Sunjoo Boo

Self-perceived health versus actual cardiovascular disease risks

AIM Self-perceived poor health is related to cardiovascular disease (CVD) risk perception, cardiovascular event, hospital readmission, and death from CVD. This study evaluated the associations between self-perceived health and actual CVD risk in South Koreans as well as the influence of sociodemographic and cardiovascular risk factors on self-perceived poor health. METHODS This is a secondary data analysis of the 2010 Korea National Health and Nutrition Examination Survey. The sample was 4535 South Koreans aged 30-74 years without CVD. Self-perceived health status was compared with actual cardiovascular risk separately by sex using χ(2) -tests. Logistic regressions were used to identify potential sociodemographic and cardiovascular risk factors of self-perceived poor health. RESULTS Self-perceived poor health was related to higher CVD risk but there were substantial gaps between them. Among cardiovascular risk factors, dyslipidemia, obesity, smoking, and a family history of CVD did not affect self-perceived health. CONCLUSION Gaps between perceived health and actual CVD risk should be closed to optimize cardiovascular health of South Koreans. Koreans need to increase risk perception to a level commensurate with their actual risk. Healthcare providers should try to provide individuals at increased CVD risk with better information more frequently, especially those who have favorable perceptions of their health but smoke or have elevated cholesterol levels and bodyweight.

Burns in South Korea: An analysis of nationwide data from the Health Insurance Review and Assessment Service

INTRODUCTION The purpose of the study was to identify and describe the incidence of burn injuries in patients seen and treated in South Korea. Characteristics of inpatients and outpatients with burns were analyzed according to gender, age, burn site, and burn severity. METHODS This retrospective study examined the characteristics of a stratified sample of burn patients seen and treated in South Korea during the calendar year 2011. The sample was drawn from the national patient database Health Insurance Review and Assessment (HIRA). RESULTS Approximately 1.71% of the total patients in the Patient Sample of HIRA for 2011 were burn-injured patients. The numbers of patients treated for burns were 913/10(5) males (n=8009) and 1454/10(5) females (n=11,881). Nearly all of these patients (94.1%) were covered by national health insurance and the majority of these patients (80.6%) were treated as outpatients. Nearly half of the burn injuries were of the upper extremities (43.5%), and most of these injuries (71.5%) were rated as second-degree burns. CONCLUSION A review of the national data on patients seen and treated for burns in 2011 revealed that people in South Korea may experience higher numbers and more severe cases of burns and burn-related injuries than found in other countries. General burn prevention programs as well as gender- and age-specific prevention strategies are needed to reduce the risk of burns in this population.

Accuracy of Inhaler Use in Patients With Chronic Obstructive Pulmonary Disease

Inaccurate use of medication inhalers can reduce effectiveness, patient adherence, and disease stability. Therefore, the accurate use of inhalers in patients with chronic obstructive pulmonary disease (COPD) is crucial. This cross-sectional study evaluated 196 Korean patients with COPD for step-by-step accuracy of inhaler use with four different types of inhalers (metered-dose inhaler [MDI], Turbuhaler, Diskus, and HandiHaler); differences in accuracy levels by sociodemographic or clinical characteristics were evaluated. Descriptive statistics and t tests were used for data analysis. The proportion of patients with completely accurate inhaler use was low, ranging from 21.9% (Turbuhaler) to 46.2% (MDI). Errors with all types of inhalers were most commonly seen in the “breathing out” steps, before and after medication inhalation. Personalized nursing educational programs, correcting errors individually for each patient, could dramatically increase the accuracy of inhaler use and the effectiveness of the inhaled medications in patients with COPD.

