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Original Articles
Beyond Medical Bills: High Prevalence of Financial Toxicity and Diverse Management Strategies Among Vietnamese Patients With Cancer
Binh Thang Tran, Thanh Gia Nguyen, Dinh Duong Le, Minh Tu Nguyen, Nhan P. T. Nguyen, Minh Hanh Nguyen, The Due Ong
J Prev Med Public Health. 2024;57(4):407-419.   Published online June 24, 2024
DOI: https://doi.org/10.3961/jpmph.24.090
  • 6,976 View
  • 302 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients.
Methods
This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cut-off scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking.
Results
The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (34.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT.
Conclusions
FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.
Summary
Key Message
- This first large-scale analysis looks into the financial toxicity faced by patients with cancer in Vietnam, as an example of low- and middle-income countries.
- Financial toxicity was remarkably high prevalent and strongly associated with patient- level factors.
- Patients experiencing financial toxicity tend to use various cost-coping strategies.
- These findings underscore the need for routine screening for financial toxicity risk and interventions.
Changes in Adolescent Health Behavior and the Exacerbation of Economic Hardship During the COVID-19 Pandemic: A Cross-sectional Study From the Korea Youth Risk Behavior Survey
Chaeeun Kim, Haeun Lee, Kyunghee Jung-Choi, Hyesook Park
J Prev Med Public Health. 2024;57(1):18-27.   Published online November 11, 2023
DOI: https://doi.org/10.3961/jpmph.23.306
  • 7,689 View
  • 447 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study investigated the association between exacerbated economic hardship during the coronavirus disease 2019 (COVID-19) pandemic and changes in the health behaviors of Korean adolescents.
Methods
We analyzed data from the 2021 Korea Youth Risk Behavior Survey and included 44 908 students (22 823 boys and 22 085 girls) as study subjects. The dependent variables included changes in health behaviors (breakfast habits, physical activity, and alcohol use) that occurred during the COVID-19 pandemic. The aggravation of economic hardship by COVID-19 and the subjective economic status of the family were used as exposure variables. Multiple logistic regression analysis was utilized to calculate the prevalence odds ratios (PORs).
Results
Severe exacerbation of a family’s economic hardship due to COVID-19 was negatively associated with the health behaviors of adolescents, including increased breakfast skipping (POR, 1.85; 95% confidence interval [CI], 1.55 to 2.21 for boys and POR, 1.56; 95% CI, 1.27 to 1.92 for girls) and decreased physical activity (POR, 1.37; 95% CI, 1.19 to 1.57 for boys and POR, 1.38; 95% CI, 1.19 to 1.60 for girls). These negative changes in health behaviors were further amplified when combined with a low subjective family economic status.
Conclusions
The experience of worsening household hardship can lead to negative changes in health behavior among adolescents. It is crucial to implement measures that address the economic challenges that arise from stressful events such as COVID-19 and to strive to improve the lifestyles of adolescents under such circumstances.
Summary
Korean summary
이 연구는 코로나바이러스감염증-19 (COVID-19) 대유행 기간 악화된 가구의 경제적 상황과 청소년의 건강 행태 변화의 관련성을 청소년건강행태조사를 이용하여 분석하였다. 가구의 경제적 상황이 COVID-19로 인해 심각하게 악화된 경우, 청소년 건강 행태의 부정적인 변화와 연관성이 관찰되었다. 가구의 경제적 상황이 악화되는 경험은 청소년들의 건강 행태에 부정적인 변화를 초래할 수 있다. COVID-19와 같은 사회적 사건으로 인해 발생하는 경제적 어려움에 대응하는 조치를 마련하고, 이러한 상황에서 청소년들의 건강 행태를 개선하기 위한 개입이 필요하다.
Key Message
This study investigated the association between exacerbated economic hardship during the coronavirus disease 2019 (COVID-19) pandemic and changes in the health behaviors of Korean adolescents using the 2021 Korea Youth Risk Behavior Survey. Severe exacerbation of a family’s economic hardship due to COVID-19 was negatively associated with the health behaviors of adolescents. The experience of worsening household hardship can lead to negative changes in health behavior among adolescents. It is crucial to implement measures that address the economic challenges that arise from stressful events such as COVID-19 and to strive to improve the lifestyles of adolescents under such circumstances.

Citations

Citations to this article as recorded by  
  • Family Dynamics, Socioeconomic Hardships, and Health Risk Behaviours of Bulgarian Adolescents during the COVID-19 Pandemic
    Elitsa Dimitrova, Anna Alexandrova-Karamanova
    Children.2024; 11(8): 1016.     CrossRef
Comorbid Conditions in Persons Exposed to Ionizing Radiation and Veterans of the Soviet–Afghan War: A Cohort Study in Kazakhstan
Saule Sarkulova, Roza Tatayeva, Dinara Urazalina, Ekaterina Ossadchaya, Venera Rakhmetova
J Prev Med Public Health. 2024;57(1):55-64.   Published online November 1, 2023
DOI: https://doi.org/10.3961/jpmph.23.333
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  • 321 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
This study investigated the prevalence and characteristics of comorbid conditions in patients exposed to ionizing radiation and those who were involved in the Soviet–Afghan war.
Methods
This study analyzed the frequency and spectrum of morbidity and comorbidity in patients over a long-term period (30-35 years) following exposure to ionizing radiation at the Semipalatinsk nuclear test site or the Chornobyl nuclear power plant, and among participants of the Soviet–Afghan war. A cohort study, both prospective and retrospective, was conducted on 675 patients who underwent comprehensive examinations.
Results
Numerical data were analyzed using the Statistica 6 program. The results are presented as the mean±standard deviation, median, and interquartile range (25-75th percentiles). The statistical significance of between-group differences was assessed using the Student t-test and Pearson chi-square test. A p-value of less than 0.05 was considered statistically significant. We found a high prevalence of cardiovascular diseases, including hypertension (55.0%) and cardiac ischemia (32.9%); these rates exceeded the average for this age group in the general population.
Conclusions
The cumulative impact of causal occupational, environmental, and ultra-high stress factors in the combat zone in participants of the Soviet–Afghan war, along with common conventional factors, contributed to the formation of a specific comorbidity structure. This necessitates a rational approach to identifying early predictors of cardiovascular events and central nervous system disorders, as well as pathognomonic clinical symptoms in this patient cohort. It also underscores the importance of selecting suitable methods and strategies for implementing treatment and prevention measures.
Summary
Key Message
This study investigated the long-term health effects on 675 individuals exposed to ionizing radiation at Semipalatinsk and Chornobyl, and those involved in the Soviet–Afghan war. Results showed a higher prevalence of cardiovascular diseases, notably hypertension (55%) and cardiac ischemia (32.9%), compared to the general population. The findings highlight the need for early detection of cardiovascular and central nervous system disorders in these groups, emphasizing tailored treatment and prevention strategies.

Citations

Citations to this article as recorded by  
  • Global trends in research on Semipalatinsk nuclear testing health effects: A bibliometric analysis and short review
    Nailya Chaizhunussova, Lyudmila Pivina, Dariya Shabdarbayeva, Andrey Orekhov, Raushan Dosmagambetova, Galiya Alibayeva, Meruyert Massabayeva, Alexandra Lipikhina, Gulshara Abildinova, Askar Kassymov, Zhanargul Smailova, Rauan Kissina, Diana Ygiyeva, Ernar
    Journal of Environmental Radioactivity.2025; 290: 107793.     CrossRef
  • Long-Term Consequences of Combat Stress in Afghan War Veterans: Comorbidity of PTSD and Physical and Mental Health Conditions
    Ekaterina Ossadchaya, Roza Tatayeva, Zhibek Sembayeva, Akmaral Nursafina, Mira Zhakenova, Gaukhar Slamkhanova
    Psychiatry International.2025; 6(4): 141.     CrossRef
Gender Inequalities in Mental Health During the COVID-19 Pandemic: A Population-based Study in Korea
Minku Kang, Sarah Yu, Seung-Ah Choe, Daseul Moon, Myung Ki, Byung Chul Chun
J Prev Med Public Health. 2023;56(5):413-421.   Published online August 19, 2023
DOI: https://doi.org/10.3961/jpmph.23.170
  • 7,653 View
  • 148 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study explored the effect of the coronavirus disease 2019 (COVID-19) pandemic on psychosocial stress in prime working-age individuals in Korea, focusing on gender inequalities. We hypothesized that the impact of COVID-19 on mental health would differ by age and gender, with younger women potentially demonstrating heightened vulnerability relative to men.
Methods
The study involved data from the Korea Community Health Survey and included 319 592 adults aged 30 years to 49 years. We employed log-binomial regression analysis, controlling for variables including age, education, employment status, marital status, and the presence of children. The study period included 3 phases: the period prior to the COVID-19 outbreak (pre–COVID-19), the early pandemic, and the period following the introduction of vaccinations (post-vaccination).
Results
The findings indicated that women were at a heightened risk of psychosocial stress during the early pandemic (relative risk [RR], 1.01; 95% confidence interval [CI], 0.98 to 1.05) and post-vaccination period (RR, 1.07; 95% CI, 1.04 to 1.10) compared to men. This pattern was prominent in urban women aged 30-34 years (pre–COVID-19: RR, 1.06; 95% CI, 1.02 to 1.10; early pandemic: RR, 1.16; 95% CI, 1.08 to 1.25; post-vaccination period, RR, 1.22; 95% CI, 1.14 to 1.31).
Conclusions
The COVID-19 pandemic has exerted unequal impacts on psychosocial stress among prime working-age individuals in Korea, with women, particularly those in urban areas, experiencing a heightened risk. The findings highlight the importance of addressing gender-specific needs and implementing appropriate interventions to mitigate the psychosocial consequences of the pandemic.
Summary
Korean summary
코로나19 대유행이 국내 경제활동인구의 정신건강에 미친 젠더화된 영향을 조사하였다. 연구대상자는 2017-2021년 지역사회건강조사 조사대상자 319,592명이다. 연구 결과, 대유행 이후 30-39세 연령대 여성의 스트레스 수준이 남성에 비하여 현저히 증가한 것으로 나타났으며, 사회적 거리두기를 엄격하게 시행하였던 도시 지역에서 이러한 경향이 두드러졌다. 이번 연구 결과는 대유행 대응 노력에서 취약 집단을 지원하기 위한 중재 정책의 필요성을 강조한다
Key Message
We investigate the gendered impact of the COVID-19 pandemic on the mental health of the working-age population in Korea, focusing on ages 30-49, utilizing data from the Korea Community Health Survey (KCHS) from 2017 to 2021 including 319,592 participants. Findings reveal a notable increase in stress levels among women in the 30-39 age group after the pandemic compared to men, accentuating in urban areas with stringent social distancing measures. Our results underscore the necessity for intervention policies to support vulnerable groups in pandemic response efforts.

