Influences of Type D Personality, Positive Psychological Capital, and Emotional Labor on the Burnout of Psychiatric Nurses / 정신간호학회지

Purpose@#The purpose of this study was to examine the relationships between type D personality, positive psychological capital, emotional labor, and burnout in psychiatric nurses. @*Methods@#The participants were 187 psychiatric nurses from 12 mental health hospitals in South Korea selected through convenience sampling. Data were collected July-August 2019 through self-reporting questionnaires. @*Results@#Burnout significantly correlated with emotional labor, and positive psychological capital. Emotional labor, positive psychological capital, and type D personality were significant factors, explaining approximately 65.6% of the variance in burnouts. @*Conclusion@#Based on these results, emphasizing the importance of understanding emotional labor and careful management of type D personality, an intervention program focusing on reinforcing positive psychological capital is needed to prevent burnout.

Cohort Profile: The Cardiovascular and Metabolic Diseases Etiology Research Center Cohort in Korea

Mortalities from cardiovascular disease in Korea have decreased markedly over the past three decades. The major cardiovascular and metabolic risk factors, however, remain prevalent, and their burden on health is large. The Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) planned a cohort study in order to identify novel risk factors and to develop evidence-based prevention strategies of cardiovascular and metabolic diseases. The CMERC deliberately designed two prospective cohorts, a community-based general population cohort (the CMERC cohort) and its sister cohort (a hospital-based high-risk patient cohort), covering a broad spectrum of cardiovascular and metabolic diseases. This paper describes the CMERC cohort study of community-dwelling adults aged 30 to 64 years. A total of 8097 adults completed baseline measurement between 2013 and 2018. Baseline measurements assessed socio-demographic factors, medical history, health-related behaviors, psychological health, social network and support, anthropometry, body composition, and resting blood pressure and comprised electrocardiography, carotid artery ultrasonography, fasting blood analysis, and urinalysis. Both active follow-up through an annual telephone survey and a 5-year on-site health examination survey and passive follow-up through secondary data linkage with national databases, such as national death records, have been applied. Researchers interested in collaborative research may contact the corresponding author.

Effects of Nurse-Physician Collaboration on Nursing Performance and Organizational Commitment in Intensive Care Unit Nurses / 간호행정학회지

PURPOSE: This study was done to identify the effects of nurse-physician collaboration on nursing performance and organizational commitment in intensive care unit (ICU) nurses. METHODS: A cross-sectional survey was used and data were collected from 203 ICU nurses working in two advanced general hospitals and two general hospitals. Data were analyzed using descriptive statistics, independent t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients and Hierarchical multiple regression with SPSSWIN 23.0 program. RESULTS: The sub-domains of nursephysician collaboration were as follows: 3.77±0.51 for sharing of patient information, 3.36±0.65 for decision-making process on the cure or care, and 3.20±0.72 for relationship between nurse and physician. Nurse-physician collaboration was significantly positively correlated with nursing performance and organizational commitment. Regression analysis showed that nurse-physician collaboration explained an additional 24.9%p of nursing performance and an additional 13.4%p of organizational commitment. 'Sharing of patient information' and 'Relationship between nurse and physician' were significant predictors of nursing performance. 'Relationship between nurse and physician' was a significant predictor of organizational commitment. CONCLUSION: These results provide evidence that the collaboration between nurses and physicians should be enhanced in terms of sharing patient information and mutual respect, to improve nursing performance and organizational commitment of ICU nurses.

Effect of a Nursing Practice Environment on Nursing Job Performance and Organizational Commitment: Focused on the Mediating Effects of Job Embeddedness / 간호행정학회지

PURPOSE: The purpose of this study was to test the mediating effect of job embeddedness in the relationship between nursing practice environment on nursing job performance and organizational commitment. METHODS: For this study a descriptive design with survey method was utilized. Participants were 192 clinical nurses recruited from 2 hospitals in A, B city and J province in Korea. From June, 6 to 24, 2018, a questionnaire scale was used to collect the data. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation analysis, and liner regression analysis. RESULTS: There were significant positive relationships for nursing job performance and organizational commitment with nursing practice environment. In addition, job embeddedness had a full mediating role in the relationship between nursing practice environment and nursing job performance, and a partial mediation effect in nursing practice environment and organizational commitment. CONCLUSION: The purpose of this study was to identify the mediating effects of job embeddedness and to find ways to improve organizational commitment, which is a useful variable to predict performance outcomes, nurse job performance and job behavior of organizational members. Also, the study results can be used as basic data for nursing manpower management strategies.

