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As the prevalence of developmental disorders (DDs) has increased, many OECD countries provide a national screening examination for early detection and intervention for DDs. This study examined effects of the National Health Screening Program in Korea. 65,334 children (39%) were DD-screened and 35,466 children (21%) received a false negative among the 167,050 study subjects. The DD-screened rate had increased from 3208 (27.2%) in 2008 to 8471 (47.3%) in 2012, then decreased to 5544 (29.8%) in 2017. Changes in the false negative rates increased from 2.7% in 2008 to 23.8% in 2017 were one of the most influential factors in these fluctuations. The DD-screened rate was influenced by demo-geographic and economic factors as well as by age-related characteristics of the subconditions.

Prevalence of developmental disorders (DDs) has been increasing worldwide. This study identifies a trend in their prevalence and incidence, using nationwide population-based data to analyze the characteristics of children with DDs in Korea. The prevalence of DDs steadily increased by more than four times (from 0.6 to 2.5) from 2003 to 2017. Boys had higher incidence than girls throughout the period, during which the gap increased from 19.1 to 31.4%. The incidence also increased by the size of city and medical insurance quartile. The ratio of autism spectrum disorder, developmental delay and language disorders among the total incident cases of DDs increased by 13.7%, 817.6%, and 30.7%, respectively, indicating their contribution to the trend of increasing prevalence.

Background: Understanding the self-rated health of industrially disabled individuals is an important variable that significantly affects their quality of life, satisfaction, and return to work after an industrial accident. Since the health of people with industrial disabilities is affected by various environments and variables, interventions and policies that are suitable for their characteristics are needed. Objectives: This study aimed to identify changes in self-rated health among industrially disabled individuals, distinguish between different latent classes, and verify predictive factors for each latent class. Methods: Four time-point datasets from the 2018–2021 panel study of Korean workers' compensation insurance were used. Using the latent growth curve model, an overall trajectory of self-rated health of industrially disabled individuals was confirmed, and the number and characteristics of different trajectories were identified using the latent class growth model. Multinomial logistic regression analysis was used to identify the predictive factors for each class. Results: Four classes of self-rated health trajectories were identified: low-decreasing (21.7%), moderate-increasing (15.7%), high-decreasing (56.1%), and low-stable (6.5%) classes. A multinomial logistic regression analysis revealed that significant determinants (age, capacity, type of industrial accident, grade of disability, mental activity, outdoor activity, and social relationships) were different for each latent class. Capacity level affected all potential class classifications. Conclusions: To improve the self-rated health of industrially disabled individuals, it is necessary to develop an appropriate strategy that considers the characteristics of the latent class. [ABSTRACT FROM AUTHOR]

Limited English proficiency (LEP) is one of the most influencing factors of personal health literacy (PHL) in the older immigrant population. Over the years, the proportion of older Korean immigrants with LEP has not improved and it is still noted as a major barrier to PHL. Therefore, organizational approaches are needed to enhance the PHL of older immigrants with LEP. This study aims to find the mediating effect of social support and acculturation between LEP and PHL by conceptualizing social support and acculturation as an organizational health literacy strategy. Data from 244 older Korean immigrants living in the states of Alabama and Georgia, USA, were used to conduct the study. Korean version of the Multidimensional Scale of Perceived Social Support (MSPSS), East Asian Acculturation Measure (EAAM), and Health Literacy Survey-12 Questionnaires (HLS-Q12) were used to measure the variables. The path analysis was conducted to find the serial mediation effects of social support and acculturation. The results showed that 77.5% of the participants reported not having fluent English proficiency. English proficiency (β =− 0.21, p = 0.007), social support (β = 0.17, p = 0.004), and acculturation (β = 0.18, p = 0.011) significantly predicted the PHL, and social support (β = 0.04, p = 0.028) and acculturation (β = 0.14, p < 0.001) mediated the relationship between LEP and PHL. Discussion: Health-related organizations and communities are encouraged to provide external social support and acculturation opportunities to enhance PHL in older Korean immigrants with LEP. [ABSTRACT FROM AUTHOR]