Citations

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  • Resilience Factors Mitigate the Impact of (COVID)-19 Concerns on Depressive Symptoms
    Young-Mee Kim, Sung-il Cho
    American Journal of Health Behavior.2025; 49(2): 27.     CrossRef
  • Psychological distress and compliance with sanitary measures during the Covid-19 pandemic
    Irwin Hecker, Solène Wallez, Honor Scarlett, José Luis Ayuso-Mateos, Richard Bryant, Giulia Caggiu, Claudia Conflitti, Katalin Gémes, Josep Maria Haro, Vincent Lorant, Roberto Mediavilla, Ellenor Mittendorfer-Rutz, Anna Monistrol-Mula, Matteo Monzio Compa
    PLOS One.2025; 20(7): e0317272.     CrossRef
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    Chan-Young Kwon
    Frontiers in Psychology.2024;[Epub]     CrossRef
  • Exploring the association between consultation themes and suicidal ideation: a gender-stratified analysis of Hangzhou Mental Health Hotline (2014-2023)
    Deyuan Wu, Yating Wei, Qiuxia Chen, Xiaonv Fu, Haidong Song
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Special Article
Examining the Role of Psychosocial Stressors in Hypertension
Komal Marwaha
J Prev Med Public Health. 2022;55(6):499-505.   Published online November 30, 2022
DOI: https://doi.org/10.3961/jpmph.21.266
  • 24,886 View
  • 489 Download
  • 21 Crossref
AbstractAbstract PDF
Despite advances in medicine and preventive strategies, fewer than 1 in 5 people with hypertension have the problem under control. This could partly be due to gaps in fully elucidating the etiology of hypertension. Genetics and conventional lifestyle risk factors, such as the lack of exercise, unhealthy diet, excess salt intake, and alcohol consumption, do not fully explain the pathogenesis of hypertension. Thus, it is necessary to revisit other suggested risk factors that have not been paid due attention. One such factor is psychosocial stress. This paper explores the evidence for the association of psychosocial stressors with hypertension and shows that robust evidence supports the role of a chronic stressful environment at work or in marriage, low socioeconomic status, lack of social support, depression, anxiety, post-traumatic stress, childhood psychological trauma, and racial discrimination in the development or progression of hypertension. Furthermore, the potential pathophysiological mechanisms that link psychosocial stress to hypertension are explained to address the ambiguity in this area and set the stage for further research.
Summary

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    Songmi Lee, Clint L. Miller, Amy R. Bentley, Michael R. Brown, Pavithra Nagarajan, Raymond Noordam, John L Morrison, Karen Schwander, Kenneth Westerman, Minjung Kho, Aldi T. Kraja, Paul S. de Vries, Farah Ammous, Hughes Aschard, Traci M. Bartz, Anh Do, Ch
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    Shara Johnson, Samantha Moore, Muqtasida Fatima, Adam McInnes, Heather Foulds
    Frontiers in Stroke.2026;[Epub]     CrossRef
  • Exploring the complex relationship between psychosocial stress and the gut microbiome: implications for inflammation and immune modulation
    Komal Marwaha, Ryan Cain, Katherine Asmis, Katya Czaplinski, Nathan Holland, Darly C. Ghislaine Mayer, Jessica Chacon
    Journal of Applied Physiology.2025; 138(2): 518.     CrossRef
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    Journal of Public Health.2025; 47(3): e288.     CrossRef
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    Maham Fatima, Adeel Aslam, Maheen Ijaz, Mudassir Anwar, Shazia Jamshed, Saeed Asiri, Wajid Syed
    International Journal of General Medicine.2025; Volume 18: 4763.     CrossRef
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    Christa O’Hana San Luis Nobleza, Monisha A. Kumar
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    Lucia Bubulac, Mirela Zivari, Irina Anca Eremia, Constantin Erena, Consuela-Mădălina Gheorghe, Iuliana-Raluca Gheorghe, Viorica Tudor, Claudia Florina Bogdan-Andreescu, Emin Cadar, Cristina-Crenguța Albu
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    Lijun Zhang, Meiyan Liu
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    Salihah Kashum, Ghareeb Bahari
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    Jung-Eun Lee, Anthony Kityo, Sang-Ah Lee
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    Ali Aldirawi, Fadwa Alhalaiqa, Abdallah Alwawi, Samer Abuzerr
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    Abdulaziz M. F. Shayea, Amna A. Alshatti, Danah H. Alfadhli, Almutairi Fatimah Ibrahim, Mariam Kh. Almutairi, Mohammed Sh. Nadar
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  • Adjustment disorders, hypertension and type 2 diabetes: a cardiologist’s view (literature review)
    D.K. Miloslavsky, S.M. Koval
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  • Letter to the Editor: Insights on Health, Religion/Spirituality, and Vulnerable Populations
    Fides A. del Castillo
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  • Moderating effect of mindfulness on the relationship between anxiety and somatization symptoms in middle‐aged and elderly female patients with hypertension
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Brief Report
Effects of Forest Therapy on Psychological Improvement in Middle-aged Women in Korea
Bum-Jin Park, Won-Sop Shin, Chang-Seob Shin, Poung-Sik Yeon, Chung-Yeub Chung, Si-Hyung Lee, Dong-Jun Kim, Youn-Hee Kim, Chang-Eun Park
J Prev Med Public Health. 2022;55(5):492-497.   Published online September 20, 2022
DOI: https://doi.org/10.3961/jpmph.22.086
  • 7,796 View
  • 201 Download
  • 6 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Women experience more stress in middle age than in other periods of their lives. Therefore, health management programs that enable middle-aged women to cope with and manage stress are needed. This study investigated the psychological effects of a meditation-focused forest therapy program among 53 middle-aged women living in urban areas in Korea.
Methods
Participants were divided into 2 groups: one group underwent the program for 3 days in a forest, followed by 3 days in an urban environment, and the other group underwent the program for 3 days in the urban environment, followed by 3 days in the forest. The psychological effects of the forest therapy program were evaluated using the Profile of Mood States-Brief (POMS-B). Differences in mood state before and after the program conducted in the forest (experimental group) and in the urban environment (control group) were evaluated using the paired-samples t-test.
Results
The program in the forest significantly reduced tension, depression, anger, fatigue, and confusion among the domains of the POMS-B. The program in the urban area significantly reduced tension, but not depression, anger, fatigue, or confusion.
Conclusions
Meditation-focused forest therapy programs are expected to contribute to promoting psychological health and enhancing the quality of life of middle-aged women.
Summary
Korean summary
중년 여성이 건강을 관리할 수 있는 프로그램이 필요하다. 이 연구는 명상 중심의 산림치유 프로그램이 중년 여성의 심리적 건강 증진에 효과적인지 검증하기 위해 프로그램 시행 전후에 참가자의 기분상태(POMS-B)를 측정하여 비교하였다. 결과에 의하면 긴장, 우울, 분노, 피곤, 혼돈이 통계적으로 유의하게 감소하였다.

Citations

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  • Effects of forest and simulated nature meditation on university students’ well-being
    Yawei Wei, Won Sop Shin, Michael Lee, Tahia Devisscher, Guangyu Wang
    Journal of Forestry Research.2025;[Epub]     CrossRef
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    S. Sacchelli, E. Barbierato, S. Baldessari, F. Becheri, A. Cerutti, S. Notaro, S. Righi, A. Paletto, I. Bernetti
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    Xueyan Shang, Jiahao Lu, Meng Tao, Cheng Fei, Jiaming Fei
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    Susan A Abookire, Sujata G Ayala, Nancy A Shadick
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COVID-19: Original Article
Associations Between General Perceptions of COVID-19 and Posttraumatic Stress Disorder in Korean Hospital Workers: Effect Modification by Previous Middle East Respiratory Syndrome Coronavirus Experience and Occupational Type
Youngrong Lee, Kwanghyun Kim, Sungjin Park, Sun Jae Jung
J Prev Med Public Health. 2021;54(2):86-95.   Published online January 19, 2021
DOI: https://doi.org/10.3961/jpmph.20.540
  • 8,812 View
  • 224 Download
  • 4 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study investigated associations between perceptions of coronavirus disease 2019 (COVID-19) and the prevalence of posttraumatic stress disorder (PTSD) in workers at hospitals designated to treat COVID-19, as well as the difference in the magnitude of these associations by occupational type and previous Middle East respiratory syndrome coronavirus (MERS-CoV) experience.
Methods
The participants were workers at hospitals designated to treat COVID-19 who completed a questionnaire about their perceptions related to COVID-19, work experience during the previous MERS-CoV outbreak, and symptoms of PTSD ascertained by the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders. Participants’ characteristics were compared using the chi-square test. Multivariable logistic regression was performed to evaluate the associations between perceptions and the prevalence of PTSD, stratified by occupational type and previous MERS-CoV experience.
Results
Non-medical personnel showed stronger associations with PTSD than medical personnel according to general fear (odds ratio [OR], 6.67; 95% confidence interval [CI], 1.92 to 23.20), shortages of supplies (OR, 1.29; 95% CI, 1.07 to 1.56), and issue-specific fear (OR, 1.29; 95% CI, 1.05 to 1.59). Those with prior MERS-CoV quarantine experience were more prone to PTSD than those without such experience in terms of general fear (OR, 1.70; 95% CI, 1.22 to 2.37), shortages of supplies (OR, 1.24; 95% CI, 1.10 to 1.40), and issue-specific fear (OR, 1.21; 95% CI, 1.06 to 1.38).
Conclusions
During the COVID-19 pandemic, non-medical personnel tended to have higher odds of being categorized as having PTSD. Workers with prior MERS-CoV experience were more susceptible than those without such experience. These findings suggest the need for timely interventions to manage human resources for a sustainable quarantine system.
Summary
Korean summary
본 연구는 COVID-19관련 인식과 COVID-19 안심 병원 근로자들의 외상 후 스트레스 장애 (PTSD) 유병률 사이의 연관성에서 직업 유형과 이전 중동 호흡기 증후군 (MERS-CoV) 방역 경험 여부로 인한 연관성의 크기 차이를 조사하였다. 비의료인이 의료인보다 PTSD유병에 더 강한 연관성을 보였고, 이전 메르스 방역 경험이 있는 근로자들이 COVID-19에 대한 "일반적 공포", "물품 부족 공포" 및 "특정 문제에 따른 공포"로 구분한 인식의 크기가 클 수록 방역 경험이 없는 근로자들보다 PTSD유병과의 관련성이 더 컸다. 결론적으로 COVID-19 대유행 기간 중 비의료 인력은 PTSD유병 확률이 더 높은 경향이 있었다. 이전 MERS-CoV 경험이 있는 근로자는 그러한 경험이 없는 근로자보다 더 취약했다.

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Original Articles
Public Sector Workers’ Mental Health in Argentina: Comparative Psychometrics of the Perceived Stress Scale
Agustín Ramiro Miranda, Ana Veronica Scotta, Ana Lucía Méndez, Silvana Valeria Serra, Elio Andrés Soria
J Prev Med Public Health. 2020;53(6):429-438.   Published online October 5, 2020
DOI: https://doi.org/10.3961/jpmph.20.229
  • 10,966 View
  • 218 Download
  • 17 Crossref
AbstractAbstract PDF
Objectives
Given that Argentinian public-sector workers are highly exposed to stressful conditions, and that the psychometric properties of the widely used Perceived Stress Scale (PSS) should be evaluated in different settings, this work aimed to compare the psychometric properties of the Latin American Spanish PSS-10 and PSS-4 and to identify the optimal scale for stress assessment.
Methods
A sample of 535 participants was randomly divided into 2 groups to evaluate dimensionality by exploratory and confirmatory factor analyses. The reliability of both scales was also evaluated. Convergent validity was estimated using the Executive Complaints Questionnaire, the average variance extracted, and the composite reliability. Discriminant validity was based on the correlation with the Utrecht Work Engagement Scale and the phi-square correlation between the components.
Results
The factor analyses supported bidimensionality of the PSS-10 (stress and coping), which showed a better fit than the PSS-4. Moreover, the reliability of the PSS-10 was higher, whereas the PSS-4 did not achieve adequate values of internal consistency. The PSS-10 was also correlated significantly with all validation scales, and presented proper internal convergent and divergent validity.
Conclusions
The PSS-10 is a reliable and structurally valid instrument to measure perceived stress and coping in a Latin American Spanish-speaking population with high work demands, and the findings of this study expand our knowledge on the geographical and sociocultural applicability of the PSS.
Summary

