCLUSIONS: This study showed that subclinical hypothyroidism is associated with depression. The results also suggest the need for regular screening of depressive symptoms of patients with subclinical hypothyroidism. Especially, elderly and women with subclinical hypothyroidism may be the main targets of depressive symptom.

Depression in Patients with Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis

BACKGROUND@#Symptoms of subclinical hypothyroidism include depression, memory loss, myocardial contractility disorder, lipid metabolic disorder, and atherosclerosis. However, the relationship between subclinical hypothyroidism and depression has not been consistent. Therefore, the purpose of this study was to provide the scientific evidence for the relationship between subclinical hypothyroidism and depression.@*METHODS@#This study was a meta-analysis of depression in subjects with subclinical hypothyroidism. The search engine of PubMed, EBSCO, ScienceDirect, and RISS was used to search the studies published since the 1990s. A total of 176 documents were retrieved from the literature search, and finally 10 studies were included in the analysis. Statistical analysis of effect sizes was performed using Comprehensive Meta-Analysis software version 2.2.064.@*RESULTS@#Of the 10 studies, five studies reported that depression was associated with subclinical hypothyroidism. Two of these studies were on women and two were on the elderly. The effect size of depression in patients with subclinical hypothyroidism was 3.46 (95% confidence interval 0.20–0.74, P=0.001), and the subclinical hypothyroidism was significantly associated with depression.@*CONCLUSIONS@#This study showed that subclinical hypothyroidism is associated with depression. The results also suggest the need for regular screening of depressive symptoms of patients with subclinical hypothyroidism. Especially, elderly and women with subclinical hypothyroidism may be the main targets of depressive symptom.