Effects of Perceived Collaboration with Nurses and Physicians on Nursing Performance in Perioperative Nurses / 간호행정학회지

PURPOSE: The aim of this study was to identify effects of perceived nurse-nurse collaboration and nurse-physician collaboration on nursing performance in perioperative nurses. METHODS: A cross-sectional survey was used and data were collected in September 2016. Participants were 186 perioperative nurses from three advanced general hospitals and nine general hospitals. Data were analyzed using descriptive statistics, independent t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients and hierarchical multiple regression with the SPSS/WIN 23.0 program. RESULTS: The mean scores were for nurse-nurse collaboration, 2.92±0.28 out of 4, for nurse-physician collaboration, 3.29±0.65 out of 5, and for nursing performance, 3.85±0.47 out of 5. There were statistically significant positive correlations among nurse-nurse collaboration, nurse-physician collaboration, and nursing performance. Hierarchical multiple regression analysis revealed that nurse-nurse collaboration explained an additional 29%p of nursing performance. Shared processes, conflict management, and professionalism of nurse-nurse collaboration were statistically significant predictors of nursing performance. The nurse-physician collaboration explained an additional 3%p of nursing performance. Sharing of patient information was a statistically significant predictor of nursing performance. CONCLUSION: Findings indicate that intervention programs that integrate and strengthen shared processes, conflict management, professionalism, and sharing of patient information are useful to enhance nursing performance.

Effects of Family Stress on Family Adaptation to a Family Member with Mental Illness: Mediating Effects of Family Strengths and Perceived Stigma / 정신간호학회지

PURPOSE: The aim of this study was to identify the mediating effects of perceived stigma and family strength on the relationship between family stress and adaptation in family members of patients with mental illness. METHODS: Participants were 189 primary family caregivers of persons with mental illness in G city, C, G, and J provinces. Data were collected from May to June 2018 using the FILE (Family Inventory of Life Events and Changes), K-ISMI (Korean Version of Internalized Stigma of Mental Illness Scale), FAS III (Family Adaptability Scale III), and KFSS-II (Korea Family Strengths Scale). Collected data were analyzed with t-tests, one-way ANOVAs with Scheffé' test, Pearson's correlation coefficients, and PROCESS macro mediation analysis. Mediators were tested by calculating bias-corrected 95% confidence intervals using bootstrapping with 5,000 resampling. RESULTS: Family stress was directly associated with family adaptation. Family strengths had a partially mediating effect on the relationship between family stress and adaptation, but perceived stigma did not. CONCLUSION: Based on our study findings, developing a nursing intervention program focused on improving family strengths might be necessary to facilitate family members' successful adaptation to persons with mental illness.

Importance, Performance and Rates of Nurse Performance of Nursing Interventions in Long-term Care Hospitals / 간호행정학회지

PURPOSE: The purpose of this study was to identify the importance, performance and rates of nurses' performance of nursing interventions in long-term care hospitals. METHODS: A cross-sectional descriptive study was used and data were collected in 2015. Participants were 174 clinical nurses working in 14 long-term care hospitals. The collected data were analyzed using the SPSS/WIN 18.0. RESULTS: The nurses' perceived importance of nursing interventions was 4.48±0.51, and the degree of nursing intervention performance in long-term care hospitals was 3.97±1.07 out of 5. The rates of nursing interventions performed by nurses ranged from 33.9% to 99.4% with an average of 82.5%. There were statistically significant positive correlations among perceived importance, performance in hospitals, and rates for nurses' performance of nursing interventions (p<.001). CONCLUSION: The results indicate that interventions with a high degree of importance and performance could be the core nursing interventions in long-term care hospitals. These core nursing interventions should be included in education for nurses. These findings can be used in developing realistic guidelines and effective strategies for nurses and administrators to improve the quality of nursing and the status of nursing professionals in long-term care hospitals.