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    Agustín Ramiro Miranda, Ana Veronica Scotta, Mariela Valentina Cortez, Elio Andrés Soria, Pracheth Raghuveer
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Effect of Burnout on Post-traumatic Stress Disorder Symptoms Among Firefighters in Korea: Data From the Firefighter Research on Enhancement of Safety & Health (FRESH)
Woojin Kim, Munjoo Bae, Sei-Jin Chang, Jin-Ha Yoon, Da Yee Jeong, Dae-Sung Hyun, Hye-Yoon Ryu, Ki-Soo Park, Mi-Ji Kim, Changsoo Kim
J Prev Med Public Health. 2019;52(6):345-354.   Published online October 24, 2019
DOI: https://doi.org/10.3961/jpmph.19.116
  • 16,373 View
  • 285 Download
  • 21 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
It is well-known that post-traumatic stress disorder (PTSD) among firefighters contributes to their job-related stress. However, the relationship between burnout and PTSD in firefighters has rarely been studied. This study therefore explored the association between burnout and its related factors, such as trauma and violence, and PTSD symptoms among firefighters in Korea.
Methods
A total of 535 firefighters participated in the Firefighter Research on Enhancement of Safety & Health study at 3 university hospitals from 2016 to 2017. The 535 participants received a baseline health examination, including questionnaires assessing their mental health. A Web-based survey was also conducted to collect data on job-related stress, history of exposure to violence, burnout, and trauma experience. The associations among burnout, its related factors, and PTSD symptoms were investigated using structural equation modeling.
Results
Job demands (β=0.411, p<0.001) and effort-reward balance (β=-0.290, p<0.001) were significantly related to burnout. Burnout (β=0.237, p<0.001) and violence (β=0.123, p=0.014) were significantly related to PTSD risk. Trauma (β=0.131, p=0.001) was significantly related to burnout; however, trauma was not directly associated with PTSD scores (β=0.085, p=0.081).
Conclusions
Our results show that burnout and psychological, sexual, and physical violence at the hands of clients directly affected participants’ PTSD symptoms. Burnout mediated the relationship between trauma experience and PTSD.
Summary
Korean summary
535명의 현직소방관을 대상으로 소방공무원에서 업무관련스트레스, 폭력노출, 외상노출, 소진(번아웃), 외상후 스트레스 장애(PTSD) 증상 설문을 시행하였고, 구조방정식 통해 업무스트레스에 의한 소진이 PTSD에 주는 영향과 다른 요인간의 연관성을 분석하였다. 그 결과, 업무 환경에서의 높은 직무요구수준과 낮은 노력-보상 균형은 소진을 증가시키며, 업무스트레스에 의한 소진과 근무 중 겪게 되는 폭력노출 경험은 PTSD 점수와 양의 연관관계를 보였다. 반면, 업무 도중 외상사건 경험은 PTSD 점수와 직접적으로 유의한 연관관계를 보이지 않았으나, 소진을 통한 간접적으로 영향을 주는 것을 확인하였다.

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The Relationship Between Job Stress, Job Satisfaction, and the Symptom Checklist-90-Revision (SCL-90-R) in Marine Officers on Board
Jae Hee Kim, Soong-nang Jang
J Prev Med Public Health. 2016;49(6):376-385.   Published online September 12, 2016
DOI: https://doi.org/10.3961/jpmph.16.046
  • 15,633 View
  • 272 Download
  • 16 Crossref
AbstractAbstract PDF
Objectives
This study was conducted to investigate the relationships among job stress, job satisfaction, and mental health in marine officers.
Methods
The researchers gathered data on marine officers working at a harbor in Chungcheong Province, South Korea, using a self-reported questionnaire. Mental health was measured by the Symptom Checklist-90-Revision (SCL-90-R), and general characteristics including socioeconomic factors, job stress, and job satisfaction were measured by structured questionnaires. Multiple regression analysis was performed to investigate the relationships among job stress, job satisfaction, and mental health status according to the symptom dimensions of the SCL-90-R.
Results
Among the marine officers, obsessive-compulsive behavior, depression, and somatization were the most problematic symptoms. Those who reported poor health, low job satisfaction, and high job stress had a higher prevalence of psychoticism, somatization, depression, anxiety, and phobic anxiety.
Conclusions
An occupational health system should be introduced that would regularly check the mental health of marine officers in charge of ships and sailors, in order to help reduce their stress levels, enhance their job satisfaction, and thereby improve their mental health.
Summary

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The Association Between Oxidative Stress and Depressive Symptom Scores in Elderly Population: A Repeated Panel Study
Changwoo Han, Youn-Hee Lim, Yun-Chul Hong
J Prev Med Public Health. 2016;49(5):260-274.   Published online August 23, 2016
DOI: https://doi.org/10.3961/jpmph.16.029
  • 12,271 View
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  • 13 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Previous epidemiological studies about oxidative stress and depression are limited by hospital-based case-control design, single-time measurements of oxidative stress biomarkers, and the small number of study participants. Therefore, in this study, we analyzed the association between biomarker of oxidative stress and depressive symptom scores using repeatedly measured panel data from a community-dwelling elderly population.
Methods
From 2008 to 2010, a total of 478 elderly participants residing in Seoul, Korea, were evaluated three times. Participants underwent the Korean version of the Short Form Generic Depression Scale (SGDS-K) test for screening depression, and urinary malondialdehyde (MDA) levels were measured as an oxidative stress biomarker. We used a generalized estimating equation with a compound symmetry covariance structure to estimate the effects of oxidative stress on depressive symptom scores.
Results
A two-fold increase in urinary MDA concentration was significantly associated with a 33.88% (95% confidence interval [CI], 21.59% to 47.42%) increase in total SGDS-K scores. In subgroup analyses by gender, a two-fold increase in urinary MDA concentration was significantly associated with increased SGDS-K scores in both men and women (men: 30.88%; 95% CI, 10.24% to 55.37%; women: 34.77%; 95% CI, 20.09% to 51.25%). In bivariate analysis after an SGDS-K score ≥8 was defined as depression, the third and the fourth urinary MDA quartiles showed a significantly increased odds ratio(OR) of depression compared to the lowest urinary MDA quartile (third quartile OR, 6.51; 95% CI, 1.77 to 24.00; fourth quartile OR, 7.11; 95% CI, 1.99 to 25.42).
Conclusions
Our study suggests a significant association between oxidative stress and depressive symptoms in the elderly population.
Summary

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Replication of Early B-cell Factor 1 (EBF1) Gene-by-psychosocial Stress Interaction Effects on Central Adiposity in a Korean Population
Hyun-Jin Kim, Jin-Young Min, Kyoung-Bok Min
J Prev Med Public Health. 2016;49(5):253-259.   Published online July 10, 2016
DOI: https://doi.org/10.3961/jpmph.16.028
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AbstractAbstract PDF
Objectives
Central obesity plays a major role in the development of many chronic diseases, including cardiovascular disease and cancer. Chronic stress may be involved in the pathophysiology of central obesity. Although several large-scale genome-wide association studies have reported susceptibility genes for central adiposity, the effects of interactions between genes and psychosocial stress on central adiposity have rarely been examined. A recent study focusing on Caucasians discovered the novel gene , which was associated with central obesity-related traits via interactions with stress levels. We aimed to evaluate EBF1 gene-by-stress interaction effects on central adiposity traits, including visceral adipose tissue (VAT), in Korean adults.
Methods
A total of 1467 Korean adults were included in this study. We selected 22 single-nucleotide polymorphisms (SNPs) in the EBF1 gene and analyzed their interactions with stress on central adiposity using additive, dominant, and recessive genetic modeling.
Results
The four SNPs that had strong linkage disequilibrium relationships (rs10061900, rs10070743, rs4704967, and rs10056564) demonstrated significant interactions with the waist-hip ratio in the dominant model (pint<0.007). In addition, two other SNPs (rs6556377 and rs13180086) were associated with VAT by interactions with stress levels, especially in the recessive genetic model (pint<0.007). As stress levels increased, the mean values of central adiposity traits according to SNP genotypes exhibited gradual but significant changes (p<0.05).
Conclusions
These results suggest that the common genetic variants for EBF1 are associated with central adiposity through interactions with stress levels, emphasizing the importance of managing stress in the prevention of central obesity.
Summary

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    Michael J. Griffin
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The Effects of Temperature on Heat-related Illness According to the Characteristics of Patients During the Summer of 2012 in the Republic of Korea
Wonwoong Na, Jae-Yeon Jang, Kyung Eun Lee, Hyunyoung Kim, Byungyool Jun, Jun-Wook Kwon, Soo-Nam Jo
J Prev Med Public Health. 2013;46(1):19-27.   Published online January 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.1.19
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AbstractAbstract PDF
Objectives

This study was conducted to investigate the relationship between heat-related illnesses developed in the summer of 2012 and temperature.

Methods

The study analyzed data generated by a heat wave surveillance system operated by the Korea Centers for Disease Control and Prevention during the summer of 2012. The daily maximum temperature, average temperature, and maximum heat index were compared to identify the most suitable index for this study. A piecewise linear model was used to identify the threshold temperature and the relative risk (RR) above the threshold temperature according to patient characteristics and region.

Results

The total number of patients during the 3 months was 975. Of the three temperature indicators, the daily maximum temperature showed the best goodness of fit with the model. The RR of the total patient incidence was 1.691 (1.641 to 1.743) per 1℃ after 31.2℃. The RR above the threshold temperature of women (1.822, 1.716 to 1.934) was greater than that of men (1.643, 1.587 to 1.701). The threshold temperature was the lowest in the age group of 20 to 64 (30.4℃), and the RR was the highest in the ≥65 age group (1.863, 1.755 to 1.978). The threshold temperature of the provinces (30.5℃) was lower than that of the metropolitan cities (32.2℃). Metropolitan cities at higher latitudes had a greater RR than other cities at lower latitudes.

Conclusions

The influences of temperature on heat-related illnesses vary according to gender, age, and region. A surveillance system and public health program should reflect these factors in their implementation.

Summary

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The Relationship Between Psychosocial Stress and Allergic Disease Among Children and Adolescents in Gwangyang Bay, Korea
Mee-Ri Lee, Bu-Soon Son, Yoo-Ri Park, Hye-Mi Kim, Jong-Youn Moon, Yong-Jin Lee, Yong-Bae Kim
J Prev Med Public Health. 2012;45(6):374-380.   Published online November 29, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.6.374
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AbstractAbstract PDF
Objectives

Stress is considered a causal factor in many diseases, allergic disease being one of them. The prevalence of allergic disease is increasing in Korea, but the relationship between allergic symptoms and stress is not empirically well known. We aimed to evaluate the relationship between allergy-related symptoms and stress in children and adolescents.

Methods

We investigated 698 children and adolescents living in Gwangyang Bay, Korea, using a multi-stage cluster sampling method. Using the International Study of Asthma and Allergies in Childhood and the Psychosocial Well-being Index, these subjects were surveyed on allergy-related symptoms and psychosocial stressors in their lives, respectively. We used a multivariate logistic analysis for odds ratios for the complaint rate of allergic symptoms, after adjusting for age, gender, household income, body mass index, and residence.

Results

After adjustments, lifetime rhinitis (odds ratio [OR], 1.024), rhinoconjunctivitis (OR, 1.090), diagnosis of itchy eczema (OR, 1.040), treatment of itchy eczema (OR, 1.049), 12-month allergic conjunctivitis (OR, 1.026), diagnosis of allergic conjunctivitis (OR, 1.031), and treatment of allergic conjunctivitis (OR, 1.034) were found to be significantly associated with stress.

Conclusions

Our results support the notion that there is a relationship between stress and allergic symptoms in children and adolescents. Further research into any causal relationship between stress and allergies, as well as preventative public health plans for decreasing stress in children and adolescents are needed.

