Kyung Ja June

Low back pain and work-related factors among nurses in intensive care units.

AIM To examine the relationship of low back pain prevalence and treatment to personal and work-related characteristics among intensive care unit nurses. BACKGROUND Back pain is the most common work-related health problem among nurses. DESIGN A cross-sectional study including a survey conducted in 2007. METHODS The study sample included 1345 nurses in 65 intensive care units in 22 South Korean hospitals. Back pain prevalence was measured by the frequency of back pain (always, once a week, once a month or once in two or more months) during the past year. Multilevel logistic regression analyses were conducted to examine the relationship between back pain and personal and work-related characteristics. RESULTS The mean age of nurses was 27.2 years. Overall, 90.3% of nurses had back pain at least once a month (21.9% always, 40.7% once a week and 27.7% once a month). Only 18.3% had received medical treatment for their back pain. Compared with neonatal intensive care unit nurses, who had the lowest prevalence, nurses in other specialties, excluding paediatric intensive care units, had a greater likelihood of back pain. Specialty medical (e.g. cardiology, neurology) intensive care unit nurses had the greatest probability of back pain and treatment. Perceiving staffing as inadequate and working 6 or more night shifts per month were related to a 64% increase (OR = 1.64; 95% CI =1.16-2.33) and 48% increase (OR =1.48; 95% CI = 1.10-1.99) in back pain, respectively. Nurses with 2-4 years of working experience in intensive care units had the greatest probability of back pain and treatment. CONCLUSIONS A high prevalence of back pain was found in intensive care unit nurses, even though they comprise a very young workforce in Korea. RELEVANCE TO CLINICAL PRACTICE Improving nurse staffing, reducing the frequency of night shifts and assessing risk factors in specific intensive care unit specialties are suggested to decrease back pain prevalence.

Effects of Case Management using Resident Assessment Instrument-Home Care (RAI-HC) in Home Health Services for Older People

PURPOSE To evaluate the effects of case management using Resident Assessment Instrument-Home Care (RAI-HC) in home health service for older people. METHODS All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Cognitive Performance Scale (CPS), Depression Rating Scale (DRS), Pain and the number of Clinical Assessment Protocols (CAP). RESULTS Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression (odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL (OR: 4.423, CI: 1.151-16.999) and the number of CAP (OR: 11.443, CI: 3.805-34.410). CONCLUSION Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

[Effects of community-based case management program for clients with hypertension].

PURPOSE The purpose of this study was to analyze effects of a community-based case management program for clients with hypertension living in the community. METHODS The research design was a one group pre and post-test design with 30 participants with hypertension who agreed to participate in the 8-12 week case management program provided by case managers from the National Health Insurance Corporation in 2002. Data were collected three times, before and after the case management services, and 6 months later. Outcomes included changes in blood pressure, knowledge of hypertension and daily life practices, including alcohol consumption, smoking, exercise, and medication adherence. RESULTS Repeated-measures ANOVA and post-hoc tests of means revealed significant differences before and after service for systolic blood pressure, daily life practices (monitoring body weight and BP, low salt and cholesterol and high vegetable diet, and stress-relief practices), and exercise. The goal for medication adherence was attained after service. Significant improvements from baseline to 6 months after service were observed in measures of salt and vegetables in diet. There were no significant differences on hypertension knowledge, alcohol consumption or smoking behavior between before service and after, and at 6 months. CONCLUSION The findings provide preliminary evidence that case management intervention can have positive outcomes on BP control, daily life practices, exercise, and medication adherence for clients with hypertension. However, additional interventions are needed to sustain long-term effects.

Evaluation of the Hypertension Disease Management Program in Korea

This study evaluated how the Hypertension Disease Management Program (HDMP) affects patient’s blood pressure, knowledge, health behaviors, and use of medical services. Evaluation was performed by 2 measures, which were before and after comparison within the management group (n = 210) and comparison between the management group and control group (n = 1050) in 2005. Systolic and diastolic blood pressure of management group significantly decreased from 137.5 and 86.0 mm Hg to 131.2 and 83.8 mm Hg (P < .001, P < .01), respectively. Dieting, snack control, consumption of low-sodium meals, low-cholesterol meals, and fruits or vegetables, regular checking of blood pressure, and stress management techniques significantly increased after HDMP. However, there was no significant difference in the use of medical service between the disease management group and the control group. This study showed that the HDMP improved lifestyle and reduced blood pressure on the disease management group, but changed neither medical costs nor use of medical services. Long-term evaluation should be performed to determine if the HDMP reduce medical costs and use of medical services.

