Factors Affecting Diet-Related Quality of Life Among Hemodialysis Patients According to Age-group

This study identified factors influencing diet-related quality of life (QoL) among hemodialysis patients by age. In a cross-sectional correlational study in South Korea, 175 participants from two age groups—20–59 years and 60 years and above—completed self-report questionnaires assessing demographic and health-related characteristics, eating status, subjective health status, disease-related factors, dietary knowledge, and xerostomia severity. Findings indicated that the predictors of diet-related QoL included subjective health status and regular eating status (20–59 years) and self-efficacy, attitude toward hydration behaviors, and exercise (60 years and above). In order to improve the diet-related quality of life of dialysis patients, young adults need to focus on their physical health and regular meals, and the elderly need a differentiation strategy that considers psychological factors such as self-efficacy and attitude toward pollination.

Structural Equation Model for Evaluating Factors Affecting Health-related Quality of Life in Adolescents With Moyamoya Disease: Based on Salutogenesis Theory

BackgroundMoyamoya disease is a cerebrovascular disorder and a significant chronic health concern requiring regular monitoring to control the disease and its related complications.ObjectiveTo develop a structural model based on the salutogenesis theory, and to identify how social support, sense of coherence, and stress contribute to health behaviors, subjective health status, and quality of life in adolescents with moyamoya disease.MethodsWe examined a hypothetical model by integrating the concepts of a structural health-related quality-of-life model based on the salutogenesis theory among 239 adolescents with moyamoya disease in Korea. Data on health-related quality of life of adolescents with moyamoya disease were collected using the following scales: social support rating scale, sense of coherence scale, stress scale, health behavior scale, subjective health status scale, and quality-of-life scale. A structural equation model was used to analyze the data.ResultsThe final model demonstrated goodness-of-fit. A sense of coherence directly influenced quality of life (β = 0.504, p < 0.01) and indirectly influenced quality of life (β = 0.299, p < 0.05) through health behavior. Stress (β = -0.414, p < 0.001) and health behavior (β = -0.085, p < 0.01) directly influenced quality of life. Social support directly influenced health behavior (β = 0.321, p < 0.01) and subjective health status (β = 0.112, p < 0.01).DiscussionSince moyamoya disease, a chronic disease, is progressive, it is very important to identify factors for health promotion.This study found that sense of coherence and social support were significant factors contributing to lower stress, improved health, and quality of life in adolescents with moyamoya disease. This paper is intended to help health experts to develop an intervention strategy based on theory as an approach for chronic disease management.

A Comparative Study of the Factors Associated with Geriatric Depression between Two Sex Groups Living Alone

Purpose: The aims of this study were to identify depression rates depending on the sex among elderly people living alone and to compare depression-related ecological system factors between two sex groups.Methods: A cross-sectional study was conducted using secondary data from the 7th Korean Longitudinal Study of Aging survey in 2018. A total of 893 elders living alone were included (152 men and 741 women). Hierarchical logistic regression was used to identify depression-related ecological system factors depending on the sex.Results: Men had significantly higher rates of depression (28.6%) than women (24.0%, p<.001). Depression-related ecological system factors in elderly women were higher educational level, poor subjective health status, impairment of instrumental activities of daily living, low satisfaction with children’s relation, financial based on children’s support, and rare meetings with close people. However, relation satisfaction with children was the only relevant depression-related ecological system factor in the men’s group.Conclusion: Our study findings show that depression-related ecological system factors vary depending on the sex of elderly people living alone. Thus, mental health professionals should provide sex-specific interventions to develop or implement depression-prevention strategies for the elderly living alone depending on the sex.

How Does Health Literacy Modify Indicators of Health Behaviour and of Health? A Longitudinal Study with Trainees in North Germany

Background: Health literacy (HL) is a resource that can help individuals to achieve more control over their health and over factors that influence health. In the present follow-up study, we have investigated the extent to which HL in trainees changes over time and whether or to what extent HL influences health behaviour and health. Methods: In 2017, we performed a baseline survey (T0) of trainees from six different branches, who were contacted through vocational colleges in four northern federal states in Germany. The survey was repeated at the midpoint of their training in 2019 (T1). Demographic data were surveyed, together with information on HL (HLS-EU-Q16), health behaviour and on health status (psychological well-being, subjective health status). Multivariate regression analyses were performed in SPSS 26. Results: Three hundred and ninety-one (391) data sets were evaluated, with a follow-up rate of 27%; 79% of the trainees were female. The mean age was 21.2 years. Over all subjects, the mean HL increased over time ( (SD): 11.9 (2.9) to 12.2 (2.9), p = 0.070). This increase was only statistically significant for the health service trainees ( (SD): 12.1 (2.8) to 12.5 (2.9), p = 0.019). Relative to persons with adequate HL, the odds ratio over time for impaired psychological well-being was increased by 230% in persons with inadequate HL (OR: 3.3, 95% CI: 1.70–6.32, p < 0.001). For persons with problematical HL, the corresponding increase in odds ratio was 110% (OR: 2.1, 95% CI: 1.30–3.38, p = 0.002). Relative to persons with adequate HL, trainees with inadequate HL exhibited a significant increase in odds ratio of 2.8 over time for poor or less good subjective health status (OR: 2.8, 95% CI: 1.23–6.33, p = 0.014). Conclusions: We observed a positive longitudinal association between HL and health. A significant increase in HL was observed in trainees in the health service. Thus the study shows that the concept of HL may provide a potential preventive approach for trainees.