Summary

Citations

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Placental Superoxide Dismutase, Genetic Polymorphism, and Neonatal Birth Weight.
Yun Chul Hong, Kwan Hee Lee, Moon Whan Im, Young Ju Kim, Eun Hee Ha
J Prev Med Public Health. 2004;37(4):306-311.   Published online November 30, 2004
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AbstractAbstract PDF
BACKGROUND
The roles of antioxidants in the placenta and genetic susceptibility to oxidant chemicals in relation to neonatal birth weight have not been elucidated. We determined whether the level of placental manganese superoxide dismutase (MnSOD) and its genetic polymorphism plays any role in oxidative stress and neonatal birth weight. METHODS: We measured placental MnSOD and determined MnSOD genetic polymorphism among 108 pregnant women who were hospitalized for delivery and their singleton live births in Korea. Main outcome measurements are maternal urinary malondialdehyde (MDA) and birth weight. RESULTS: Maternal urinary concentrations of MDA were significantly associated with neonatal birth weight (P=0.04). The enzyme level of placental MnSOD was also significantly associated with MDA concentration (P=0.04) and neonatal birth weight (P< 0.01). We observed dose-response relationships between placental MnSOD and maternal urinary MDA, and neonatal birth weight after adjusting for maternal weight, height, age, and neonatal sex. After controlling for covariates, MnSOD variant genotype increased maternal urinary MDA concentrations (P< 0.01) and reduced birth weight by 149 gm (P=0.08). CONCLUSIONS: This study demonstrates that the placental level of MnSOD during pregnancy significantly affects fetal growth by reducing oxidative stress, and that genetic polymorphism of MnSOD probably modulate the effects of oxidants on fetal growth.
Summary
Research Support, Non-U.S. Gov't
Relationship Between Depression Anxiety Stress Scale (DASS) and Urinary Hydroxyproline and Proline Concentrations in Hospital Workers.
Keou Won Lee, Soo Jeong Kim, Jae Beom Park, Kyung Jong Lee
J Prev Med Public Health. 2011;44(1):9-13.
DOI: https://doi.org/10.3961/jpmph.2011.44.1.9
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AbstractAbstract PDF
OBJECTIVES
Although increased reactive oxygen species (ROS) is caused by stress accelerates collagen degradation, there was no data on the relationship between stress and urinary hydroxyproline (Hyp) and proline (Pro), a good marker of collagen degradation. The purpose of this study was to evaluate the relationship between depression, anxiety, and stress (DAS) and concentrations of urinary Hyp and Pro. METHODS: 97 hospital employees aged 20 to 58 were asked to fill out comprehensive self-administrated questionnaires containing information about their medical history, lifestyle, length of the work year, shit-work and DAS. Depression Anxiety Stress Scale (DASS) was applied to evaluate chronic mental disorders. Urine samples were analyzed using High Performance Liquid Chromatography (HPLC) with double derivatization for the assay of hydroxyproline and proline. RESULTS: The mean value of Hyp and Pro concenturation in all subjects was 194.1+/-113.4 micromol/g and 568.2+/-310.7 micromol/g. DASS values and urinary Pro concentrations were differentiated by sex (female > male, p < 0.05) and type of job (nurse > others, p < 0.05). In the stepwise multiple linear regressions, urinary Hyp and Pro concentrations were influenced by stress (Adjusted r2 = 0.051) and anxiety and job (Adjusted r2 = 0.199), respectively. CONCLUSIONS: We found that stress and anxiety were correlated with urinary Hyp and Pro concentrations. To identifying a definite correlation, further study in large populations will be needed.
Summary

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English Abstract
Crisis Intervention for Workers in Severely Stressful Situations After Massive Layoffs and Labor Disputes.
Jong Min Woo, Jeong Ho Chae, Soo Chan Choi
J Prev Med Public Health. 2010;43(3):265-273.
DOI: https://doi.org/10.3961/jpmph.2010.43.3.265
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AbstractAbstract PDF
OBJECTIVES
Due to the economic crisis and globalization, many workers have been suffering from severe occupational stress due to job insecurity and struggles related to downsizing and restructuring. This study aims to assess the stress levels among workers involved in fierce labor disputes and massive layoffs and to evaluate their specific needs and satisfaction with counseling services set up to help workers cope with severely stressful situations? METHODS: The authors provided crisis intervention to workers in traumatic situations to compare the differential level of stress responses and needs among the workers remaining employed in a large auto factory, those laid off by it, and those laid off by other companies in the same region (Pyeongtaek, Gyeonggi Province). We measured stress levels using the worker's stress response inventory (WSRI) and heart rate variability (HRV), and assessed workers' satisfaction with the counseling services. RESULTS: 502 workers participated in the program. Fifty-seven percent of them consulted with occupational problems. The mean WSRI score of the workers remaining employed in the automobile factory was higher than that of the unemployed (employed: 39.8+/-19.9, unemployed: 29.3+/-18.8). Ninety-five percent of workers responded that they were satisfied or very satisfied with the counseling services. CONCLUSIONS: This study suggests the urgent need for the establishment of a national crisis intervention program dedicated to supporting workers in severely stressful situations.
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Review
Gene-Diet Interaction on Cancer Risk in Epidemiological Studies.
Sang Ah Lee
J Prev Med Public Health. 2009;42(6):360-370.
DOI: https://doi.org/10.3961/jpmph.2009.42.6.360
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AbstractAbstract PDF
Genetic factors clearly play a role in carcinogenesis, but migrant studies provide unequivocal evidence that environmental factors are critical in defining cancer risk. Therefore, one may expect that the lower availability of substrate for biochemical reactions leads to more genetic changes in enzyme function; for example, most studies have indicated the variant MTHFR genotype 677TT is related to biomarkers, such as homocysteine concentrations or global DNA methylation particularly in a low folate diet. The modification of a phenotype related to a genotype, particularly by dietary habits, could support the notion that some of inconsistencies in findings from molecular epidemiologic studies could be due to differences in the populations studied and unaccounted underlying characteristics mediating the relationship between genetic polymorphisms and the actual phenotypes. Given the evidence that diet can modify cancer risk, gene-diet interactions in cancer etiology would be anticipated. However, much of the evidence in this area comes from observational epidemiology, which limits the causal inference. Thus, the investigation of these interactions is essential to gain a full understanding of the impact of genetic variation on health outcomes. This report reviews current approaches to gene-diet interactions in epidemiological studies. Characteristics of gene and dietary factors are divided into four categories: one carbon metabolism-related gene polymorphisms and dietary factors including folate, vitamin B group and methionines; oxidative stress-related gene polymorphisms and antioxidant nutrients including vegetable and fruit intake; carcinogen-metabolizing gene polymorphisms and meat intake including heterocyclic amins and polycyclic aromatic hydrocarbon; and other gene-diet interactive effect on cancer.
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Brief Communication
Determination of Appropriate Sampling Time for Job Stress Assessment: the Salivary Chromogranin A and Cortisol in Adult Females.
Ran Hi Hong, Yun Jung Yang, Sang Yon Kim, Won Young Lee, Yeon Pyo Hong
J Prev Med Public Health. 2009;42(4):231-236.
DOI: https://doi.org/10.3961/jpmph.2009.42.4.231
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AbstractAbstract PDF
OBJECTIVES
This study was conducted to determine the appropriate sampling time of the salivary stress markers, chromogranin A (CgA) and cortisol as objective indices of job stress assessment in adult females. METHODS: The subjects were 20~39-year-old women (13 office workers, 11 sales-service workers, and 11 college students) who were eligible for the study and free of acute and chronic medical conditions. Salivary CgA and cortisol levels were determined by enzyme-linked immunosorbent assay (ELISA). Saliva samples were collected (2ml each) at 7:00, 8:00, 10:30, 12:00, 17:30, and 22:30 on a typical day. Salivary CgA and cortisol levels, according to sampling time, were compared among the three groups using general linear model. The full version of the Korean Occupational Stress Scale (KOSS), which includes socioeconomic characteristics, health behavior, work-related characteristics, and BMI, was used to access the subjects' job stress. Multiple regression analysis of the job stressors identified by the KOSS was performed on salivary CgA and cortisol levels. RESULTS: The salivary CgA level peaked at 7:00 (time of awakening), then decreased and were maintained at a low level throughout the day, and increased slightly at 17:30. The salivary cortisol level increased steeply within the 1st hour after awakening, followed by a gradual decrease by 12:00, and was then maintained at a low level throughout the day. The salivary cortisol levels of subjects who worked < or =5 days per week and graduated from the university were significantly lower at 8:00 (p=0.006). The salivary cortisol levels of non-smokers were significantly lower at 7:00 (p=0.040) and 8:00 (p=0.003) compared to smokers. There were no significant differences in salivary CgA and cortisol levels at 10:30 and 12:00 in general characteristics. The regression coefficients on salivary CgA level were significant with interpersonal conflict at 17:30 and job insecurity at 22:30. Regression coefficients on salivary cortisol level were significant with organizational system and total job stressors at 17:30. CONCLUSIONS: We suggest that the appropriate sampling times for the salivary stress markers, CgA and cortisol, are at 7:00 (time of awakening), 8:00 (1 hour after awakening), 17:30 (early evening), and 22:30 (before sleep).
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English Abstracts
Psychological Health in Residents Participating in Clean-up Works of Hebei Spirit Oil Spill.
Minkyo Song, Yun Chul Hong, Hae Kwan Cheong, Mina Ha, Hojang Kwon, Eun Hee Ha, Yeyong Choi, Woo Chul Jeong, Jongil Hur, Seung Min Lee, Eun Jung Kim
J Prev Med Public Health. 2009;42(2):82-88.
DOI: https://doi.org/10.3961/jpmph.2009.42.2.82
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AbstractAbstract PDF
OBJECTIVES
Our objective was to examine and evaluate the psychological health of the residents of Taean during the cleanup of the Hebei Spirit (HS) oil spill and to review some factors associated with the results. METHODS: A community survey of 71 men and women was conducted 8 weeks after the HS oil spill. Questionnaires used were the PWI (Psychological Well-being Index) scale for psychosocial distress, the CES-D (Center for Epidemiologic Studies-Depression) scale for depressive symptoms, and a questionnaire created to assess suicidal impulses. RESULTS: The overall prevalence of high-risk psychosocial distress among the study group was 64.2%. The percentages of respondents with scores on the CES-D Scale above 16 and above 21 were 77.6% and 62.7%, respectively. The percentage of respondents categorized as having suicidal impulses was 18.3%. When compared with unexposed groups in the general population taken from various sources, the residents of Taean were 6.5 times as likely to have high stress and 9.4-9.7 times as likely to be depressed. No significant difference in the rate of suicidal impulse was found between the residents of Taean and the general population. Factors associated with high stress, depression, and suicidal impulses were age, a change in income, educational level, number of days working on the cleanup, and positive responses to questions about "affected daily activity" and "hospital visit due to work on cleanup." CONCLUSIONS: The results suggest that the HS oil spill had a significant impact on the psychological health of residents of Taean, but the comparability of the unexposed groups is a limitation of the study.
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Multiple Roles and Health among Korean Women.
Su Jin Cho, Soong Nang Jang, Sung Il Cho
J Prev Med Public Health. 2008;41(5):355-363.
DOI: https://doi.org/10.3961/jpmph.2008.41.5.355
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AbstractAbstract PDF
OBJECTIVES
Most studies about multiple roles and women's health suggested that combining with paid job, being married and having children was more likely to improve health status than in case of single or traditional roles. We investigated whether there was better health outcome in multiple roles among Korean women coinciding with previous studies of other nations. METHODS: Data were from the 2005 Korea National Health & Nutritional Examination Survey, a subsample of women aged 25-59 years (N=2,943). Health status was assessed for self-rated poor health, perceived stress and depression, respectively based on one questionnaire item. The age-standardized prevalence of all health outcomes were calculated by role categories and socioeconomic status. Multiple logistic regression was used to assess the association of self rated health, perceived stress, and depression with multiple roles adjusted for age, education, household income, number of children and age of children. RESULTS: Having multiple roles with working role was not associated with better health and psychological wellbeing. Compared to those with traditional roles, employed women more frequently experienced perceived stress, with marital and/or parental roles. Non-working single mothers suffered depression more often than women with traditional roles or other role occupancy. Socioeconomic status indicators were potent independent correlates of self-rated health and perceived stress. CONCLUSIONS: Employment of women with other roles did not confer additional health benefit to traditional family responsibility. Juggling of work and family responsibility appeared more stressful than traditional unemployed parental and marital role in Korean women.
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Original Article
Psychological Distress and Occupational Injury: Findings from the National Health Interview Survey 2000-2003.
Jaeyoung Kim
J Prev Med Public Health. 2008;41(3):200-207.
DOI: https://doi.org/10.3961/jpmph.2008.41.3.200
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AbstractAbstract PDF
OBJECTIVES
This study examined whether serious psychological distress (SPD) is associated with occupational injury among US employees. METHODS: The employed population aged 18-64 years was examined (n=101,855) using data from the National Health Interview Survey (NHIS) 2000-2003. SPD was measured using the Kessler 6-item Psychological Distress Scale (K-6), a screening scale designed to identify persons with serious mental illness. The predicted marginal prevalence of psychological distress and occupational injury with the adjusted odds ratio were estimated using multiple logistic regression analyses. RESULTS: The age-adjusted 3-month prevalence of occupational injury was 0.80+/-0.12% in workers with SPD, which was 37% greater than in workers without SPD (0.58+/-0.03%). The odds of occupational injury in workers with SPD were higher compared to workers without SPD (OR=1.34, 95% CI=0.93-1.92), after controlling for sex, age, race, education, occupation, and activity limitation by at least one medical condition. Male, service and blue collar occupation, and activity limiation by co-morbidity showed significantly higher odds of occupational injury for workers with SPD. CONCLUSIONS: The findings suggest that SPD accounts for an increased likelihood of occupational injury among US employees. A further longitudinal study is needed to differentiate the mechanism or causal pathways linking individual injury risk at the workplace, SPD, and socioeconomic factors.
Summary

