Eunok Park

The Prevalence of Metabolic Syndrome and Related Risk Factors Based on the KNHANES V 2010

Korea National Health and Nutrition Examination Survey (KNHANES V) conducted in 2010, data of 5,670 adults who responded to all the questionnaires of health interview and had metabolic syndrome in the health examination were included in this analysis. SAS 9.2 was used for statistical analysis with complex sample survey modules and commands.

Gender- and age-specific prevalence of metabolic syndrome among Korean adults: analysis of the fifth Korean National Health and Nutrition Examination Survey.

Background:Despite the growing prevalence of metabolic syndrome (MetS) in Korea, information is lacking on gender- and age-specific patterns in prevalence of MetS among Korean adults. Aims:The aims of this study were to examine (1) gender-specific prevalence of MetS by its component abnormalities, (2) the prevalence of MetS and its component abnormalities by gender and 10-year age groups, and (3) gender-specific lifestyle risk factors for MetS presentation among Korean adults. Methods:A secondary data analysis was performed using the most recent national survey. A sample group of 5760 adults (mean age, 44.6 ± 0.46 years; 43.5% men) completed household interviews to provide blood (for high-density lipoprotein cholesterol, triglyceride, and glucose) and anthropometric measurements (ie, waist circumference, weight, and height) to define MetS, as well as data on lifestyle risk factors. Results:Approximately 1 in 4 Korean adults met the MetS diagnostic criteria. Given each component abnormality, MetS was the most prevalent in men with low high-density lipoprotein cholesterol (63.4%), followed by abdominal obesity (62.3%). In women, it was most prevalent in those with hypertriglyceridemia (73.2%), followed by hyperglycemia (69.7%). Metabolic syndrome showed an association with advanced age for both men and women (P < .001 for both), with greater prevalence of MetS in young and middle-aged men than in women (6.7%–39.9% vs 3.3%–36.4%); these patterns were reversed in people 60 years or older (34.0%–40.5% vs 55.2%–64.1%). Gender-specific lifestyle risk factors for MetS presentation showed a significant association with heavy alcohol drinking and obesity for both men (odds ratio, 1.65 and 5.26, respectively; P < .001 for both) and women (odds ratio, 1.96 and 5.94; P < .042 and < .001, respectively). Conclusions:Metabolic syndrome is prevalent in a representative sample of Korean adults, with gender- and age-specific patterns. These results are helpful in identification of vulnerable subgroups at high risk for MetS, providing a basis for promotion of cardiovascular health and risk management of MetS.

A Comparative Study of Youth Health Risk Behaviors by Region: Focused on Metropolitan Areas, Medium Sized and Small City Areas, and Rural Areas

PURPOSE This study was done to compare health risk behavior prevalence for youth living in metropolitan, medium sized and small cities or rural area, in order to enhance understanding regional differences. METHODS For this study, data from the 2006 Youth Health Risk Behavior Online Survey collected by the Korean Center for Disease Control were analyzed using SPSS. RESULTS In the metropolitan areas, prevalence for disease and perceived obesity were higher than in other areas. Lack of intense or moderate physical activity, obesity, fast food intake, and insufficient sleep showed higher prevalence than in rural areas. Prevalence of lifetime smoking, lifetime alcohol consumption, present alcohol use, fruit intake less than once a day, and not wearing a seat belt were higher in rural areas than in urban areas. Gender, smoking, and alcohol use were correlated. Spearman correlation between living with parent and skipping breakfast were significant. Smoking, alcohol use, and sexual behavior were correlated. CONCLUSION As significant differences in prevalence of youth health risk behaviors exist between regional areas, health education and health promotion programs considering these differences have to be developed and implemented for adolescents. Programs for prevention of smoking and alcohol use, programs for improvement of fruit intake and safety are suggested for adolescents in rural areas, whereas programs to enhance physical activity and obesity management are suggested for adolescents in metropolitan areas.

