Won Ju Hwang

Work-related cardiovascular disease risk factors using a socioecological approach: implications for practice and research

Background: Cardiovascular disease (CVD) is a leading cause of mortality. Numerous investigations have linked occupational factors and CVD. Occupational factors such as overtime work have an enormous effect on the CVD risk of industrial workers. However, risk factors for CVD are not systematically reviewed in the workplace. The purpose of the paper is to review work-related risk factors for CVD. Methods: A systematic review of work-related CVD risk factors was performed, yielding 180 articles. All articles were assessed in relation to inclusion and exclusion criteria, resulting in 44 articles being reviewed. The sole inclusion criteria was work-related environmental factors and intra/inter-personal factors (psychosocial factors), which is based on the socioecological perspective. The articles were also assessed regarding the quality of each study using the scoring methods developed by Cesario et al. and Brown et al. Conclusion: The literature review demonstrated that work environment factors such as shift work, overtime work, and noise and chemical exposures; and psychosocial factors such as job stress, social support, and socioeconomic status cannot be explained or intervened by one single risk factor. Furthermore, certain occupational factors were shown to aggravate or attenuate other risk factors. The implication of these findings is to incorporate work-related environmental and psychosocial factors into assessment of the patient’s CVD risks and intervention plan. Future research should also incorporate a well-defined conceptual framework to address the effects of work-related environmental and psychosocial factors on CVD among CVD patients.

Prevalence of Overweight and Obesity in Children With Intellectual Disabilities in Korea

BACKGROUND Overweight and obesity in children with intellectual disabilities may be a major health threat. The purpose of this study was to examine the prevalence of overweight and obesity in Korean children with intellectual disabilities aged 7-18 years who did not have specific genetic syndromes or physical disabilities. MATERIALS AND METHODS Participants were 2,404 children with intellectual disabilities aged 7-18 years attending thirteen special schools in Korea. Data from school health records were analysed using SAS (version 9.2). The differences between boys and girls were assessed for childrens height and weight using t-tests and for childrens age and weight status, such as using Chi-Square (χ(2) ) test. The relationships between childrens weight status, age and gender were reassessed using Chi-Square (χ(2) ) test, and strengths of the relationships were measured using Gamma coefficient. RESULTS Approximately one-quarter of children with intellectual disabilities were either overweight or obese. Childrens gender was significantly associated with their weight status, such that overweight and obesity were more prevalent in girls than in boys, specifically girls aged 15-18 years. There was a positive relationship between age and the prevalence of overweight and obesity in children for both boys and girls. CONCLUSIONS The high rates of overweight and obesity in children with intellectual disabilities highlight the need for interventions to help children achieve healthy weight. Before conducting weight management interventions, identifying risk factors that influence weight status in children with intellectual disabilities is an important step.

Factors Associated with Blue-collar Workers’ Risk Perception of Cardiovascular Disease

PURPOSE The purpose of this study was to investigate the contribution of actual cardiovascular disease (CVD) risk, as well as, individual, psychosocial, and work-related factors as predictors of CVD risk perception among Korean blue-collar workers. METHODS The participants were 238 Korean blue-collar workers who worked in small companies. Data were collected through a survey; anthropometric and blood pressure measures; and blood sampling for lipid levels. RESULTS Blue-collar workers had high actual CVD risk and low CVD risk perception. The significant predictors of risk perception included perceived health status, alcohol consumption, knowledge of CVD risk, actual CVD risk, decision latitude, and shift work. The model explained 26% of the variance in CVD risk perception. CONCLUSION The result suggests when occupational health nurses are giving routine health examination in small companies, they can enhance CVD risk perception in blue-collar workers by providing essential information about CVD risk factors and personal counseling on the individual workers CVD risk status.

Effect of psychosocial factors on metabolic syndrome in male and female blue-collar workers.

