The Psychological Burden of COVID-19Stigma: Evaluation of the Mental Health of Isolated Mild Condition COVID-19 Patients

Background@#The objective of this article is to assess the mental health issues of the mild condition coronavirus disease 2019 (COVID-19) patients admitted to a community treatment center (CTC) in Korea. @*Methods@#A total of 107 patients admitted to a CTC were included as the study population, and their mental health problems including depression (patient health questionnaire-9), anxiety (generalized anxiety disorder scale-7), post-traumatic stress disorder (PTSD) (PTSD checklist-5) and somatic symptoms (by patient health questionnaire-15) were evaluated every week during their stay. The stigma related to COVID-19 infection was evaluated with an adjusted version of the Middle East respiratory syndrome (MERS) stigma scale. @*Results@#During the first week of isolation, the prevalence of more-than-moderate depression was 24.3%, more-than-moderate anxiety was 14.9%, more-than-moderate somatic symptoms was 36.5% and possible PTSD was 5.6% of total population. For depression and anxiety, previous psychiatric history and stigma of COVID-19 infection were significant risk factors. For PTSD, previous psychiatric history and stigma of COVID-19 infection as well as total duration of isolation were found to be significant risk factors. Prevalence of depression, anxiety and possible PTSD remained similar across the four weeks of observations, though the prevalence of severe depression, increased after four weeks of stay. Somatic symptoms seemed to decrease during their stay. @*Conclusion@#The results suggest that social mitigation of COVID-19 related stigma, as well as care of patients with pre-existing mental health problems are important mental health measures during this crisis period. It is also important that clinical guidelines and public health policies be well balanced over the protection of the public and those quarantined to minimize the negative psychosocial consequences from isolation of the patients.

Comparison of Health Status in Primary Care Underserved Area Residents and the General Population in Korea / 가정의학회지

Background@#This study compared chronic diseases and health-related quality of life (HRQoL) in between primary care underserved areas residents and the general population. @*Methods@#Underserved areas were identified according to accessibility and the time relevance index for primary care. Overall, 279 participants aged ≥60 years from four counties enrolled voluntarily. A total of 1,873 individuals were assigned in the control group using the Korea National Health and Nutrition Examination Survey database. We assessed the differences in prevalence, awareness, and control of hypertension and diabetes and HRQoL using both subjective health status and the Korean version of the EuroQol-5D (EQ-5D) questionnaire using multivariate logistic regression analysis between the two groups. @*Results@#For hypertension, prevalence did not differ significantly between the two groups, whereas awareness and control were lower in the underserved areas than that in the general population; the adjusted odds ratios (95% confidence interval) were 0.40 (0.25–0.64) and 0.27 (0.18–0.41), respectively. For diabetes, differences in prevalence, awareness, and control were statistically insignificant. The proportion reporting poor subjective health status and problems in four EQ-5D indexes (ability to exercise, daily activities, pain/discomfort, anxiety/depression) was higher in the underserved areas, which also had a lower EQ-5D index, than that in the general population. @*Conclusion@#Primary care underserved area residents were underdiagnosed and under-controlled for hypertension and reported poorer subjective health and HRQoL compared to the general population. Primary care is the attributable factor to awareness and control of chronic diseases and subjective health and QoL in communities.

Investigating the effects of interprofessional communication education for medical students / 한국의학교육

PURPOSE: Interprofessional communication skills are an essential competency for medical students training to be physicians. Nevertheless, interprofessional education (IPE) is relatively rare in Korean medical schools compared with those overseas. We attempted to evaluate the effectiveness of the first IPE program in our school. METHODS: In the first semester of the school year 2018, third-grade medical students (N=149) at the Seoul National University College of Medicine participated in ‘communication between healthcare professionals in the clinical field’ training, which consisted of small group discussions and role-play. To evaluate the effectiveness of this training, we conducted pre- and post-training questionnaire surveys. Comparing paired t-tests, we evaluated the students' competency in interpersonal communication and their attitude towards the importance of IPE before and after the training. The Global Interpersonal Communication Competence Scale (GICC-15) was used to evaluate competency in interpersonal communication. RESULTS: Out of 149 students, 144 completed the pre- and post-training questionnaires. The total GICC-15 scores before and after training were 55.60±6.94 (mean±standard deviation) and 58.89±7.34, respectively (p=0.000). All subcategory scores of GICC-15 after training were higher after training and were statistically significant (p<0.05), except for two subcategories. The importance of IPE score also improved after training but was not significant (p=0.159). The appropriateness of content and training method scores were 3.99±0.92 and 3.94±1.00, respectively. CONCLUSION: From the results, our school's IPE program demonstrated a positive overall educational effect. Deployment of systematic and varied IPE courses is expected in the future, with more longitudinal evaluation of educational effect.