Structural Equation Modeling on Health-Related Quality of Life in Adults with Epilepsy

PURPOSE: This study aimed to identify variables influencing the health-related quality of life (HRQoL) of adults with epilepsy in order to establish a structural model and design an intervention strategy to improve patients' HRQoL. METHODS: The selected subjects were 212 patients with epilepsy aged between 18 and 70 years who were currently receiving treatment from hospital, general hospital, and clinic. They were surveyed using a structured questionnaire. RESULTS: The goodness of fit measures of the final hypothetical model were as follows: χ2/df=2.51, GFI=.91, AGFI=.90, CFI=.96, SRMR=.04, NFI=.93, and RMSEA=.08. The major variables influencing the HRQoL of adults with epilepsy were epilepsy self-efficacy, depression, social support, and side effects of anti-epileptic drugs (AEDs), which were significant in the mentioned order, whereas the duration of AEDs use and perceived stigma did not show any effects. Six variables accounted for 75.6% of HRQoL. Variables having a direct and total effect on the HRQoL of adults with epilepsy were the side effects of AEDs, social support, epilepsy self-efficacy, and depression, and those with an indirect effect were the side effects of AEDs and social support. CONCLUSION: It is necessary to accurately identify the side effects of AEDs in adults with epilepsy and accurately observe the physical changes caused by depression. In addition, it is imperative to establish an active and effective nursing intervention program to strengthen the self-efficacy of the patients and to improve their quality of life through social support provided by family members and medical professionals.

Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort: study protocol and results of the first 3 years of enrollment / 한국역학회지

Although the etiologies of cardiovascular disease (CVD) are widely understood, the goal of finding a globally effective solution for preventing CVD is unrealistic. Therefore, we aimed to conduct a community-based prospective study on the prevention and management of CVD in Korean adults. This study was designed to recruit 8,000 healthy adults over the course of 5 years. The baseline assessment includes a wide range of established CVD risk factors, including demographic characteristics, medical history, health behaviors, psychological conditions, body size and composition, blood pressure, the augmentation index, carotid ultrasonography, an electrocardiogram, and biochemical indicators, as well as some novel factors, such as social network characteristics, exposure to environmental pollutants, inflammatory markers, hemostatic markers, and immunosenescence markers. Annual telephone interviews and follow-up health examinations at 5-year intervals after the baseline assessment are planned to collect information on changes in health status and its determinants. Additionally, indirect follow-up using secondary data sources will be conducted to obtain information on health services utilization and death. So far, more than 6,000 adults have been enrolled during the first three and a half years, and almost all participants have been tracked by annual telephone follow-up surveys. The data have been uploaded to iCReaT, the clinical research information management system of the Korea National Institute of Health.

Factors Influencing Self-care in Elders with Hypertension Living at Home / 기본간호학회지

PURPOSE: The purpose of the study was to identify the level of resilience, autonomous motivation, depression and self-care and their correlates in elders with hypertension. METHODS: The participants were 200 elders with hypertension living in J, I, and K city. Data were collected through face-to-face interviews using the Resilience Scale, Treatment Self Regulation Questionnaire, Short Form Geriatric Depression Scale, and Hypertension Self-care Scale. RESULTS: Total scores for resilience, autonomous motivation, depression, and self-care were 109.65± 20.78, 38.18±5.99, 8.33±2.61, and 52.06±6.94, respectively. Autonomous motivation, income, acceptance of self and life, resilience, experience of hypertension education, and gender were verified as factors influencing self-care. These factors accounted for 51.6% of self-care. CONCLUSION: Understanding these factors is essential for developing effective interventions to improve self-care in elders with hypertension.

Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort: study protocol and results of the first 3 years of enrollment / 한국역학회지

Although the etiologies of cardiovascular disease (CVD) are widely understood, the goal of finding a globally effective solution for preventing CVD is unrealistic. Therefore, we aimed to conduct a community-based prospective study on the prevention and management of CVD in Korean adults. This study was designed to recruit 8,000 healthy adults over the course of 5 years. The baseline assessment includes a wide range of established CVD risk factors, including demographic characteristics, medical history, health behaviors, psychological conditions, body size and composition, blood pressure, the augmentation index, carotid ultrasonography, an electrocardiogram, and biochemical indicators, as well as some novel factors, such as social network characteristics, exposure to environmental pollutants, inflammatory markers, hemostatic markers, and immunosenescence markers. Annual telephone interviews and follow-up health examinations at 5-year intervals after the baseline assessment are planned to collect information on changes in health status and its determinants. Additionally, indirect follow-up using secondary data sources will be conducted to obtain information on health services utilization and death. So far, more than 6,000 adults have been enrolled during the first three and a half years, and almost all participants have been tracked by annual telephone follow-up surveys. The data have been uploaded to iCReaT, the clinical research information management system of the Korea National Institute of Health.

Influence of Emotional Intelligence and Empathy on the Facilitative Communication Ability of Psychiatric Nurses / 정신간호학회지

PURPOSE: The purpose of this study was to examine the relationship among emotional intelligence, empathy and facilitative communication ability of psychiatric nurses. METHODS: Participants were 173 conveniently selected psychiatric nurses from 10 hospitals in Korea. Data were collected from June to September, 2015 through self-reported questionnaires. RESULTS: Facilitative communication ability was significantly different depending on educational level (t=6.06, p=.003). There were significant positive correlations between emotional intelligence and facilitative communication ability (r=.61, p<.001), and also between empathy and facilitative communication ability (r=.63, p<.001). In the multiple regression, except for education level, emotional intelligence (β=.17, p=.003) and empathy (β=.21, p=.000) explained 38.2% of the variance in facilitative communication ability. CONCLUSION: These findings indicate that emotional intelligence and empathy are important factors in psychiatric nurses' facilitative communication ability. Accordingly, to improve the facilitative communication ability of psychiatric nurses, educational programs based on development of emotional intelligence and empathy are necessary.

A Study on Disaster Preparedness Competency in Public Health Center Workers / 한국간호교육학회지

PURPOSE: The purpose of this study was to explore the levels of disaster preparedness competency in public health workers and identify influential factors on disaster preparedness competency. METHODS: The data was collected through self-report questionnaires from a convenience sample of 281 public health workers in 2014 in Korea. The data was analyzed using descriptive statistics, t-test, ANOVA, and multiple regression. RESULTS: The mean disaster preparedness competency score was 2.77 and the mean disaster educational needs score was 4.01. Disaster preparedness competency had a statistically significant difference by gender, position, experience of disaster education in workplace, and experience of BLS education. As a result of the multiple regression analysis, disaster preparedness competency accounted for 11.6% of the variance by gender, experience of disaster education in workplace, and experience of BLS education. CONCLUSION: The results of this study reveal that gender, strengthening education of disasters in the workplace, and education of BLS should be taken into consideration and integrated when developing an effective educational program in order to enhance disaster preparedness competency in public health workers.

Effect of Human Rights Sensitivity and Social Distance on Attitude toward Mental Illness in Psychiatric Hospital Orderlies / 정신간호학회지

PURPOSE: The purpose of this study was to examine the effects of human rights sensitivity and social distance in psychiatric hospital orderlies on attitudes toward mental illness, including authoritarianism, benevolence, social restrictiveness, and community mental health ideology. METHODS: Participants were 201 psychiatric hospital orderlies working in one national mental hospital or one of 10 private mental hospitals. Data were collected from May 9 to June 22, 2016. Data were analyzed with descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficients and hierarchical multiple regression using the SPSS/WIN 21.0 program. RESULTS: Human rights sensitivity and social distance were statistically significant predictors for the attitude toward mental illness in psychiatric hospital orderlies. Hierarchical multiple regression analysis revealed that human rights sensitivity and social distance explained an additional 23% of authoritarianism, 16% of benevolence, 35% of social restrictiveness and 29% of community mental health ideology. CONCLUSION: These findings suggest that education programs to increase levels of human rights sensitivity and reduce the levels of social distance among psychiatric hospital orderlies would improve their attitude toward patients with the mental illness.