Prevalence and Risk Factors of Clonorchiasis among the Populations Served by Primary Healthcare Posts along Five Major Rivers in South Korea

Objectives: Clonorchiasis is an infectious disease caused by the Chinese liver fluke Clonorchis sinensis. In this study, we investigated the prevalence and risk factors of clonorchiasis among the populations served by primary healthcare posts along five major rivers in South Korea. Methods: Forty primary healthcare posts that are located less than 5 km from one of the five rivers were selected from 26 counties. For the purpose of the survey, community health practitioners selected the nearest villages from the riversides in their own catchment area. From January to May 2009, a total of 2788 stool samples were collected and examined using the formalin–ether sedimentation technique. Village inhabitants were also interviewed by means of questionnaires in order to obtain information on potential risk factors. Results: The prevalence rates of clonorchiasis at various river basins were as follows: Seomjin River, 21.3%; Nakdong River, 13.5%; Geum River, 9.2%; Han River, 7.6%; and Yeongsan River, 4.9%. The total number of people infected with C. sinensis was 329 (11.3%). By gender, 14.3% of males and 7.6% of females were infected. In case of both males and females, the prevalence rate was highest in those in their 40s. Consumption of raw freshwater fish was confirmed as a risk factor based on a logistic regression analysis. Conclusion: The present findings suggest that clonorchiasis is still highly prevalent among the inhabitants of riverside areas in southern Korea, and, accordingly, it is necessary to implement a systematic control program in the endemic areas.

Socioeconomic disparities in household secondhand smoke exposure among non-smoking adolescents in the Republic of Korea

ABSTRACT This nationally representative study examined (a) gender and age differences in household secondhand smoke exposure (HSHSE) and (b) associations between socioeconomic status (SES) and HSHSE among non-smoking Korean adolescents. Two subsamples were analysed: males (n = 25,648) and females (n = 30,240). The HSHSE measures were incidence of HSHSE (yes/no) and number of days of HSHSE (1–7 days); the SES measures were parental education, perceived economic status, and family wealth. For the first aim, chi-square test, t-test, and bivariate negative binomial regression analysis were performed; For the second aim, multivariate logistic regression and negative binomial regression analyses were performed. The incidence and number of days of HSHSE were significantly higher among females (32.35% and 3.48 days) than males (26.83% and 3.08 days). The HSHSE incidence was significantly higher among younger adolescents (23.32% to 31.08% of males and 26.58% to 37.03% of females). Lower SES was associated with (a) greater odds of HSHSE (odds ratio: 1.12–1.58 among males and 1.19–1.85 among females) and (b) greater incidence rates of HSHSE (incidence rate ratio: 1.05–1.17 among males and 1.10–1.14 among females). Efforts should be made to decrease HSHSE among adolescents, particularly low-SES youth.

Prevalence and Risk Factors of Clonorchiasis among Residents of Riverside Areas in Muju-gun, Jeollabuk-do, Korea

We evaluated the status of Clonorchis sinensis infection and potential risk factors among residents of riverside areas (Geumgang) in Muju-gun, Jeollabuk-do (Province), Korea. From January to February 2010, a total of 349 (171 males, 178 females) stool samples were collected and examined by the formalin-ether concentration technique. Also, village residents were interviewed using questionnaires to obtain information about C. sinensis infection-related risk factors. Overall egg-positive rate of C. sinensis was 13.2%. Egg-positive rates were significantly higher in males, farmers, and residents who had lived there more than 20 years, and in residents who had eaten raw freshwater fish than in opposite groups, respectively. However, there was no significant difference between age groups, education levels, cigarette smoking, alcohol drinking, health status, past history of infection, and experience of clonorchiasis medication and examination. Logistic regression analysis was performed to determine risk factors for clonorchiasis. On univariate analysis, the odds ratios for males, farmers, those who had lived there more than 20 years, and who had eaten raw freshwater fish were 2.41, 4.44, 3.16, and 4.88 times higher than those of the opposites, respectively. On multivariate analysis, the odds ratio of residents who had eaten raw freshwater fish was 3.2-fold higher than that of those who had not. These results indicate that residents living in Muju-gun, along the Geum River, Korea, have relatively high C. sinensis egg-positive rates, and the habit of eating raw freshwater fish was the major factor for the maintenance of clonorchiasis.

Application of Resident Assessment Instrument – Home Care to assess the functional status of Korean older people

The purpose of this study is to assess the functional status of the Korean elderly using the Resident Assessment Instrument – Home Care (RAI‐HC). According to the results, problematic conditions were significantly different for older adults by sex, age groups, and geographical areas. Most of the subjects were assessed at the independent level of activities of daily living (ADL) self‐performance, while more dependent older adults exhibited more problematic conditions. Conclusively, the use of RAI‐HC was recommended to develop long‐term care services at the community or national level.