Awareness of the Prevention of Work-Related Diseases among Farmers - Based on Qualitative Research Methods / 農村醫學 地域保健

Objective@#This study was conducted to investigate the awareness of work-related disease prevention of farmers.Method: As a research method, a qualitative focus group interview was conducted in 18 participants. @*Results@#Prevention and management services for work-related diseases of farmers mostly are based on research from other fields and so are not highly effective because their content is not relevant to agricultural work. It has been suggested that such program designers be required to have some appropriate related knowledge, and that incentives and a certification system for participation in such education be established. To analyze work-related diseases of farmers, fields of prevention, diagnosis, treatment, and rehabilitation should be created. They demanded the designation of hospitals and the actualization of compensation for farmers' safety insurance. The work-related diseases to address were include musculoskeletal diseases, pesticide poisoning-related diseases (cardiovascular disease, respiratory disease), psychiatric diseases such as depression, and allergic diseases. However, this must have been the result of the harmful factors they felt during agricultural work. And for farmer patients diagnosed with work-related diseases, it was said to strengthen farmer safety insurance. @*Conclusion@#In order to increase the safely and health effects of agricultural work, it is necessary to prevent and manage work-related diseases of farmers. Projects should be developed in consideration of cultural and economic barriers of farmers and the characteristics of the work.

Associations between Frailty in Older Adults and Malnutrition in Rural Areas: 2019 Updated Version of the Asian Working Group for Sarcopenia

Purpose@#The purpose of this study was to evaluate the prevalence of frailty among an older adult population living in rural communities and to determine if frailty is associated with nutritional status after adjusting for sarcopenia and depression. @*Materials and Methods@#This research used baseline data from the Namgaram-2 study. Frailty was evaluated using the Kaigo-Yobo checklist in an older Korean population. The nutritional statuses of older people were measured using the Korean version of the mini nutritional assessment (MNA). The recent criteria of the Asian Working Group for Sarcopenia were applied for diagnosis of sarcopenia, and depression was assessed using the Geriatric Depression Scale-Short Form. @*Results@#The prevalence of frailty was 18.8% (male: 9.6%; female: 23.4%) and was significantly higher in individuals in their 80s [male, 35.3% (p<0.001); female, 42.3% (p<0.001)], those of poor economic status [male, 18.2% (p=0.012); female, 34.9% (p<0.001)], those with hypertension [female, 27.7% (p=0.008)], those with sarcopenia [male, 34.1% (p<0.001); female, 37.2% (p<0.001)], those with depression [male, 46.4% (p<0.001); female, 51.7% (p<0.001)], and those at high risk of malnutrition [male, 44.4% (p<0.001); female, 51.7% (p<0.001)]. After adjusting for demographic variables, including hypertension, diabetes, sarcopenia and depression, frailty was significantly associated with nutritional status [male: odds ratio (OR)=6.73, 95% confidence interval (CI), 1.84–24.65; female: OR=4.83, 95% CI, 2.88–8.11]. @*Conclusion@#For older adults, MNA is a suitable tool of use in assessing both nutritional status and frailty. Moreover, the nutritional status of older adults appears to be associated with frailty, even after corrections for physical and psychological function.

Barriers related to Walking Activity according to the Age Group of Rural residents / 農村醫學 地域保健

Objective@#This study aimed to report the relationship between walking activity and perceived physical activity barriers after classifying the age group(≤64, 65-74, ≥75). @*Methods@#The subjects were conducted on 1500 residents of two areas, and the walking activity was defined as five or more times a week, 10 minutes or more at a time, and 30 minutes or more per day. Perceived physical activity barriers were lack of time, lack of social support, lack of energy, lack of willpower, and fear of falling. @*Results@#In the group under 64 year, the lack of time (exp(B)=0.819, p=0.002) and the lack of willpower (exp(B)=0.656, p<0.001) were significantly associated. In the 65-74 year old group, the lack of willpower (exp(B)=0.714, p<0.001) and fear of falling (exp(B)=0.787, p=0.003) were a significant association. In the group aged 75 years and over, lack ofwill power (exp(B)=0.734, p<0.001) and fear of falling (exp(B)=0.807, p=0.003) were significantly associated. @*Conclusion@#In order to solve the lack of willpower and lack of time, a walking activity should be performed together at a certain time in the village, and the elderly in the late ages should reduce the fear of falling by performing a fall prevention exercise in parallel.