Serum 25-Hydroxyvitamin D Concentration Is Independently Inversely Associated with Insulin Resistance in the Healthy, Non-Obese Korean Population

BACKGROUND: We evaluated the associations between 25-hydroxyvitamin D (25(OH)D) concentrations in serum and insulin resistance in the healthy Korean population. METHODS: We conducted this cross-sectional analysis in 1,807 healthy Korean people (628 men and 1,179 women) aged 30 to 64 years in the Cardiovascular and Metabolic Disease Etiologic Research Center study. All participants were assessed for 25(OH)D, fasting glucose, and insulin levels, and completed a health examination and lifestyle questionnaire according to standard procedures. Insulin resistance was defined as the homeostasis model assessment insulin resistance higher than the 75 percentile. RESULTS: Compared to those in the highest tertile (≥14.3 ng/mL), the odds ratio (OR) for insulin resistance was 1.37 (95% confidence interval [CI], 1.01 to 1.86) for the 1st tertile (<9.7 ng/mL) and 1.19 (95% CI, 0.08 to 1.62) for the 2nd tertile (9.7 to 14.3 ng/mL) after adjusting for age, gender, waist circumference, alcohol consumption, smoking status, physical exercise, season, and cohort. After stratification of the subjects by adiposity, these associations remained only in non-obese subjects (lowest tertile vs. highest tertile, multivariable OR, 1.64; 95% CI, 1.05 to 2.56). CONCLUSION: Serum 25(OH)D has an independent inverse association with insulin resistance in the healthy, non-obese Korean population, even among people with vitamin D insufficiency.

Effects of Health Literacy and Knowledge on Diabetic Self-care in the Elderly with DM Living Alone

PURPOSE: The aim of this study was to evaluate the level of self-care adherence in the elderly with diabetes mellitus (DM) who have lived alone, and to investigate the association between health literacy, diabetic knowledge and self-care adherence. METHODS: Descriptive research using the cross-sectional approach was conducted. Data was collected by using a convenience sampling of 201 participants who aged sixty-five years old or more and have lived alone. Statistical analysis was conducted by using an independent t-test, one-way ANOVA, Scheffé test, Pearson correlation coefficient and stepwise multiple regression analysis. RESULTS: Mean scores of health literacy, diabetic knowledge and adherence of self-care were 4.41±3.54 points out of a possible 12, 6.22±2.55 points out of a possible 15, 58.56±17.28 points out of a possible 112, respectively. Adherence of self-care showed a statistical association with health literacy (r=.26, p<.001) and diabetic knowledge (r=.30, p<.001). Statistically significant factors in the regression model were monthly income, diabetic knowledge and exercise. CONCLUSION: The level of self-care adherence in the elderly with diabetes living alone was relatively low. Diabetic knowledge was an important factor to improve the level of self-care adherence for the elderly with diabetes living alone.

Inter-Arm Difference in Brachial Blood Pressure in the General Population of Koreans

BACKGROUND AND OBJECTIVES: We investigated the inter-arm difference in blood pressure of the general Korean population to identify associated factors. SUBJECTS AND METHODS: A total of 806 participants aged 30 to 64 years without history of major cardiovascular disease were analyzed in this cross-sectional study. They participated in the Cardiovascular and Metabolic Disease Etiology Research Center cohort study that began in 2013. Brachial blood pressure was measured simultaneously for both arms using an automated oscillometric device equipped with two cuffs in seated position. After five minutes of rest, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured three times. The average of the three measurements was used for analysis. Multivariate logistic regression models were used to identify factors associated with inter-arm differences in blood pressure. RESULTS: The mean inter-arm difference was 3.3 mmHg for SBP and 2.0 mmHg for DBP. Large inter-arm differences (≥10 mmHg) in SBP and in DBP were found in 3.7% and 0.9% of subjects, respectively. A large inter-arm difference in SBP was associated with mean SBP (p=0.002) and C-reactive protein (p=0.014) while a large inter-arm different in DBP was only associated with body mass index (p=0.015). Sex, age, and anti-hypertensive medication use were not associated with differences in inter-arm blood pressure. CONCLUSION: Large inter-arm difference in blood pressure is only present in a small portion of healthy Korean adults. Our findings suggest that high SBP, chronic inflammation, and obesity may be associated with larger difference in inter-arm blood pressure.