Background: People with disabilities, who require numerous healthcare services, are vulnerable to unmet healthcare needs. This study aimed to investigate and identify the factors that influence unmet healthcare needs among people with disabilities and to compare these factors before and after the COVID-19 pandemic in South Korea. Methods: A propensity score matching analysis was conducted using two datasets from the National Survey of Disabled Persons collected in 2017 and 2020. The participants were matched based on variables known to influence healthcare utilization. Based on the Andersen model, logistic regression was performed to analyze the key characteristics of the factors associated with unmet healthcare needs, including predisposing, enabling, and need factors. Results: Propensity score matching resulted in the inclusion of 1,884 participants in each group: an experimental group and control group. Before COVID-19, factors associated with unmet healthcare needs included sex, age, marital status, and education level (predisposing factors), instrumental activities of daily living dependency, satisfaction with medical staff's understanding of disability, satisfaction with medical institutional facilities and equipment (enabling factors), subjective health status, and depressive symptoms (need factors). After COVID-19, factors included physical disability, instrumental activities of daily living dependency, and discrimination (enabling factors), and subjective health status, chronic diseases, depressive symptoms, and regular medical care (need factors). No significant predisposing factors affecting unmet healthcare needs were identified after COVID-19. Conclusions: This study compared the factors affecting unmet healthcare needs among people with disabilities before and after COVID-19. Recognizing the different factors associated with unmet healthcare needs before and after COVID-19, (e.g., sex, type of disability, satisfaction with medical staff's understanding of disabilities, medical institutional facilities and equipment considering the disabled, discrimination, chronic diseases, and regular medical care) may help governments and policymakers establish strategies to reduce and prevent unmet healthcare needs during and a future crisis. [ABSTRACT FROM AUTHOR]

Aim: As life expectancy increases worldwide, the prevalence and the disease burden of diabetes in older adults are also increasing. This study aimed to examine sex differences in the reciprocal relationship between glycemic control and depressive symptoms among older adults with diabetes by using longitudinal data at two timepoints. Methods: Wave 1 (W1, 2016–2017) and wave 2 (W2, 2018–2019) data from the Korean Frailty and Aging Cohort Study were used. Finally, 416 older adults with diabetes who satisfied the inclusion criteria were analyzed (215 males, 201 females). The reciprocal relationship between depressive symptoms and glycosylated hemoglobin A1c (HbA1c) levels was examined using a cross‐lagged panel model. Results: HbA1c levels and depressive symptoms at earlier time points were the most significant factors contributing to HbA1c levels and depressive symptoms at later timepoints. The relationship between HbA1c level and depressive symptoms differed according to sex. The cross‐path from depressive symptoms (W1) to HbA1c levels (W2) was positively statistically significant in males (β = 0.18, SD = 0.05, P = 0.001). The path from HbA1c levels (W1) to depressive symptoms (W2) was positively statistically significant in females (β = 0.12, SD = 0.06, P = 0.032). Conclusions: Early management of blood glucose levels and depressive symptoms is important in older adults with diabetes. Moreover, glycemic control through social activities in the community could be effective in relieving depressive symptoms in older females with diabetes, and managing depressive symptoms and glucose levels together could be effective in glycemic control in older males with diabetes. Geriatr Gerontol Int 2024; 24: 32–39. [ABSTRACT FROM AUTHOR]