AIM The purposes of this study were to examine the relationship between psychosocial factors and metabolic syndrome among male and female blue-collar workers, and which factors influence their metabolic syndrome by sex. METHODS A cross-sectional study was completed of 154 men and 80 women working at small companies in Korea. The data were collected through a structured questionnaire, blood test, and anthropometric and blood pressure measure. Metabolic syndrome was diagnosed from the results of blood test and the measurements of waist circumference and blood pressure. RESULTS The prevalence of metabolic syndrome among male and female blue-collar workers was 24.0% and 7.5%, respectively. Multiple logistic regression analysis was performed to examine factors of metabolic syndrome associated with sex. After controlling for age, marital status, smoking, alcohol drinking, shift work, overtime work, and physical exercise, job stress (odds ratio [OR] = 3.10, P = 0.005) and risk perception (OR = 1.12, P = 0.016) were influencing factors for men, and low job stress (OR = 0.05, P = 0.04), low social support (OR = 1.51, P = 0.009), and risk perception (OR = 1.27, P = 0.023) for women. CONCLUSION Metabolic syndrome among blue-collar workers is closely related to psychosocial factors, such as job stress, social support, and risk perception, with the effect of job stress a point of difference between men and women. Occupational health nurses should be cognizant of the importance of assessing the effect of psychosocial factors on cardiovascular risk for blue-collar workers.

Palliative care for those with heart failure: Nurses’ knowledge, attitude, and preparedness to practice

Background: Palliative care is an important element of holistic care but has received little attention in cardiac disease patients. The purpose of the paper is (a) to investigate nurses’ knowledge of palliative care, attitudes toward care of the dying, coping with death, and preparedness to practice palliative care for those with heart failure, and (b) to evaluate influencing factors on preparedness to practice on palliative care. Methods: A cross-sectional descriptive design employed a structured questionnaire that tested nurses’ knowledge, attitude, coping, and preparedness to practice on palliative care for patients with heart failure. Ninety nurses in two tertiary university hospitals in South Korea participated in the survey. Data were analyzed with descriptive statistics, correlation, and multiple regression. Results: Results showed low levels of knowledge reported (an average of 48.3% correct answers), attitude (134.8±110.1), coping (117.2±24.3), and preparedness to practice (17.3±4.7) relating to palliative care. The extent of knowledge was related to both attitudes and coping. These attitudes and coping skills were related to preparedness to practice. The multiple regression analysis showed that preparedness to practice was explained by coping and attitude (R2 =0.46, F=6.1, p<0.001). Conclusions: Palliative care training is urgently needed to improve knowledge, attitude, coping, and preparedness to practice. Guidance to assist healthcare professionals involved in palliative care for those with cardiac disease needs to be developed and provided.

Predictors of health-promoting behavior associated with cardiovascular diseases among Korean blue-collar workers.

The aim of this study was to investigate the contribution of actual cardiovascular disease (CVD) risks, psychosocial and work-related factors as predictors of health behavior. A sample of 234 Korean blue-collar workers, who worked in small companies, was included in this cross-sectional study. Data collection included a survey; anthropometric and blood pressure measures; and blood sampling. Multiple regression analyses showed that the model explained 30% of the variance in health behavior of blue-collar workers. The significant predictors for health behavior included education level, perceived general health, greater family function, higher social support, decision latitude, and non-shift work. Future research should focus on incorporating these significant predictors into effective behavioral interventions designed to promote cardiovascular health in this population.

Heavy Metal Distribution in Street Dust from Traditional Markets and the Human Health Implications

Street dust is a hazard for workers in traditional markets. Exposure time is longer than for other people, making them vulnerable to heavy metals in street dust. This study investigated heavy metal concentrations in street dust samples collected from different types of markets. It compared the results with heavy metal concentrations in heavy traffic and rural areas. Street dust was significantly enriched with most heavy metals in a heavy traffic area while street dust from a fish market was contaminated with cupper (Cu), lead (Pb) and zinc (Zn). Street dust from medicinal herb and fruit markets, and rural areas were not contaminated. Principal component and cluster analyses indicated heavy metals in heavy traffic road and fish market dust had different sources. Relatively high heavy metal concentration in street dust from the fish market may negatively affect worker’s mental health, as depression levels were higher compared with workers in other markets. Therefore, intensive investigation of the relationship between heavy metal concentrations in street dust and worker’s health in traditional marketplaces should be conducted to elucidate the effect of heavy metals on psychological health in humans.