The Association of Perceived Neighborhood Walkability and Environmental Pollution With Frailty Among Community-dwelling Older Adults in Korean Rural Areas: A Cross-sectional Study / 예방의학회지

OBJECTIVES@#The aim of this study was to evaluate the associations of frailty with perceived neighborhood walkability and environmental pollution among community-dwelling older adults in rural areas.@*METHODS@#The participants were 808 community-dwelling men and women aged 65 years and older in 2 rural towns. Comprehensive information, including demographics, socioeconomic status, grip strength, polypharmacy, perceived neighborhood environment (specifically, walkability and environmental pollution), and frailty, was collected from participants using face-to-face interviews conducted between June and August 2018. Perceived neighborhood walkability was measured using 20 items that were selected and revised from the Neighborhood Environment Walkability Scale, the Neighborhood Walkability Checklist from the National Heart Foundation of Australia, and the Physical Activity Neighborhood Environment Survey. The Kaigo-Yobo Checklist was used to assess participants’ frailty.@*RESULTS@#The overall prevalence of frailty in this community-dwelling population was 35.5%. Sex, age, cohabitation status, educational attainment, employment status, grip strength, and polypharmacy were significantly associated with frailty. In the logistic regression analysis, frailty was associated with low perceived neighborhood walkability (adjusted odds ratio [aOR], 0.881; 95% confidence interval [CI], 0.833 to 0.932; p<0.001) and severe perceived neighborhood environmental pollution (aOR, 1.052; 95% CI, 1.017 to 1.087; p=0.003) after adjusting for sex, age, cohabitation status, educational attainment, employment status, monthly income, grip strength, and polypharmacy.@*CONCLUSIONS@#More studies are warranted to establish causal relationships between walkability and environmental pollution and frailty.

Oral Impact on Daily Performance and Happiness related to Orthodontic Treatment of Some Middle and High School Students with Malocclusion / 農村醫學 地域保健

OBJECTIVES: This study investigated whether the impacts of orthodontic treatment of malocclusion on oral health-related quality of life and happiness are positive with middle and high school students. METHODS: Subjects were 157 orthodontic patients and 83 non-orthodontic in malocclusion patients. Questionnaires were collected with the self-administered method, and consisted of the general characteristics, self-esteem, social support appraisal scale(friends, family, teacher), Oral Impact on Daily Performance (OIDP) and oxford happiness questionnaire (OHQ). RESULTS: A physical factor was lower in the orthodontic treatment group (5.8±2.48) than in the non-orthodontic treatment group (7.7±2.10)(p<0.001), and OIDP was lower in the orthodontic treatment group (7.0±1.79) than in the non-orthodontic treatment group (7.8±1.80)(p=0.002). A feeling of happiness was higher in the orthodontic treatment group(4.6±0.81) than in the orthodontic treatment group (4.3±0.89) (p=0.009). As results of multiple regression analysis, OIDP was affected of orthodontic treatment(β=−0.0222, p=0.001) and OHP was affected of orthodontic treatment(β=0.087, p=0.030) and OIDP(β=0.116, p=0.003). CONCLUSIONS: Orthodontic treatment of malocclusion may positively affects happiness in teenager. Support policy for orthodontic treatment of malocclusion is necessary for adolescents.

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

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

The Association between Hopelessness, Social Support and Community Integration and Depression among Elderly Living Alone / 農村醫學 地域保健

OBJECTIVES: This study was performed to investigate the association between hopelessness, social support and community integration, and depression. METHODS: We analyzed data from a questionnaire administered to subjects aged 65 years or older living alone for a 2015 community mental health project in Gyeongnam S city. We used a correlation analysis and a hierarchical regression analysis to identify factors that affect depression. RESULTS: When controlling for socio-demographic factors, hopelessness and community integration had significant effects on depression. That is, the higher the hopelessness (B=0.768, p<.001) and the lower the community integration (B=-0.163, p=.012), the higher the depression in elderly living alone . CONCLUSIONS: There is a need for approaches at both the individual and social levels that consider and improve measures to prevent and reduce depression. Moreover, it is especially necessary to enhance community integration.

A Validation of Dietary Self-Efficacy Questionnaire in Hemodialysis Patients

BACKGROUND: This study was performed to develop a dietary self-efficacy questionnaire and to determine how dietary self-efficacy is related to selected biochemical markers and health-related quality of life in hemodialysis patients. METHODS: Participants included 172 patients who had been participating in a dialysis program for at least 6 months at two teaching hospitals. A questionnaire was used to assess socio-demographic factors, dialysis-related factors, dietary self-efficacy, and kidney disease quality of life (KDQOL). Serum levels of potassium and phosphorus and interdialytic weight gain were also measured. RESULTS: The internal reliability of dietary self-efficacy was 0.944 (Cronbach's alpha). Principal component analysis resulted in two factors, situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice. The correlation analysis showed a significant association between situational self-efficacy of compliance with dietary guidelines and serum potassium and KIDQOL. The average scores of situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice in the participants were 3.52+/-0.72 and 3.61+/-0.71 respectively. Multiple linear regression analysis showed that the situational self-efficacy of compliance with dietary guidelines was significantly associated with serum potassium level and KDQOL and self-efficacy of food choice was significantly associated with KDQOL. CONCLUSIONS: Based on our results, the developed dietary self-efficacy questionnaire may be a suitable survey tool for hemodialysis patients, which can play a role in predicting clinical indicators of patient and health-related quality of life. We recommend further research into clarifying whether the positive effects of increased dietary self-efficacy is maintained in long-term dialysis patients.