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Evaluation Studies
Stability and Intra-Individual Variation of Urinary Malondialdehyde and 2-Naphthol.
Kyoung Ho Lee, Daehee Kang
J Prev Med Public Health. 2008;41(3):195-199.
DOI: https://doi.org/10.3961/jpmph.2008.41.3.195
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AbstractAbstract PDF
OBJECTIVES
Malondialdehyde (MDA), a lipid peroxidation by-product, has been widely used as an indicator of oxidative stress. Urinary 2-naphthol, a urinary PAH metabolite, is used as a marker of ambient particulate exposure and is associated with lung cancer and chronic obstructive pulmonary disease. However, the stability and intra-individual variation associated with urinary MDA and 2-naphthol have not been thoroughly addressed. The objective of this study was to assess the stability and intraindividual variation associated with urinary MDA and 2-naphthol. METHODS: Urine samples were collected from 10 healthy volunteers (mean age 34, range 27~42 years old). Each sample was divided into three aliquots and stored under three different conditions. The levels of urinary MDA and 2-naphthol were analyzed 1) just after sampling, 2) after storage at room temperature (21degrees C) for 16 hours, and 3) after storage in a -20degrees C freezer for 16 hours. In addition, an epidemiological study was conducted in 44 Chinese subjects over a period of 3 weeks. The urinary MDA and 2-naphthol were measured by HPLC three times. RESULTS: There was no difference in the levels of urinary MDA and 2-naphthol between the triplicate measurements (n=10, p=0.84 and p=0.83, respectively). The intra-class correlation coefficients (ICC) for urinary MDA and 2-naphthol were 0.74 and 0.42, respectively. However, the levels of PM2.5 in the air were well correlated with the levels of both MDA and 2-naphthol in the epidemiological study. CONCLUSIONS: These results suggest that urinary MDA and 2-naphthol remain stable under variable storage conditions, even at room temperature for 16 hours, and indicate that these markers can be used in epidemiological studies involving various sample storage conditions. The intra-CC of urinary 2-naphthol and MDA were acceptable for application to epidemiological studies.
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English Abstracts
Associations of Non Alcoholic Fatty Liver with the Metabolic Syndrome and Serum Carotenoids.
Sun kyun Park, Hyun Jung Lee, Duk Hee Lee, Sung Kook Lee, Byung Yeol Chun, Sung Ae Kim, Hye Sung Lee, Hyo Kyung Son, Sung Hi Kim
J Prev Med Public Health. 2008;41(1):39-44.
DOI: https://doi.org/10.3961/jpmph.2008.41.1.39
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AbstractAbstract PDF
OBJECTIVES
This study was conducted to investigate the associations of non alcoholic fatty liver with metabolic syndrome and the serum carotenoids. METHODS: This study was conducted in a general hospital in South Korea from November, 2004 to August, 2005. The study subjects were 350 sampled persons who were aged from 40 years and older (males: 180, females: 170). They were grouped into the normal, mild and severe groups according to fat accumulation in their livers, as determined by ultrasonography. We analyzed the association between non alcoholic fatty liver and metabolic syndrome by multiple logistic regression analysis and we analyzed the association between non alcoholic fatty liver and the serum carotenoids by a general linear model(ANCOVA). RESULTS: After adjustment for the effect of potential covariates, the prevalence of metabolic syndrome was associated with fat accumulation in the liver (p trend <0.001). If the odds ratio of normal group is 1.00, then that of the mild group is 2.80 (95% C.I=1.17-6.71) and that of the severe group is 7.29 (95% C.I=2.76-19.30). The prevalence of metabolic alterations fitting the criteria of metabolic syndrome, according to the class of fat accumulation in the liver, was significantly increased, except for criteria of high blood pressure, a large waist circumference and low HDL (high density lipoprotein) cholesterol level (p trend <0.001). The level of serum beta-carotene was decreased according to the class of fat accumulation in the liver (p trend=0.036), but the levels of serum alpha-carotene, lycopene, bata-cryptoxanthin and lutein were not decreased. CONCLSIONS: This study shows that non alcoholic fatty liver was associated with metabolic syndrome and with the serum beta-carotene level.
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Relationship between Job Stress Contents, Psychosocial Factors and Mental Health Status among University Hospital Nurses in Korea.
Hyun Suk Yoon, Young Chae Cho
J Prev Med Public Health. 2007;40(5):351-362.
DOI: https://doi.org/10.3961/jpmph.2007.40.5.351
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AbstractAbstract PDF
OBJECTIVES
The present study was intended to assess the mental health of nurses working for university hospitals and to establish which factors determine their mental health. METHODS: Self-administered questionnaires were given to 1,486 nurses employed in six participating hospitals located in Daejeon City and Chungnam Province between July 1st and August 31st, 2006. The questionnaire items included sociodemographic, job-related, and psychosocial factors, with job stress factors (JCQ) as independent variables and indices of mental health status (PWI, SDS and MFS) as dependent variables. For statistical analysis, the Chi-square test was used for categorical variables, with hierarchical multiple regression used for determining the factors effecting mental health. The influence of psychosocial and job-related factors on mental health status was assessed by covariance structure analysis. The statistical significance was set at p<0.05. RESULTS: The factors influencing mental health status among subject nurses included sociodemographic characteristics such as age, number of hours of sleep, number of hours of leisure, and subjective health status; job-related characteristics such as status, job satisfaction, job suitability, stresses such as demands of the job, autonomy, and coworker support; and psychosocial factors such as self-esteem, locus of control and type A behavior patterns. Psychosocial factors had the greatest impact on mental health. Covariance structure analysis determined that psychosocial factors affected job stress levels and mental health status, and that the lower job stress levels were associated with better mental health. CONCLUSIONS: Based on the study results, improvement of mental health status among nurses requires the development and application of programs to manage job stress factors and/or psychosocial factors as well as sociodemographic and job-related characteristics.
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The Levels of Psychosocial Stress, Job Stress and Related Factors of Medical Doctors Practicing at Local Clinics.
Moon Kuk Kang, Yune Sik Kang, Jang Rak Kim, Baek Geun Jeong, Ki Soo Park, Sin Kam, Dae Yong Hong
J Prev Med Public Health. 2007;40(2):177-184.
DOI: https://doi.org/10.3961/jpmph.2007.40.2.177
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AbstractAbstract PDF
OBJECTIVES
This study was conducted to investigate the levels of psychosocial stress, job stress and their related factors among medical doctors practicing at local clinics. METHODS: A survey using a self administered questionnaire was administered to 1,456 doctors practicing at private clinics via post for 2 months (2006. 1 - 2006. 3). Psychosocial stress, job stress,demographic factors, job related factors and health related behaviors were investigated. Among the eligible study population, the respondents were 428 doctors (29.4%). RESULTS: The average scores of psychosocial stress and job stress were 2.19 and 3.13, respectively. The levels of psychosocial stress and job stress were statistically lower in older respondents, those who worked shorter or who were more satisfied with their job, and those with higher socioeconomic status. The level of psychosocial stress was related with smoking status, drinking status and exercise. The level of job stress was related with smoking status and exercise. In multiple linear regression analysis using psychosocial stress as a dependent variable, age, working hours per day, job satisfaction and perception on socioeconomic status were significant independent variables. In analysis using job stress as a dependent variable, age, working hours per day and job satisfaction were significant independent variables. CONCLUSIONS: Stress affects the doctor-patient relationship, productivity and overall health level of people. Therefore, it is important to manage and relieve the stress of doctors. It is suggested that more advanced studies on stress level and related factors and ways to improve the stress and health related behaviors of medical doctors should be conducted.
Summary