Comparison of Formulas for Calculating Low-density Lipoprotein Cholesterol in General Population and High-risk Patients with Cardiovascular Disease

BACKGROUND AND OBJECTIVES: Low-density lipoprotein cholesterol (LDL-C), an established cardiovascular risk factor, can be generally determined by calculation from total cholesterol, high-density lipoprotein cholesterol, and triglyceride concentrations. The aim of this study was to compare LDL-C estimations using various formulas with directly measured LDL-C in a community-based group and hospital-based group among the Korean population. SUBJECTS AND METHODS: A total of 1498 participants were classified into four groups according to triglyceride concentrations as follows: <100, 100–199, 200–299, and ≥300 mg/dL. LDL-C was calculated using the Friedewald, Chen, Vujovic, Hattori, de Cordova, and Anandaraja formulas and directly measured using a homogenous enzymatic method. Pearson's correlation coefficients, intraclass correlation coefficients (ICC), Passing & Bablok regression, and Bland-Altman plots were used to evaluate the performance of six formulas. RESULTS: The Friedewald formula had the highest accuracy (ICC=0.977; 95% confidence interval 0.974-0.979) of all the triglyceride ranges, while the Vujovic formula had the highest accuracy (ICC=0.876; 98.75% confidence interval 0.668–0.951) in people with triglycerides ≥300 mg/dL. The mean difference was the lowest for the Friedewald formula (0.5 mg/dL) and the percentage error was the lowest for the Vujovic formula (30.2%). However, underestimation of the LDL-C formulas increased with triglyceride concentrations. CONCLUSION: The accuracy of the LDL-C formulas varied considerably with differences in triglyceride concentrations. The Friedewald formula outperformed other formulas for estimating LDL-C against a direct measurement and the Vujovic formula was suitable for hypertriglyceridemic samples; it could be used as an alternative cost-effective tool to measure LDL-C when the direct measurement cannot be afforded.

Experiences of Ethical Issues and Needs for Ethics Education in Clinical Nurses / 간호행정학회지

PURPOSE: This study was done to identify the experiences of ethical issues and needs for ethics education in clinical nurses. METHODS: A cross-sectional survey was used and data were collected in 2013. Participants were 428 clinical nurses working in the general units of seven medical hospitals. The Ethical Issues in Clinical Practice Tool was used. Data analysis was performed using SPSS/WIN 19.0. RESULTS: 'Providing care with a possible risk to your health' was the most frequent and disturbing ethical problems for nurses. The highest helpful ethical topic was 'the patients' right, autonomy and informed consent'. The ethical issue experience was significantly different according to education level, work units, and type of employment. The necessity of ethics education was statistically different according to age, religion, level of education, duration of working as RN, position, shift type, and continuing education about nursing ethics. CONCLUSION: The results of this study show that nursing educators need to provide practical ethics education based on frequent ethical issues and helpful education topics. These findings can be used in developing effective education strategies for clinical nurses and nursing organizations to improve nurses' ethical decision-making abilities.

Effects of Age, Sex, and Menopausal Status on Blood Cholesterol Profile in the Korean Population

BACKGROUND AND OBJECTIVES: To investigate age-specific and sex-specific distributions of blood cholesterol in the general Korean population. SUBJECTS AND METHODS: We analyzed data for 8284 men and 9246 women aged > or =10 years who participated in the fifth (2010-2012) Korea National Health and Nutrition Examination Survey. Age-specific means, medians, and selected percentiles were calculated for men, premenopausal women, and postmenopausal women. RESULTS: Median total cholesterol (TC) level increased with age across all age groups, from 147 to 196 mg/dL in males and from 159 to 210 mg/dL in females. Triglyceride (TG) levels increased with age in females; however, in males, TG levels rapidly increased during young adulthood, peaked at 50-54 years, and then decreased. High density lipoprotein-cholesterol (HDL-C) levels were higher in females than in males and decreased with increasing age in both males and females. Low density lipoprotein-cholesterol (LDL-C) levels increased with age across all age groups, from 89 to 127 mg/dL in males and from 82 to 113 mg/dL in females. Lipoprotein-cholesterol fraction (TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, non-HDL-C) levels increased with age in females, but increased more rapidly in males during young adulthood and decreased after middle age. CONCLUSION: Blood cholesterol levels and lipoprotein-cholesterol fractions present different distributions by age, sex, and menopausal status.