Depressive Symptom and Related Factors: A Cross-Sectional Study of Korean Female Workers Working at Traditional Markets

Background: Depression is one of the psychiatric diseases with a high prevalence rate, globally, and reportedly more prevalent among women than among men. Especially, women workers working at traditional markets are in depressive conditions without occupational health services. The purpose of this study is to investigate factors having a significant effect on the depressive symptoms of women workers at traditional markets in South Korea. Methods: A cross-sectional study was used and subjects for the present study were 500 female workers in three selected representative traditional marketplaces in South Korea. Results: The results of hierarchical regression analysis indicated that increased BMI (β = 0.297, p = 0.017), poor nutritional status (β = 0.596, p < 0.001), street vendor status (β = 2.589, p = 0.001), job stress (β = 0.491, p < 0.001), lower back pain (β = 0.377, p = 0.011), lower self-efficacy (β = −0.368, p = 0.002) and diminished family function (β = −0.633, p = 0.001) affected workers’ depressive symptoms. The explanatory power of these variables was 38.5%. Conclusions: Based on these results, future research should focus on incorporating theses significant factors into effective interventions designed to decrease depressive symptoms in this population. Moreover, this study will increase interest in occupational health nursing, particularly in relation to vulnerable social groups, and expand the scope of practice in the field.

[Ecological Correlates of Cardiovascular Disease Risk in Korean Blue-collar Workers: A Multi-level Study].

PURPOSE The purpose of this study was to investigate individual and organizational level of cardiovascular disease (CVD) risk factors associated with CVD risk in Korean blue-collar workers working in small sized companies. METHODS Self-report questionnaires and blood sampling for lipid and glucose were collected from 492 workers in 31 small sized companies in Korea. Multilevel modeling was conducted to estimate effects of related factors at the individual and organizational level. RESULTS Multilevel regression analysis showed that workers in the workplace having a cafeteria had 1.81 times higher CVD risk after adjusting for factors at the individual level (p=.022). The explanatory power of variables related to organizational level variances in CVD risk was 17.1%. CONCLUSION The results of this study indicate that differences in the CVD risk were related to organizational factors. It is necessary to consider not only individual factors but also organizational factors when planning a CVD risk reduction program. The factors caused by having cafeteria in the workplace can be reduced by improvement in the CVD-related risk environment, therefore an organizational-level intervention approach should be available to reduce CVD risk of workers in small sized companies in Korea.

Impact of organisational characteristics on turnover intention among care workers in nursing homes in Korea: a structural equation model

OBJECTIVE The aim of the present study was to analyse the impact of organisational characteristics on the turnover intention of care workers working at nursing homes in Korea. METHODS Study participants included 504 care workers working at 14 nursing homes in Korea. The variables measured were: high-performance work practices, consisting of five subfactors (official training, employment stability, autonomy, employee participation and group-based payment); organisational commitment, consisting of three subfactors (affective, normative and continuance commitment); organisational support; and turnover intention. The inter-relationship between high-performance work practices, organisational support, organisational commitment and turnover intention and the fit of the hypothetical model were analysed using structural equation modelling. RESULTS According to our analysis, high-performance work practices not only had a direct effect on turnover intention, but also an indirect effect by mediating organisational support and commitment. The factor having the largest direct influence on turnover intention was organisational commitment. CONCLUSIONS The results of the present study suggest that to improve health conditions for frail elderly patients at nursing homes, as well as the efficiency of nursing homes through the continuance of nursing service and enhancement of quality of service, long-term care facilities should reduce the turnover intention of care workers by increasing their organisational commitment by actively implementing high-performance work practices.