Objectives: Although home‐visit healthcare programs in Korea are expected to expand, providing hands‐on experience to nursing students may be limited. This study aimed to develop and evaluate a problem‐based learning (PBL) simulation module that reflects home‐visit healthcare services provided by public health centers for pre‐frail older adults. Design and Sample: The simulation module, including PBL as prebriefing, was developed by the researchers and revised based on expert reviews. The module was evaluated using a mixed‐method embedded one‐group post‐test‐only design with focus group interviews (FGIs). Quantitative data (n = 29) were collected between April and June, 2021. FGIs (n = 10) were conducted twice in June 2021, and qualitative data were analyzed using an inductive content analysis approach. Results: The average score of the Simulation Design Scale was 4.67 ± 0.36. The overall mean score of the Educational Practices Questionnaire was 4.75 ± 0.37. Three themes emerged from the FGIs: immersive learning experience, changes in perspective on nursing, and enhanced nursing competency. Conclusion: This PBL‐based simulation module was evaluated as a systematic learning process in which nursing students could become self‐directed learners, interacting and collaborating with colleagues, instructors, and environments. The module encourages them to practice home visit services. [ABSTRACT FROM AUTHOR]

Purpose: Walking practice is a representative indicator of the level of physical activity of local residents. Although the world health organization addressed reduction in prevalence of insufficient physical activity as a global target, the rate of walking practice in Korea has not improved and there are large regional disparities. Therefore, this study aimed to explore the spatial variations of walking practice and its associated factors in Korea. Methods: A secondary analysis was conducted using Community Health Outcome and Health Determinants Database 1.3 from Korea Centers for Disease Control and Prevention. A total of 229 districts was included in the analysis. We compared the ordinary least squares (OLS) and the geographically weighted regression (GWR) to explore the associated factors of walking practice. MGWR 2.2.1 software was used to explore the spatial distribution of walking practice and modeling the GWR. Results: Walking practice had spatial variations across the country. The results showed that the GWR model had better accommodation of spatial autocorrelation than the OLS model. The GWR results indicated that different predictors of walking practice across regions of Korea. Conclusion: The findings of this study may provide insight to nursing researchers, health professionals, and policy makers in planning health programs to promote walking practices in their respective communities. [ABSTRACT FROM AUTHOR]

To explore the consequences, challenges, and future directions based on community health nurses' experiences during COVID-19. Qualitative study. Four focus group interviews were conducted with 27 community health nurses. Three major themes emerged: 1) Coordination of roles and duties, 2) Identifying deterioration of patients' health and increasing demand for visits, and 3) Changing service delivery strategies: a testing ground for new services. Community health nurses were essential public healthcare providers during the pandemic. The findings are informative for nurses and policy makers who can develop and suggest different services in the post-COVID era. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether cognitive frailty, compared with physical frailty or cognitive impairment alone, substantially increased the risk of long‐term care (LTC) initiation in community‐dwelling older adults. Methods: Subjects comprised a total of 39 148 participants aged 66 years from the Korean National Health Insurance–Senior cohort database. Cognitive frailty was defined as the coexistence of physical frailty and cognitive impairment, which was measured by the Timed Up and Go test and the Korean Dementia Screening Questionnaire–Prescreening, respectively. A stratified Cox model was estimated to explore the association of frailty status with LTC initiation. Results: The baseline prevalence of cognitive frailty was 8.7%. During a mean follow‐up of 5.3 years, 646 older adults started receiving LTC services. Compared with the robust group, older adults with cognitive frailty showed the highest risk of LTC initiation (hazard ratio [HR], 2.65; 95% confidence interval [CI], 2.08–3.35), followed by those with cognitive impairment (HR, 1.62; 95% CI, 1.26–2.07) and physical frailty (HR, 1.50; 95% CI, 1.25–1.81). Furthermore, cognitive frailty in depressed older adults (HR, 3.16; 95% CI, 2.31–4.33) showed a higher risk of LTC initiation than in nondepressed older adults (HR, 2.10; 95% CI, 1.46–3.04). Conclusions: Cognitive frailty was a significant predictor of LTC initiation among community‐dwelling older adults, particularly if they are depressed. Early detection and timely intervention may help to delay LTC initiation in older adults with concurrent cognitive frailty and depression. Geriatr Gerontol Int 2023; 23: 117–123. [ABSTRACT FROM AUTHOR]