Comparisons of factors associated with suicidal ideation of older individuals by health status

This study examined the factors associated with suicidal ideation among older individuals and compared those factors by their objective and subjective health status. Data were obtained from the 13th wave of the Korean Health Panel Survey in 2018. The sample of 6,283 older individuals, who are 55 years and older, was classified into four groups by their objective and subjective health status. Objective health status was measured by the number of chronic health conditions, and subjective health status was defined by an individual’s self-reported health status. To examine the factors associated with suicidal ideation among four groups of older individuals, logistic regression analyses were conducted after controlling for socio-demographic characteristics, physical health and mental health characteristics. The results show that depression and anxiety were found as common factors associated with suicidal ideation for all four groups. As for the group of older individuals who reported bad objective health and bad subjective health, younger age, being male, and low educational attainment were found to be associated suicidal ideation. For those with bad objective health regardless of their subjective health status, the level of stress was found to be related to suicidal ideation among older individuals. Based upon those results, the present study discussed practical and policy implications for suicide prevention among older individuals by reflecting their objective health and subjective health status.

Subjective Health Status: An Easily Available, Independent, Robust And Significant Predictive Factor At The Prometaphase of Vaccination Programs For The Vaccination Behavior of Chinese Adults

Background: The World Health Organization (WHO) proposed COVID-19 vaccination as an emergent and important method to end the COVID-19 pandemic. Since China started vaccination programs in December 2020, vaccination has spread to provinces and municipalities nationwide. Previous research has focused on people's vaccination willingness and its influencing factors but has not examined vaccination behavior. We examine the effectiveness of psychosocial factors in predicting vaccination behavior. Methods: A cross-sectional online survey was performed among Chinese adults on 8 May and 4 June 2021. The statistical analysis of the data included univariate analysis, receiver operator characteristics (ROC) analysis and ordinal multiclassification logistic regression model analysis. Results: Of the 1300 respondents, 761 (58.5%) were vaccinated. Univariate analysis showed that a high education level and good subjective health status were protective factors for vaccination behavior, while suffering from chronic diseases was a risk factor. ROC analysis showed that subjective health status (AUC = 0.625, 95% CI: 0.594–0.656, P < 0.001) was the best predictor of vaccination behavior. Logistic regression analysis with subjective health status as a dependent variable indicated that older age, female sex, depression, neurasthenia, obsession, hypochondriasis and chronic disease were significant risk factors, while positive coping tendencies were a significant protective factor. Conclusion: Our study found a simple and effective marker, subjective health status, that can predict vaccination behavior. This finding can guide future epidemic prevention work.

Factors influencing caregiver burden by dementia severity based on an online database from Seoul dementia management project in Korea

Backgrounds As the prevalence of dementia rises, caregiver burden also increases in South Korea, especially for informal family caregivers. This study aimed to analyze factors affecting caregiver burden by the severity of dementia based on data of patients in Seoul. Methods A total of 12,292 individuals aged ≥65 years enrolled in the Seoul Dementia Management Project from 2010 to 2016 in an online database were selected. Caregiver’s burden was assessed using the Korea version of Zarit Burden Interview. Multiple regression analyses were performed to determine factors associated with primary caregiver’s burden after stratifying the severity of dementia. Results Most patients showed moderate levels of cognitive impairment (49.4%), behavior problems (82.6%), and ADL dependency (73.6%). After stratifying the severity of dementia, caregivers caring for patients with mild symptoms of dementia were experienced with higher caregiver burden if patients were under a lower score of IADL. Significant factors for caregiver burden among caregivers supporting patients with moderate symptoms of dementia include caregivers’ residence with patients, subjective health status, and co-work with secondary caregivers. Lastly, caregivers for patients with severe dementia symptoms experienced a higher caregiver burden from limited cognitive function, problematic behavior, and caregivers’ negative health status. Conclusion In terms of sample size, this study had far more patients than any other domestic or international study. It was meaningful in that it analyzed characteristics of patients with dementia and caregivers affecting the burden of caregivers in Korea. Intensive social supports with multiple coping strategies focusing on different levels of patients’ clinical symptoms and caregivers’ needs should be planned to relieve the caregiver burden.

Smoking Behavior Changes during COVID-19 among Korean Adults

Objectives: In this study, we investigated the changes in smoking behavior during the COVID-19 outbreak in Korea in 2020. We also examined the influence of general characteristics and mental health problems due to COVID-19 on changes in smoking behavior. Methods: We collected data from August to October 2020 from adults aged 19 years and older from the Korea Community Health Survey (N=229,269). Results: Among current smokers (N=39,534), 11.0% reported an increase in smoking, and 12.8% reported a decrease in smoking. Overall, 33.3% reported perceived stress and 3.7% reported depression. Participants reported COVID-related anxiety about infecting family (83.0%), economic damage (76.3%), blame or harm from others (66.5%), infection (60.6%), and death (31.3%). Lower education level, living alone, and poor subjective health status were associated with increased smoking. Being a woman and being of older age were associated with decreased smoking. Stress, depression, and anxiety about economic damage due to COVID-19 were more likely to result in increased smoking. Anxiety related to death due to COVID-19 was more likely to result in decreased smoking. Conclusion: These findings provide insight into the changes in smoking behavior caused by COVID-19.