Suicide Ideation and the Related Factors among Korean Adults by Gender

th Korean National Health and Nutritional Examination Survey (KNHANES V-1, V-2) were used for this study. 13,165 adults (≥20 years) were included in this analysis. Results: The prevalence of suicide ideation was 9.8% for men, 18.9% for women. Renal failure, depression, melancholy, stress, perceived health status, and smoking were significant risk factors among both men and women for suicide ideation. Divorced, separated or widowed of marital status and severe physical activity were related factors of suicide ideation for men. Low educational attainment, and alcohol dependency were associated factors of suicide ideation for women. Conclusions: There was gender difference of prevalence and risk factors of suicide ideation. These gender differences should be considered for planning and implementing suicide prevention program.

Memory loss and decreased executive function are associated with limited functional capacity in patients with heart failure compared to patients with other medical conditions

Background: There is limited evidence on the degree of cognitive impairment and its association with physical functional capacity among patients with heart failure (HF) in Korea. Objectives: In this study, we compared cognitive impairment between patients with HF and community‐dwelling participants with non‐HF medical conditions (medical participants) and its association with physical functional capacity. Methods: We conducted a cross‐sectional comparative study and assessed the neuropsychological cognitive status (Seoul Neuropsychological Screening Battery) and physical functional capacity (Duke Activity Status Index) of patients with HF and medical participants using face‐to‐face interviews. Results: One hundred and eighteen patients with HF (age, 65.45 ± 9.38 years; men, 57.6%; left ventricular ejection fraction, 34.93 ± 8.72%) and 83 medical participants (age, 66.02 ± 8.28 years; men, 47.0%) were included. Using seventh‐percentile medical participant Z‐scores as cutoffs, memory and executive function were worse in patients with HF than in medical participants: immediate (35.0% vs. 6.0%) and delayed recall memory (34.5% vs. 8.4%), and executive function (28.6% vs. 6.0%). Independent of age, sex, education, comorbidity, and HF status, executive function was a significant predictor of physical functional capacity (b = 1.82, p = .021). Conclusions: More patients with HF had impaired memory and executive function, which were associated with their physical functional capacities. HIGHLIGHTSCognitive impairment occurs in nearly one third of heart failure (HF) patients.Memory and executive function are worse in HF than non‐HF medical conditions.Functional limitation increases with memory loss, independent of the HF status.Cognitive screening as a part of routine care is suggested in clinical practice.

Frailty and its related Factors in Vulnerable Elderly Population by Age Groups

PURPOSE This study aimed to investigate factors affecting frailty by age groups among vulnerable elders in Korea. METHODS In this secondary analysis, data were collected from records for 22,868 eldesr registered in the Visiting Health Management program of Publci Health Centers in 2012. Health behaviors, clinically diagnosed disease, frailty, depression and cognitive condition were assessed. Data were analyzed using stepwise regression to determine the associated factors of frailty by age group. RESULTS Alcohol consumption, physical activity, number of diseases, DM, CVA, arthritis, urinary incontinence, depression and cognitive condition were found to be factors significantly associated with frailty among the elders aged 65~74 (F=135.66, p<.001). Alcohol consumption, physical activity, CVA, arthritis, urinary incontinence, depression and cognitive condition were found to be factors associated with frailty in the elders aged 75~84 (F=245.40, p<.001). Physical activity, CVA, arthritis, depression and cognitive condition were factors associated with frailty in the elders over 85 years of age (F=96.48, p<.001). CONCLUSION The findings show that frailty of elders and associated factors were different by age group, and common factors affecting frailty were physical activity, CVA, arthritis, depression and cognitive condition. Thus, these factors should be considered in the development of intervention program for care and prevention of frailty and program should be modified according to age group.

Korean Patient-Perceived Satisfaction Scale of Community-Based Case Management Services (Korean-PSCCM): Development and Psychometric Evaluation

ABSTRACT This study aimed to develop and psychometrically test an instrument for measuring patient-perceived satisfaction with community-based case management services in Korea. The study was conducted in 4 phases: Phase I, development of the instrument; Phase II, pilot testing of the instrument; Phase III, a large-scale study to test reliability and validity; and Phase IV, conversion of the new instrument from Korean to English. The new instrument was determined to have six factors—advocacy of case manager, outcome of care, communication skills, practice of a healthy lifestyle, referral, and recognition of risk factors—and also shown to be reliable.