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Original Articles
Professional Job Perception, Job Stress and Job Satisfaction of Westerm Doctors and Oriental Doctors Practicing at Local Clinic.
Jong Yeon Kim, Sin Kam, Yune Sik Kang, Yong Kee Cho, Sang Won Lee, Dae Gu Jin, Soon Gi Ahn, Byung Yeol Chun, Min Hae Yeh
J Prev Med Public Health. 2004;37(1):44-50.
  • 3,346 View
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AbstractAbstract PDF
OBJECTIVE
This study was conducted in order to investigate the professionalism, job stress and job satisfaction in western and oriental doctors in Korea. METHODS: The authors conducted a survey using a selfadministered questionnaire, conducted between August and September, 2001. The study subjects were 457 western doctors and 161 oriental doctors practicing at local clinics in Daegu City. RESULTS: For the professionalism scale, the score for 'belief in service to the public' of western doctors was significantly higher than that of oriental doctors (p< 0.05) whereas the scores for 'sense of calling to the field' and 'feeling of autonomy' were higher in oriental doctors (p< 0.01). For the job stress scale, the scores for 'work factor', and 'clinical responsibility/decision factor' of western doctors were significantly higher than those of oriental doctors (p< 0.01). Of the western doctors, 59.7% expressed satisfaction with their job as a doctor, 69.5% responded that the role of a doctor was appropriate to their aptitude, and 61.8% answered that they wouldn't consider other kinds of job even if offered. In case of oriental doctors, these responses were83.1%, 82.5%, and 82.3%, espectively. CONCLUSION: The job stress scores of western doctors were higher than those of oriental doctors, but the job satisfaction was lower. The reasons for the above results are not clear. Further studies are required to understand the characteristics of job stress and job satisfaction in doctors.
Summary
A Study on the Related Factors with Internet Addiction of the 11th Grade Students in an Urban Area.
Moo Sik Lee, Keon Yeop Kim, Kyung Jae Ko, Hyo Jin Lee, Wook Nam, Eun Young Kim, Jee Young Hong, Bak Ju Na
Korean J Prev Med. 2003;36(4):390-398.
  • 3,091 View
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OBJECTIVES
To evaluate the degree of adolescent internet addiction, and investigate its relationship to the general characteristics, internet environments, and contents, especially the stress measured by the psychosocial wellbeing index-short form (PWI-SF). METHODS: The data was obtained from self-administered questionnaires from 886 11th grade urban area students. The questionnaires consisted of general characteristics, internet user's environments, frequencies by internet contents, internet addiction test and PWI-SF. RESULTS: The possible rate of internet use at home was 95.1%, and the area of most internet use was the home. The frequencies of internet game and porno site use were higher in males, with web searching and community uses higher in females. The total mean of internet addiction score was 56.8, and was higher for male than for female students. From multiple regression, as analyzed by the internet addiction score as a dependent variable, on-line friends, internet use times, years of internet use, frequencies of internet game & porno site use, and PWI-SF scores were significant in male. Internet use times, the frequencies of internet game, chatting, community use, and PWI-SF score were significant in female. Four PWI-SF subscales (social role & self reliability, depression, general health & vitality, and sleep disturbance & anxiety) and internet addiction were significantly correlated in both male and female students, with depression having the most correlation. CONCLUSION: The results of this study suggest that intervention should be provided to prevent internet addiction, especially for coping with stress in Korean teenage students.
Summary
In Vitro
Exposure Assessment of PCDD/Fs and Monitoring of Health Effects on Workers and Residents near the Waste Incinerators in Korea.
Jong Han Leem, Yun Chul Hong, Kwan Hee Lee, Ho Jang Kwon, Jae Yeon Jang
Korean J Prev Med. 2003;36(4):314-322.
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OBJECTIVES
In this study, the exposure status of the hazardous substances from incinerators, such as polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs), were studied, and the relationship between the exposure of these hazardous substances and their heath effects on the workers and residents near municipal solid waste (MSW) incinerators and an industrial incinerator investigated. METHODS: Between July 2001 and June 2002, 13 workers at two MSW incinerators, 16 residents from the area around the two MSW incinerators, 6 residents from the control area, and further 10 residents near an industrial incinerator, estimated to emit higher levels of hazardous substances, were interviewed. Information, including sociodemographic information, personal habits, and work history, detailed gynecologic and other medical history were collected through interviews. Blood samples were also collected from 45 subjects, and analyzed for PCDD/DFs, by high resolution gas chromatography - high resolution mass spectrometry, using the US EPA 1613 method. In addition to the questionnaire survey, urinary concentrations of 8-hydroxydeoxyguanosine (8-OH-dG) and malondialdehyde (MDA) were measured as oxidative injury biomarkers. The urinary concentrations of 8-OH-dG were determined by in vitro ELISA, and the MDA by HPLC, using an adduct with thiobarbituric acid. RESULTS: The PCDD/DFs concentrations in the residents near the industrial incinerator were higher than those in the controls, workers and residents near the MSW incinerators. The average TEQ (Toxic Equivalencies) concentrations of the PCDD/DFs in residents near the industrial incinerator were 53.4pg I-TEQs/g lipid. The estimated daily intakes were within the tolerable daily intake range (1-4 pg I-TEQ/Kg bw/day) suggested by WHO (1997) in only 30% to the people near the industrial incinerator. Animal studies have already shown that even a low body burden of PCDD/DFs, such as 10ng TEQ/kg bw, can cause oxidative damage in laboratory animals. Our study also showed that the same body burden of PCDD/DFs can cause oxidative damage to humans. CONCLUSIONS: The exposures to PCDD/DFs and the oxidative stress of residents near the industrial incinerator, were higher than those in the controls, workers and residents near the MSW incinerators. Proper protection strategies against these hazardous chemicals are needed. Because a lower body burden of PCDD/Fs, such as 10ng TEQ/kg bw, can cause oxidative damage, the tolerable daily intake range should be restrictedly limited to 1pg I-TEQ/kg bw/day.
Summary
Original Articles
Professional Job Perception, Job Stress and Job Satisfaction of Doctors Practicing in Local Clinic in Daegu City.
Dae Gu Jin, Sin Kam, Yune Sik Kang, Yong Kee Cho, Sang Won Lee, Jong Yeon Kim, Soon Gi Ahn, Byung Yeol Chun, Min Hae Yeh
Korean J Prev Med. 2003;36(2):153-162.
  • 3,654 View
  • 40 Download
AbstractAbstract PDF
OBJECTIVE
This study was conducted in order to investigate professional job perception, job stress and job satisfaction in doctors. METHOD: The authors conducted a survey using a self-administered questionnaire, conducted between August and September, 2001. The study subjects were 457 doctors practicing at local clinics in Daegu City. RESULTS: For the professionalism scale, the score for 'sense of calling to field' and 'feeling of autonomy' were relatively high. Age, working hours per day, and perception of socioeconomic status significantly influenced the professionalism scale scores (p< 0.01). For the job stress scale, the scores for 'clinical responsibility/ decision' factor were the highest of all the surveyed factors. Working hours per day significantly influenced the job stress scores (p< 0.01). To investigate the overall relationship between the variables, the authors conducted a linear structural equation model analysis. The equation was statistically appropriate and a good fit. The job stress, and the professionalism factors, respectively influenced job satisfaction negatively and positively (T> 2.0). The working hours per day and status perception also influenced their job satisfaction (T> 2.0). CONCLUSION: To promote the job satisfaction of doctors, the development of coping tools and other intervention methods are needed to increase doctor's professional job perception and reduce their job stress. Further studies are required to understand the characteristics of job satisfaction and for its promotion with doctors.
Summary
Relationships of Smoking, Stress and Social Support of High School Students.
Eun Hyun Lee, Chun Ki Hong, Mi Sook Song, Soon Young Lee, Jee Yoon Kim
Korean J Prev Med. 2003;36(2):131-136.
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OBJECTIVES
The purpose of the present study was to explore a possible interaction effect of stress and social support on the smoking status and identify smoking related factors of high school students. METHODS: A cross-sectional design was used for this study. A total of 1, 251 high school students from Gyeonggi-do were selected using stratified-proportional random cluster sampling methods. The participants completed a set of questionnaires to measure their smoking status, stress, social support and sociodemographic information. The obtained data were analyzed using descriptive statistics, x2-tests and hierarchical logistic regressions. RESULTS: The interaction effect of stress and social support on smoking status was not supported. However, stress, sex, types of school, parent's smoking and friends' smoking were significantly predicted the smoking status of the high school students. CONCLUSIONS: In relation to the prevention of adolescents' smoking, it is recommended to decrease the stress levels of students, to make adolescents' parents cease smoking, and to educate adolescents on how to refuse the temptation to smoke or pressure from their smoking friend.
Summary
Community Based Study for Stress and It's Related Factors.
Gyung Jae Oh, Jeong Mi Lee, Sang Sun Kil, Keun Sang Kwon
Korean J Prev Med. 2003;36(2):125-130.
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OBJECTIVES
This study evaluated the stress of community residents using the General Health Questionnaire, GHQ-60, as an instrument of stress measurement. METHODS: The study included 2100 residents, aged 20 and over, living in three areas, a large city, a medium sized city and a rural area, between June and September 2001. A questionnaire interviewing method was used to collect data. The data were analyzed using a t-test, ANOVA, Pearson's correlation coefficients and multiple regression analysis. RESULTS: In this study, the degree of stress, as measured by the GHQ-60, was shown to be significantly higher in the following categories: females, people over 60 years old, people engaged in the primary industries and labor work, low incomes, the divorced and the bereaved, people who received no more than an elementary education, people who suffer from chronic diseases and non-exercisers. A factor analysis suggested that there were three factors of social dysfunction factors; psychosomatic symptom, and depression and anxiety. The social dysfunction factors was statistically significant for the groups described above. The factor of psychosomatic symptoms was statistically significant in the rural residents, and in the groups described above. The depression and anxiety factor was statistically significant in the large city residents, people aged between 20-29 years, students, unmarried persons, university graduates and those having suffered from chronic diseases. From the multiple linear regression analyses, chronic disease, exercise, gender and income, proved to be significant stress related factors. CONCLUSIONS: This study suggests that special attention should be given to the management of the chronic invalided, non-exercisers, females and small income earners, in order to maintain and promote the psychological health of residents in a community.
Summary
The Impact of New Work Organizational System on Job Strain, and Psychosocial Distress.
Sang Baek Koh, Sei Jin Chang, Byeong Hwan Sun, Dong Muk Kang, Mia Son, Jong Ku Park, Bong Suk Cha
Korean J Prev Med. 2003;36(1):71-76.
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OBJECTIVES
New organizational work systems, and their impact on the mental health of employees, are considered to beone of the most important topics in the area of industrial health. This study was conducted to compare job characteristics (job demand and decision latitude) levels, and psychosocial distress of workers in acompany introducing to new organizational work systems, to those of workers managed by traditional work systems. METHODS: A study sample of 627 shipbuilding workers (446the new work organizational system and 181the traditional system) were recruited for this study. A structured-questionnaire was used to assess general characteristics, job characteristics (work demand, decision latitude), and psychosocial distress. RESULTS: The decision latitude was not significantly higher in the new work system compared to the traditional system. However, the job demand was significantly higher in the new work system than in the traditional system. The psychosocial distress was higher within the new work system than the traditional system, but no significant relationships were found. The proportion of increased strain was significantly greater with the new system than the traditional system. CONCLUSION: These results suggest that increases in the decision latitude did not sufficiently compensate for higher job strain or increased work intensity. If the increase in the decision latitude was temporary, with the typical job demand remaining high, such work can be still be considered to have a job strain. Future research should consider psychosocial distress and fatigue as important problems caused by new work organizational systems, and should be performed to assess their impact through out industry.
Summary
The Association between the Psychosocial Well-being Status and Adverse Lipid Profiles in a Rural Korean Community.
Chang Hoon Kim, Myoung Hee Kim, Sung Il Cho, Jung Hyun Nam, Bo Youl Choi
Korean J Prev Med. 2003;36(1):24-32.
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OBJECTIVES
To identify the psychosocial well-being status in a rural community, and examine the association between the psychosocial well-being status and adverse lipid profile. METHOD: In 2001, we surveyed 575 subjects in Yangpyoung, Kyounggido, including medical examination, fasting-blood sample and questionnaires for the psychosocial well-being status, socioeconomic position and behavioral risk factors. The logistic regression analysis was used to examine explanatory factors of the psychosocial well-being status, and association between the psychosocial well-being status and adverse lipid profiles. RESULT: The association between the psychosocial well-being status and adverse lipid profiles was not strong. The total cholesterol and triglyceridelevels were associated with psychosocial well-being. The adjusted odds ratio for moderate psychosocial well-being relating to total cholesterol was 1.90 (95%CI, 0.82-4.04), but that for triglyceride was 0.65 (95%CI, 0.36-1.21). The HDL-Cholesterol and LDL-Cholesterol level were not associated with the psychosocial well-being status. CONCLUSION: The total cholesterol and psychosocial well-being status were weakly associated, but the between the psychosocial well-being status and adverse lipid profiles were not consistent.