Knowledge and perception of cardiovascular disease risk among patients with rheumatoid arthritis

Patients with rheumatoid arthritis are at increased risk for cardiovascular disease. The prerequisites for reducing the risk of cardiovascular disease are adequate levels of knowledge and being aware of the risk. In this study, the levels of knowledge about cardiovascular disease among patients with rheumatoid arthritis and the perception were evaluated in relation to their actual 10-year risk of cardiovascular disease. This cross-sectional study of 200 patients with rheumatoid arthritis was conducted in a university-affiliated hospital in South Korea. The patients’ actual risk of cardiovascular disease was estimated using the Framingham Risk Score. The most common risk factor was physical inactivity, with 77% of the patients not engaging in regular exercise. The patients lacked knowledge about the effects of physical inactivity and anti-inflammatory medication on the development of cardiovascular disease. Misperceptions about the risk of cardiovascular disease were common, i.e., 19.5% of the patients underestimated their risk and 41% overestimated. Hypertension, diabetes, obesity, and smoking were the most prevalent among the patients who underestimated their risk, and these same patients had the lowest level of knowledge about cardiovascular disease. This study demonstrated the rheumatoid arthritis patients’ lack of knowledge about the effects of physical inactivity and anti-inflammatory medications on the development of cardiovascular disease, and their misperception of cardiovascular risk was common. As a preventive measure, educational programs about cardiovascular disease should be tailored specifically for patients with rheumatoid arthritis, and behavioral interventions, including routine exercise, should be made available at the time of diagnosis.

Perceived and actual risk of cardiovascular disease in patients with rheumatoid arthritis in Korea: A cross-sectional study

AbstractThe purposes of this study were to compare the perceived and actual 10-year risk for cardiovascular disease (CVD) and to evaluate the influence of cardiovascular risk factors on perceived CVD risk in patients with rheumatoid arthritis (RA) in Korea. Additionally, the attainment of CVD prevention guideline goals by 3 levels of CVD risk (low, moderate, and high) was presented.For this cross-sectional study, data were collected from 208 patients with RA. Actual CVD risk was estimated with the Systematic Coronary Risk Evaluation (SCORE), and goal attainment was assessed based on the European League Against Rheumatism guidelines. Actual CVD risk and perceived risk were compared with cross-tabulation. Chi-square tests were used to evaluate differences in cardiovascular risk factors by perceived risk. Levels of goal attainment were presented in percentages.Among patients with RA, 13.9% were identified as being at high risk for CVD, whereas 39.9% were at moderate risk, and 46.2% were at low risk. The majority of those at high risk (96.6%) underestimated their risk for CVD. The use of antihypertensive or lipid-lowering medications and having a parental history of CVD significantly increased the likelihood that subjects with RA would perceive themselves as being at high risk for CVD. Diabetes, smoking, physical inactivity, and obesity did not affect perceived risk. A substantial proportion of the subjects with RA did not meet the prevention guideline goals.Patients with RA who are at increased risk of developing CVD must be managed as soon as possible to attain the guideline goals and, accordingly, lower their risk of future CVD.

Secondary analysis of national survey datasets

AIM This paper describes the methodological issues associated with secondary analysis of large national survey datasets. METHODS Issues about survey sampling, data collection, and non-response and missing data in terms of methodological validity and reliability are discussed. RESULTS Although reanalyzing large national survey datasets is an expedient and cost-efficient way of producing nursing knowledge, successful investigations require a methodological consideration of the intrinsic limitations of secondary survey analysis. CONCLUSIONS Nursing researchers using existing national survey datasets should understand potential sources of error associated with survey sampling, data collection, and non-response and missing data. Although it is impossible to eliminate all potential errors, researchers using existing national survey datasets must be aware of the possible influence of errors on the results of the analyses.

Diabetes‐Specific Quality of Life of Korean Children and Adolescents With Type 1 Diabetes

PURPOSE The purpose of this study was to explore the quality of life of children in Korea with type 1 diabetes and related factors. METHODS Children were recruited from a diabetes camp. Data were collected using four instruments: the PedsQL™ 3.2 Diabetes Module, Self-Efficacy for Diabetes Self-Management, the Center for Epidemiological Studies Depression Scale for Children, and the Diabetes Management Behavior Scale. RESULTS Children who were older (t = 2.197, p = .041), male (t = -3.579, p = .002), and less depressed (t = -2.859, p = .010) were more likely to have better quality of life. CONCLUSION Further research is needed in children with type 1 diabetes in countries where this disease is rare, and governmental support and public awareness are limited.