Development and Evaluation of Allergic Rhinitis-Specific Quality of Life (ARSQOL) Scale for Adults

PURPOSE The purpose of this study was to develop an Allergic Rhinitis-Specific Quality of Life (ARSQOL) scale and verify its validity and reliability. METHODS ARSQOL was developed in 5 steps. Items for the preliminary instrument of ARSQOL were developed through a literature review and deep interviews with allergic rhinitis patients. Face validity with Content Validity Index (CVI), construct validity using factor analysis, and known group comparison, criterion validity test using correlation between ARSQOL and total nasal symptoms score (TNSS) were conducted to evaluate the validity of ARSQOL. Cronbachs α was used to evaluate the reliability of ARSQOL. RESULTS CVI for the items in the final ARSQOL were .92. Five factors including discomfort associated with nasal symptoms (4 items), physical function (7 items), mental function (5 items), sleep disorder and social function (4 items), and problems of daily life (6 items) were identified through factor analysis and these five factors explained 66.6% of the total variance. The correlation coefficient between TNSS and the total score of life quality was -.69. In the group comparison, the persistent allergic rhinitis group showed lower ARSQOL scores than the intermittent patient group, and moderate to the severe allergic rhinitis patient group presented poorer ARSQOL than the mild symptom patient group. The Cronbachs α reliability coefficient was .95. CONCLUSION Results show that the ARSQOL has good reliability and validity and thus ARSQOL is a useful scale for clinical practices and research as a measure of quality of life in adults with allergicr hinitis.

Factors Influencing Patient-Perceived Satisfaction With Community-Based Case Management Services:

This study aimed to identify factors that significantly affect patient-perceived satisfaction with community-based case management services and provide practical strategies for improving patient-perceived quality of care. Secondary data analyses were performed in 2010, 2013, 2015, and 2016, which included Pearson’s and Spearman’s correlation, Mann–Whitney U and Kruskal–Wallis tests, and stepwise multiple regression. The response variable was measured by the Korean Patient-Perceived Satisfaction Scale of Community-Based Case Management Services (Korean-PSCCM; a 10-level Likert-type scale), whereas explanatory variables were derived from prior studies. Significant predictors of patient-perceived satisfaction with community-based case management services included “capacity to change,” “patient-perceived time spent with a case manager,” “support/advocacy,” “working period,” and “emotional connectedness.”

The Cognitive Impact of Chronic Diseases on Functional Capacity in Community-Dwelling Adults

Background: People with chronic diseases may experience poor cognitive functioning associated with advanced age, progression of disease, or other comorbid chronic conditions. Empirical evidence of this phenomenon is limited despite the clinical relevance of cognitive decline and associated adverse outcomes such as poor physical functioning. Purpose: The purpose of this study was to examine cognitive functioning in the domains of memory, attention, and executive function and its association with functional capacity in a sample of community-dwelling adults with a spectrum of chronic diseases. Methods: An exploratory cross-sectional study was conducted in a sample of community-dwelling adults with chronic diseases, including hypertension (58.9%), diabetes mellitus (DM; 20.0%), and dyslipidemia (14.4%). Participants’ mean age was 64.1 ± 11.2 years, and 48.9% were male. Ninety persons completed the face-to-face interviews, which evaluated cognitive functioning in the domains of memory, attention, and executive function using neuropsychological tests and the physical well-being test, which measured functional capacity using the Duke Activity Status Index. Results: Compared with those with other chronic diseases, our sample with hypertension and DM had significantly more memory loss and poorer executive function. These significant differences were nullified when adjusting for age, gender, and education. Approximately one third had functional limitations (n = 29, 32.2%), using a cutoff point of 35 or less (Duke Activity Status Index). Memory loss (delayed recall, b = 1.5, p = .016) and poor executive function (Trail Making Test Part A, b = −0.2, p < .001) were predicting factors of functional decline, independent of age, gender, education, and comorbidity. Conclusions/Implications for Practice: Cognitive function, particularly memory and executive function, was poorer among chronically ill Korean adults in the community with hypertension or DM than their counterparts. Functional decline was worse in the presence of memory loss and poor executive function. Studies examining the mechanism by which overall functioning is impacted by cognitive decline and its relevance to functional declines in a larger representative sample are warranted.