Summary
The Effect of Social Support on Chronic Stress and Immune System in Male Manufacturing Workers.
Sei Jin Chang, Sang Baek Koh, Jong Ku Park, Bong Suk Cha
Korean J Prev Med. 2002;35(4):287-294.
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OBJECTIVES
To examine whether cumulative chronic stress influences the immune status, and to verify the effect of social support on the relationship between these two dimensions in male manufacturing workers. METHODS: A total of 39 workers were recruited for this study. A structured-questionnaire was used to assess general characteristics, job characteristics (work demand and decision latitude), psychosocial distress, and social support. The serum levels of CD4 and CD8 were measured as immune markers, and were collected between 8:00 and 10:00am in order to standardize the markers. Nonparametric statistics were used to estimate the differences between job characteristics and the immune markers. RESUJLTS: General characteristics, and health-related behaviors, were not associated with CD4, CD8 or CD4/CD8. No relationships were found between job characteristics and the mean levels of immune reactivity. These results were consistent, even after controlling for social support. Social support failed to modify the relationship toward work demand, decision latitude or psychosocial distress to CD4, CD8, and CD4/CD8. CONCLUSION: Cumulative chronic life stress might not influence the immune status, and the effects of social support on the immune function under chronic stress, may not play a crucial role in modifying the relationships. This implication supports that the effect of stress on the immune function may be determined by the characteristics of that stress. Further research should effectively considers the type, magnitude and timing of a stress event, and modifiable factors, such as personality traits, coping style, and hormone excretion levels, on the alteration of immune status.
Summary
Determination of Free 4-hydroxyproline with Dansylchloride by HPLC in Human Urine.
Keou Weon Lee, Kyung Jong Lee, Young Bong Cho
Korean J Prev Med. 2002;35(4):282-286.
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OBJECTIVES
The level of 4-hydroxyproline (4-Hyp) in human urine was measured using high performance liquid chromatography (HPLC) with a fluorescence detector. This method is useful for medical examinations and investigating the radicals induced by physical, chemical, mental stresses. This method is superior to many published several methods in terms of its low cost and ability to analyze many samples. METHODS: The urine from workers in a tire manufacturing company (22 male pre- and post-shift workers) and 18 office-workers as controls were analyzed. Data concerning age, the cumulative drinking amount and the cumulative smoking amount was collected with a questionnaire. The optimum applied amount of dansyl-Cl, the optimum reaction temperature and time, the recoveries and the optimum pH of the eluent and buffer were determined. 4-Hyp from human urine was derivatized with dansyl-Cl (dimethylamino-naphthalene-1-sulfonyl chloride) after removing the alpha-amino acid by a treatment with phthalic dicarboxaldehyde (OPA) and cleaned with Bond Elut C18 column. The 4-Hyp derivatives were separated on a reversed phase column by gradient elution with a phosphate buffer (5 m mol, pH 8.0) and acetonitrile, and detected by fluorescence measurements at 340 nm (excitation) and 538 nm (emission). RESUJLTS: The detection limit for the urinary free 4-Hyp was 0.364 micro mol/l. The recovery rate of 4-Hyp was 99.7 %, and the effective pH of the phosphate buffer and borate buffer were 3.0 and 8.0, respectively. From statistical analysis, age, drinking and smoking did not affect the urinary free 4-Hyp in both the controls and workers. The range of urinary 4-Hyp in the controls, pre-shift, and post-shift workers were 0.33-16.44, N.D-49.06, and 0.32-56.27 micro mol/l. From the pared-sample t-test, the urinary 4-Hyp levels in post-shift workers (11.82+/-16.73 n mol/mg Cre) were 2-fold higher than in pre-shift workers (5.36+/-5.53 n mol/mg Cre) and controls (4.91+/-4.89 n mol/mg Cre). CONCLUSIONS: This method was developed with high sensitivity, accuracy, and precision. The present method was effectively applied to analyze the urinary free 4-Hyp in both controls and workers.
Summary
Comparison of Job Stressors between Managers and Employees in White-Collar Workers of an Electric Company.
Jin Kook Tak, Kang Sook Lee, Hyun Sook Hong
Korean J Prev Med. 2002;35(2):160-168.
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OBJECTIVES
This study was intended to investigate the differences of job stressors between managers and low level employees among white-collar workers. Another objective of this study was to examine whether the effects of job stressors on mental health differ between the two groups. METHODS: Data was obtained from 204 managers and 251 low level employees who were employed in white-collar jobs. Fourteen job stressors and seven job stress variables were measured. RESULTS: Among the 14 job stressors, role overload, job insecurity, and work-family conflict were higher job stressors for the manager group whereas role conflict, work-aptitude incongruity, participation in decision making, and promotion problems were higher job stressors for the low level of employees. There were no differences in job stress scores between the two groups. However, differences in the effects of job stressors on job stress were found between the two groups. For the manager group, job insecurity, work-aptitude incongruity, and work-family conflict significantly affected in explanation of job stress whereas for the low level employees, role underload, peer satisfaction, and environmental problems significantly explaining the job stress variables. CONCLUSIONS: There were significant differences in job stressors between managers and low level employees among white-collar workers. Additionally there were differences in the effects of job stressors on job stress between the two groups.
Summary
Job Stress and Its Related Factors in South Korean Doctors.
Yune Sik Kang, Sin Kam, Sang Won Lee, Byung Yeol Chun, Min Hae Yeh
Korean J Prev Med. 2001;34(2):141-148.
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OBJECTIVE
To investigate the sources, extent and related factors in South Korean doctors. METHODS: The study subjects were 934 doctors in Taegu, Kyungpook Province, Korea(540 independent practitioners, 105 employed at hospitals and 289 residents in training). Information concerning job stress was obtained using a 9-item questionnaire. Information regarding related factors such as demographic characteristics(age, sex, marital status), perceptions on the socioeconomic status of doctors and working conditions(work time, on-call days per week) was also obtained by self-administered questionnaire during April and May, 2000. RESULTS: Major sources of job stress included clnical responsibility/judgement factor, patient factor and work loading factor. The job stress score of residents was the highest among three groups. The score was lower in older doctors. The score was low among those who thought doctors socioeconomic status was not good. The longer the work time, the higher the job stress score was. Multiple regression analysis was conducted to control for the mutual influence of independent variables. In regression analysis, the score of residents was higher than practitioners. Work time and socioeconomic status perception had negative effects on job stress score. CONCLUSION: The average job stress score of the doctors was high. Age, work type, working conditions and perceptions of socioeconomic status were found to besignificantly related to job stress score. Although the job stress of doctors is somewhat inevitable due to the nature of the doctor's job, control of work time, development of coping tools and other intervention methods are needed to reduce job stress of doctors. Further studies are required to understand the characteristics of job stress and reduce the job stress of doctors.
Summary
Transient Effects on the Risk of Occupational Injuries as an Acute Events: a Case-crossover Study.
Seon A Jeong, Jong Tae Lee, Jong Uk Won, Jaehoon Roh
Korean J Prev Med. 2001;34(1):35-40.
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OBJECTIVES
To elucidate the transient effects on the risk of occupational injuries as acute events and establish an alternative proposal. METHODS: The study population comprised a total of 302 workers randomly selected from applications for occupational injury compensation reported to the Inchon local labor office from January 1, 1999 to December 31. A case-crossover design, where each case serves its own control, was applied to this study. Through a telephone interview, workers provided useful data concerning five job related stressful events such as company transfer, work load change, overtime work, exchange duty, and work-part transfer. They were asked whether there were stressful events within a week of the occurrence of injury and the degree of stress. Exposure status from one year prior was used as control information. In the end, the data provided by 158 of selected persons was used for the analysis based on the quality of the data provided by the participants. A conditional logistic regression was used to discover the transient effects on the risk of occupational injuries as acute events. RESULTS: The effect of a company transfer and work load change on occupational injury was statistically significant on the risk of occupational injuries as an acute event(RR=5.5, 95% CI=2.501-12.428; RR=3.1, 95% CI=1.963-5.017, respectively). Other stressful events were found to elevate the risk factor for the occurrence of occupational injury, but were not significant. CONCLUSIONS: Our results suggested that transient stressful events elevated the risk factor for the occurrence of occupational injury.
Summary
Relationship of Level of Stress, Life Style, Subjective Symptoms and Clinical Diagnosis in Clients taken Multiphasic Screening Program.
Jun Han Park, Jin Ho Chun, Jang Mi Kang, Byung Chul Son, Dae Hwan Kim, Chang Hee Lee, Kui Won Jeong, Sang Hwa Urm
Korean J Prev Med. 1998;31(4):728-739.
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To improve wellness and quality of life by recognizing the health effects of stress, the author estimated the relationships between stress, subjective symptoms and clinical diagnosis through a questionnaire and a battery of specified laboratory tests - electrocardiography, blood pressure, cholesterol, aspartate aminotransferase(AST), alanine aminotransferase(ALT), gamma glutamyl transferase(gamma-GTP), fasting blood sugar, gastro-endoscopy or UGI, abdominal sonography, etc. The data was gathered from 337 clients who were undergoing multiphasic screening program at a University Hospital from January to March 1998. The mean age of subjects was 46.5+/-11.2 years and the mean of body mass index was 24.0+/-3.7kg/m2. The mean level of stress was 18.5+/-6.0 expressed as the score out of 40. By general characteristics and life style among male, mean level of stress was significantly higher in case of lower socioeconomic status, habitual drug use, longer daily working time(>10 hours), no regular exercise, drinkers, irregular meal, skipping breakfast(p<0.05). In case of female, that was significantly higher in case of lower education, lower socioeconomic status, longer daily working time(>10 hours), no regular exercise, drinkers, smokers, irregular meal, skipping breakfast(p<0.05). Significant correlations were observed between stress and subjective symptoms in all kinds of organ system(p<0.01). Correlation coefficients of stress among male were relatively high with neuro-psychiatric symptom(gamma=0.476) and cardio-vascular symptom(gamma=0.361) in order, and correlation coefficients of stress among female was highest with neuro-psychiatric symptom(gamma=0.371). The prevalence of the diagnosis through the battery of laboratory tests was high in upper gastrointestinal disorders and hypercholesterolemia in order in both sex group. Among male the mean score of stress was significantly high in ulcerative peptic disorder of upper gastrointestine and hepatopathy in order (p<0.05) . Among female that was significantly high in diabetes mellitus. In summary, it is likely that there are associations between stress, subjective symptoms and clinical diagnosis. To promote wellness and quality of life through, therefore, it would be of value that periodic stress evaluation program and stress management including appropriate control of smoking and drinking, regular exercise and meal.
Summary
The Association between Job Characteristics, Psychosocial Distress and Homocysteine.
Bong Suk Cha, Sang Baek Koh, Sei Jin Chang
Korean J Prev Med. 1998;31(4):719-727.
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This study was carried out to assess the relationship between jobstrain, psychosocial distress and homocysteine. The study design was cross-sectional, and included 152 industrial workers in middle sized city. A self-adminstered questionnaire measured general characteristic, job strain and psychosocial distress. Blood was drawn into EDTA tube, and total plasma homocysteine was measured by HPLC. Homocysteine in the high job demand group was significantly higher than that in the low job demand. Cholesterol in the high job control group was significantly higher than that in the low job control. Homocysteine was significantly higher in the high job strain group than that in the other group. Folate and vitamin B12 showed a significantly negative correlation with homocysteine. Multiple regression analysis was used to determine whether the psychosocial distress and other variable contributed to explaining the homocysteine. Stress correlates with the homocysteine.
Summary
Relationship between Life Style, the Level of Stress and Irritable Bowel Syndrome on 1498 Male White Collars.
Jong Ryul Kim, Sang Hwa Urm, Jin Ho Chun, Soo Jin Jeong, Chang Hee Lee, Kui Won Jeong, Soon Seok Choi, Ki Taek Pee
Korean J Prev Med. 1997;30(4):791-804.
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Irritable bowel syndrome(IBS) is one of the common health problem that has been considered as stress-induced. This study was conducted to investigate the relationship between life style and the level of stress and IBS by structured questionnaire which included questions on life style, the self-esteemed gastrointestinal symptoms, and Psychosocial Well-being Index(PWI). Subjects were 1,498 male white collars who get the regular health check and participated in survey at Inje University Health Promotion Center from January to December, 1996. The overall prevalence of IBS was 37.5%(561 cases), and the level of stress by PWI score was higher in IBS group(41.8+/-14.2) than symptom-free group(34.6+/-12.6). As the result of comparison between the two groups, heavier smoking (adjusted OR=2.48, 95% CI 1.81-3.41), longer daily working time (adjusted OR=5.19, 95% CI 3.59-7.56), stimulatory food materials-mainly hot or salty (adjusted OR=1.87, 95% CI 1.44-2.45), higher body mass index (adjusted OR=1.80, 95% CI 1.27-2.57), and higher level of stress (adjusted OR=2.81, 95% CI 1.80-4.43) were estimated as risk factors of IBS. On the contrary, 6-8 hours sleeping per day (adjusted OR=0.38 95% CI 0.21-0.70), 3-4 times exercise per week (adjusted OR=0.57 95% CI 0.39-0.83), and tenure more than 20 years (adjusted OR=0.25 95% CI 0.16-0.35) were considered as protective factors to IBS. In summary, the assessment of the stress level might be placed in the first priority to control IBS, at least by some degree, which suggested that IBS could be controlled by avoiding such risk factors and by encouraging such protective factors.