Investigating the effects of interprofessional communication education for medical students / 한국의학교육

PURPOSE@#Interprofessional communication skills are an essential competency for medical students training to be physicians. Nevertheless, interprofessional education (IPE) is relatively rare in Korean medical schools compared with those overseas. We attempted to evaluate the effectiveness of the first IPE program in our school.@*METHODS@#In the first semester of the school year 2018, third-grade medical students (N=149) at the Seoul National University College of Medicine participated in ‘communication between healthcare professionals in the clinical field’ training, which consisted of small group discussions and role-play. To evaluate the effectiveness of this training, we conducted pre- and post-training questionnaire surveys. Comparing paired t-tests, we evaluated the students' competency in interpersonal communication and their attitude towards the importance of IPE before and after the training. The Global Interpersonal Communication Competence Scale (GICC-15) was used to evaluate competency in interpersonal communication.@*RESULTS@#Out of 149 students, 144 completed the pre- and post-training questionnaires. The total GICC-15 scores before and after training were 55.60±6.94 (mean±standard deviation) and 58.89±7.34, respectively (p=0.000). All subcategory scores of GICC-15 after training were higher after training and were statistically significant (p<0.05), except for two subcategories. The importance of IPE score also improved after training but was not significant (p=0.159). The appropriateness of content and training method scores were 3.99±0.92 and 3.94±1.00, respectively.@*CONCLUSION@#From the results, our school's IPE program demonstrated a positive overall educational effect. Deployment of systematic and varied IPE courses is expected in the future, with more longitudinal evaluation of educational effect.

Healthcare access challenges facing six African refugee mothers in South Korea: a qualitative multiple-case study / 소아과

PURPOSE: Following legal reform in 2013, the annual number of asylum seekers entering South Korea has increased from 1,143 in 2012 to 5,711 in 2015. We interviewed six African refugee mothers of young children regarding their health needs and barriers to access maternal child health services. METHODS: We recruited mothers who had visited a clinic for immigrants between July 2013 and August 2015. Participants were African refugee women, aged over 18 years, who had given birth in Korea within the previous 5 years and had come to Korea over a year before recruitment. Interview questions examined participants' experiences in pregnancy and childbirth and concerns regarding their child's health status. Initial data analysis involved all researchers' immersion in the entire collection of transcripts. We then noted recurrent topics and themes and identified similar issues. RESULTS: At the time of giving birth, 5 participants were asylum seekers and one had undocumented status. The following barriers impeded their access to maternal child healthcare: socioeconomic factors (unstable social identity, low economic status, difficulty obtaining health insurance), language barriers (lack of linguistically appropriate health information, limited access to translation services), and cultural barriers (religious and cultural differences). Weak social support also hindered access to healthcare soon after migration; however, social links with the community emerged as a key coping strategy following settlement. CONCLUSION: We identified barriers to maternal and child healthcare and coping strategies among African refugee mothers in Korea. Future research should assess refugees' health status and improve health access and literacy among refugee mothers.

Coffee Consumption and Bone Mineral Density in Korean Premenopausal Women / 가정의학회지

BACKGROUND: Although Asian people are known to have lower bone mass than that of Caucasians, little is known about coffee-associated bone health in Asian. This study aimed to assess the relationship between coffee consumption and bone mineral density (BMD) in Korean premenopausal women. METHODS: Data were obtained from the Fourth Korea National Health and Nutrition Examination Survey 2008-2009. The study population consisted of 1,761 Korean premenopausal women (mean age 36 years) who were measured for lumbar spine and femoral neck BMD and who completed a standardized questionnaire about coffee intake frequency. We excluded the participants who took hormone replacement therapy or medication for osteoporosis. The cross-sectional relationship between coffee consumption and impaired bone health (osteopenia or osteoporosis) was investigated by bone densitometry. RESULTS: Coffee consumption showed no significant association with BMD of either femoral neck or lumbar spine, independent of other factors. The adjusted odds ratios for BMD for those who consumed once in a day, twice a day and three times a day were 0.94 (0.70-1.26), 0.93 (0.67-1.28), and 1.02 (0.69-1.50), respectively (P for trend = 0.927). CONCLUSION: This study does not support the idea that coffee is a risk factor for impaired bone health in Korean premenopausal women.

Coverage of Influenza Vaccination among Elderly in South Korea: A Population Based Cross Sectional Analysis of the Season 2004-2005

BACKGROUND: Influenza vaccine coverage among the elderly is important for informed vaccination policies and programs. There are few studies that define influenza coverage in the elderly in South Korea. The aim of this study is to examine influenza vaccination coverage among those 65 years old and older in South Korea over the 2004-2005 influenza season and to identify the socioeconomic and clinical factors associated with vaccination. METHODS: We analyzed data retrieved from The Third Korea National Health and Nutrition Examination Survey (KNHANES III) 2005 conducted by the Korea Centers for Disease Control and Prevention. Subjects included in this study were older than 65 years. We used questionnaires to obtain information regarding demographics, chronic diseases, and individual health behavioral risk factors. Univariate analysis, logistic regression, and trend test were performed. RESULTS: There were 1,097 persons included in this study. Influenza vaccination among those 65 years old and older was 77.2 %. There was no difference of coverage by sex, education level, and income status. For elderly females, the moreunheal thy lifestyle (currently smoking, heavy alcohol use, and no exercise) that was practiced, the less likely they wereto be vaccinated (p for trend=0.007). CONCLUSION: The influenza vaccination coverage rate among the elderly in South Korea during the 2004-2005 flu season was relatively high compared to that of Europe (19.3-26.5 %) during the same season. Nevertheless, the coverage rate in elderly women with unhealthy lifestyle was not satisfactory causing them to be more vulnerable to related illnesses than those who practiced a healthy lifestyle. To prevent influenza related illnesses, clinicians should, in particular, encourage vaccination in those with an unhealthy lifestyle, as well as, lifestyle modification.