Summary
Effects of Cigarette Smoking on Psychosicial Distress and Occupational Risks.
Bong Suk Cha, Sei Jin Chang, Jong Ku Park, Sang Baek Ko, Myung Guen Kang, Sang Yul Ko
Korean J Prev Med. 1997;30(3):540-554.
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The effects of cigarette smoking on the psychosocial distress, the absenteeism, the occupational injuries, and on the prevalence for the accidents were assessed in 795 male workers who had been employed since March 1994. The results show that the prevalence of current smokers were higher in young men, lower educational level, lower income, single men(unmarried or divorced), alcohol drinkers, and blue collar workers. In the bivariate analyses, the workers with the high job demand and low work control were more likely to smoke, although the relationship was not strong. Those who reported lower satisfaction on his job tended to smoke more. Mean scores of psychosocial well-being Index(PWI) were higher in current smokers than nonsmokers. For the hierarchical multiple regression analyses, interaction terms between cigarette smoking and job stressors(job demand and work control) were not significant. For smokers, the odds ratios for the occupational injuries, and the accidents were 1.40(95% confidence interval 0.77-2.57) and 1.96 (95% confidence interval 0.75-5.09), respectively. The mean absent day were 4.13 for smokers, 3.65 for nonsmokers, although the differences were not statistically significant. It seems that cigarette smoking had not caused any crucial effects on the psychosocial well-being status and the occupational risks. Some considerations for the further research on the relationship of cigarette smoking on the mental health status and the occupational risks were also discussed.
Summary
Association between Job characteristics and Psychosocial Distress of Industrial Workers.
Sei Jin Chang, Bong Suk Cha, Sang Baek Koh, Myung Geun Kang, Sang Ryul Koh, Jong Ku Park
Korean J Prev Med. 1997;30(1):129-144.
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This study was carried out to assess the relationship between job characteristics(job strain) and psychosocial distress, and to find out the effect of social support on psychosocial distress. The study design was cross-sectional, and included 1,211 industrial workers in middle-sized city. A self-administered questionnaire measured job characteristics(jod demand, job control), and social support(coworker support, supervisor support) at work. Psychosocial distress was measured using PWI(Psychosocial Well-being Index), a 45-item self-administered instrument. Among the 1,211 respondents, the prevalence of psychosocial distress was 24.8%. High job strain (high job demand + low job control) was present in 8% of the subjects. The crude odds ratio of high job strain was 4.76 (95% CI : 2.60-8.74), and those of active group and passive group were 3.81(95% CI : 1.82-3.95) and 2.64(95% CI : 1.77-3.94), respectively. The odds ratios of each group adjusted for sex, age, support, and religion were still significant. Our results supported the association between job strain and psychosocial distress. Social support at work, although significantly associated with psychosocial distress, did not modify the association between job strain and psychosocial distress.
Summary
The Effect of Job Stress and Social Support on the Organizational Effectiveness of Hospital Employees.
Jong Wook Ko, Young Joon Seo, Ha Young Park
Korean J Prev Med. 1996;29(2):295-308.
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The purpose of this study is to investigate the effect of job stress and social support on the organizational effectiveness of hospital employees and to examine the role of social support in the experience of job stress among the employees. Previous studies have yielded mixed results regarding the role of social support. Some studies provide supporting evidence for the buffering effect of social support, while others do not. Still others report findings about reverse buffering effects. These inconsistent findings are, in part, accounted for by methodological problems such as poor measurement, small sample size, and the existence of high multicollinearity. To examine more rigorously the role of social support in relation to the negative effects of job stress, this study was carefully designed to overcome methodolgical shortcomings found in the past research. In addition, unlike the previous studies, which were concerned mostly with health-related variables as consequences of job stress, in this study, three work-related variables (job satisfaction, organizational commitment, and intent to stay) which had close relationships with organizational effectiveness were examined as output variables. The sample used in this study consisted of 353 employees from a university hospital in the suburbs of seoul. Data were collected with self-administered questionnaires and analyzed using canonical analysis and hierarchical regression analysis. The results of this study indicate that; (l) job stress has negative main effects on job satisfaction, organizational commitment, and intent to stay; (2) social support has positive main effects on the same three output variables, (3) social support does not moderate the harmful effects of job stress on the three outcome variables, and (4) the three-way interaction effects of (social support * job stress * gender) and of (social support * job stress * education) are not supported The implications of these findings for the management of human resources are discussed.
Summary
Reliability and Validity of PWI (Psychosocial Wellbeing Index).
Chae Yong Lee, Jong Young Lee
Korean J Prev Med. 1996;29(2):255-264.
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To study reliability and validity of PWl, this newly developed self-administered questionnaire which measures stress, was given to medial students. All respondent(133) were followed 4 weeks later and 92 were retested. Cronbach's a coefficient of data was 0.93. Test-retest reliability measured by pearson's correlation coefficient was 0.72(p<0.01l). Exploratory factor analysis(EFA) performed by principal axis factor method without iteration and by varimax rotation explored 13 principal components(eigenvalues > l). After exploring 4 factor structure according to previous study results, factor 1 showed good agreement but other factors did not. Confirmatory factor analysis(CFA) showed poor fit of 4 factor model to data. In the further study, it may be considered to model that has unidimensional factor structure.
Summary
The Relationship between Noise Exposure Level in Worksite and Workers' Stress symptoms.
Kyung Ok Park, Myung Sun Lee
Korean J Prev Med. 1996;29(2):239-254.
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Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modern diseases and death have come to be related to stress and mental health deeply, therefore noise-induced mental disorder, like a stress became very important. In this point, the purpose of this study was to analyze the relationship between noise exposure level in worksite and workers' stress symptoms. This study included a survey of 786 manual workers selected from 89 worksites in 21 factories in Puchon. The results were as follows: 1. For demographic characteristics, most of the workers were males(80.8%), the 20~29 years old were 34.5% and those who graduated from high school were 65.3%. The workers whose monthly income ranged from 500,000 to 800,000 won were 37.5% and who have a religion were 47.9%. 2. For occupational characteristics, workers who had worked 1~5 years in the factories were 33.0%. Those who felt much for them workload were 43.9% and who worked more than 8 hours a day were 73.9 %. Those who were dissatisfied with their job and pay were 31.9% and 50.6%. The workers who responded ventilation condition of their worksites were bad were 51.9% and the dissatisfied with working environment of their wofksites were 45.9%. 3. Workers who were suffering from tinnitus were 53.3% and those who perceived hearing loss were 50.l%. Persons who reported they always wore earplugs at work were 35.4%. Those who felt earplugs bigger than their ears were 30.6% and those who experienced eardiseases caused by earplugs were 25.6%. 4. For the noise exposure level in worksite, workers who were exposed to 80-90dB were 30.3%, 90-100dB were 26.4% and 50~70dB were 19.2%. 5. workers' stress symptoms were significantly related to marital status and their monthly income p< 0.05). Workers who were single and had lower monthly income showed higher PSl (Psychiatric symptom Index) scores than those who were married and had higher monthly income. Higher PSl scores were also significantly related to l~2 days night-work per week, much for them workload, dissatisfaction with their job, and bad relationship with their bosses and coworkers. 6. Higher PSl scores were significantly related to severe tinnitus and perceived hearing loss p<0.001). Workers who felt the earplugs they use did not fit their ears showed significantly higher PSl scores(p<0.01). Workers who reported that they did not feel they need earplugs showed significantly higher PSl scores(p<0.05). Increased experience of eardisease caused by earplugs that did not fit were also significantly related to higher PSl scores(p<0.001). 7. The higher noise exposure level in worksite from 80dB was, the more severe stress symptoms including PSl subparts were reported; Anxiety, Anger, Depression, and cognitive disorder(p<0.001). 8. According to the results of stepwise multiple regression analysis, factors affecting workers' PSl scores were perceived hearing loss(R2=0.160), noise exposure level jn worksite(R2=0.110), relationship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total R2 of this 6 factors was 0.371. 9. The most significant factors that have impact on manual workers' stress symptoms were perceived hearing loss and noise exposure level in worksite, especially noise exposure level in the worksite was the most affective factor on the depression symptom.
Summary
The Degree and Related Factors of the Depression and Burnout among Private Practice Physicians.
Jun Ho Shin, Gun Su Kim, Yo Sub Park, Bek Ju Na, Seok Joon Sohn, Byong Woo Kim
Korean J Prev Med. 1995;28(3):563-575.
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In order to investigate the prevalence and the factors related to the depression and burnout among private practice physicians, a SDS(self-rating depression scale) and MBl(Maslach burnout inventory) -based questionnaire study was performed on 344 private practice physicians in Kwangju and chonnam area. The results were summarized as follows. 1. Mean SDS score was 38.3 in total subjects and the prevalence rate of depression was 48.8%. As for the frequency order of the items of the SDS, decreased libido, diurnal variation and hopelessness were relatively high, and suicidal rumination, constipation and agitation were noted low. 2. Noticeable factors related with depression were smoking, coffee use, sleeping time and satisfaction with income. 3. As a result a factor analysis with the MBl data, five factors named as emotional exhaustion, depersonalization, personal accomplishment, involvement and self-interest were extracted. Statistical analysis of the data demonstrated that 48.8% of the physician sample reported high scores on emotional exhaustion, and 45.3% scored high on depersonalization. Personal accomplishment scores remained high with 45.3% reporting high personal accomplishment. 4. Variables related to the burnout were age, sleeping time, family size religion, medical speciality. duration of practice setting, visiting patient number, closing day per month and job satisfaction. 5. In the relationship with depression, burnout was closely related to depression. Above results showed that the high percentage of private practice physicians experiencing depression and burnout suggests the need for further research to establish trends, to identify causal factors, and to develop avenues to reduce stress.
Summary
Community screening for stress by using General Health Questionnaire.
Soo Sung Oh, Kwang Seub Lee, Seok Joon Sohn, Jin Su Choi, Jung Ae Rhee
Korean J Prev Med. 1995;28(1):123-140.
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This study investigated the stress of community residents in Kwang-Ju and Chonnam areas by using the General Health Questionnaire(GHQ-60) as a instrument of stress measurement. The number of subject were 445 residents who lived in three areas (large city, middle city, and rural area) and they were individually interviewed in March, 1994. The result of study showed that the degrees of stress measured by GHQ-60 were statistically significant in the residents' area, age. sex variables: (a) the residents in middle city among three area had the highest level of stress: (b) the resident who were more than 60 in age had the highest level of stress: (c) the female resident had more stress than male residents: (d) particularly, the residents who were more than 60 years old in the middle city had the highest level of stress. Further, the results of factor analysis showed that there were three factors of social dysfunction, depression and anxiety, and psychosomatic symptom. The social dysfunction factor was statistically significant in both age and resident area variables. The depression and anxiety factor was statistically significant in the residents' area, age. sex variables. The psychosomatic symptom factor was statistically significant in both age and sex variables. The study suggested that they should give a special attention to solve the old people's stress because stress was closely related to residents age.
Summary
Association of Stress Level with Smoking Amounts among University Students.
Jong Myon Bae, Yoon Ok Ahn, Byung Joo Park
Korean J Prev Med. 1994;27(1):1-10.
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The aim of this study was to assess the degree of association between individual stress and the amount of smoking among male senior students of a medical college. The questionnaire survey was conducted twice for collecting the data on stress level in terms of BEPSl score, smoking amounts, alcohol intake, and residence type in 1992 and 1993. Among the 223 responders, 39.9% were smokers. In the smokers, the association between stress level and smoking amount was significant after controlling for alcohol intake and residence type (P < 0.l). Especially in the group of living without family, the association was more significant (p=0.06). Therefore, it is recommendable that the stress management program is called upon for the student smokers to reduce smoking amount.
Summary

JPMPH : Journal of Preventive Medicine and Public Health
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