Background: Despite the increasing demand for global health education, relatively few global health courses currently are offered in Korea. Method: This mixed-methods study examined the need for global health competency and global health education experience for nursing students. A survey of 208 nursing students was conducted from May 2020 to August 2020, and three focus groups were conducted with 12 nursing students. Results: The average score of global health nursing competencies was 2.8 ± 0.7 on a scale ranging from 1 to 4. Female, higher academic achievement, fluent English, and higher global health education experience had a significant effect on global health competency. The most influential factor was more experience with global health education. Nursing students' perceptions and educational needs related to global health education were classified into four subthemes. Conclusion: The development of global health education programs for nursing students is needed. [J Nurs Educ. 2023;62(2):75–82.] [ABSTRACT FROM AUTHOR]

Aim: To identify the factors associated with retention intention among Registered Nurses in South Korean nursing homes. Background: Although nurses are not mandatory personnel, Korean nursing homes employ Registered Nurses. Introduction: Determining the factors related to Registered Nurses' retention intention is important for their job stability and ensure provision of quality care. Methods: This mixed‐methods study employed a sequential explanatory design. A self‐reported questionnaire survey was conducted between May 1 and July 3, 2019, with 155 Registered Nurses providing direct care from 37 nursing homes. In‐depth qualitative interviews were conducted with 10 participants from August 1 to September 30, 2019. Data were analyzed using multilevel analysis for quantitative study and thematic analysis for qualitative study. Results: The participants' average age was 48.48 years. Personal factors related to retention intention were Registered Nurses' role, educational level, and job satisfaction. Institutional factors were ownership, number of beds, and working environment. The qualitative study revealed five themes: "Satisfaction with meaningful relationships," "Potential for professional growth," "Nursing service accompanied by emotional labor," "Poor working environments in nursing homes," and "Unprotected nursing expertise." Discussion: A nursing home's work environment is related to the Registered Nurses' retention intention. Most Registered Nurses in Korea received low wages, lacked access to career management programs, and experienced emotional labor. Conclusion: This study highlighted the personal and institutional factors related to retention intention among Registered Nurses in South Korean nursing homes. Implications for nursing and nursing policy: A law that designates Registered Nurses as an essential nursing home workforce is required. Further, nursing homes should increase the number of Registered Nurses to improve working conditions and thereby job satisfaction. It is also necessary to foster a working environment that facilitates professional development opportunities and job clarity. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to examine the relationship between oral health and social activity, and explore the mediating effect of depressive symptoms on the relationship between oral health and social activity among community‐dwelling older adults in Korea. Methods: A total of 5033 community‐dwelling older adults aged ≥65 years were included in the analysis. Data were obtained from the seventh wave (2018) of the Korean Longitudinal Study of Aging. Descriptive statistics, Pearson's correlation analysis and path analysis for mediation analysis were used. Results: Path analysis showed that older adults with better oral health had more social activities (β = 0.177, P < 0.001) and fewer depressive symptoms (β = −0.174, P < 0.001). Depressive symptoms had a mediating role partially in the relationship between oral health and social activity (β = 0.014, P < 0.001). The results of in‐depth exploration using oral health subdomains showed that physical oral function and oral pain or discomfort were directly related to the social activity (β = 0.083 and β = 0.149, respectively) and indirectly mediated by depressive symptoms (β = 0.006 and β = 0.004, respectively). However, psychosocial oral function only had an indirect effect on social activity mediated by depressive symptoms (β = 0.006, P = 0.005). Conclusions: Better oral health had a significant association with higher levels of social activities, which was partially mediated by decreased depressive symptoms. It is necessary to pay more attention to oral health promotion for older adults to decrease depressive symptoms and increase participation in social activities. Geriatr Gerontol Int 2022; 22: 766–772. [ABSTRACT FROM AUTHOR]

Background: People with disabilities are vulnerable to chronic diseases such as hypertension. In South Korea, over half of the population living with a physical disability suffer from hypertension. Understanding the typology of hypertension self-management patterns will assist with behavioural interventions for people with physical disabilities. Thus, this study aims to identify the typology of hypertension self-management behavioural patterns, the factors associated with the latent classes, and to recognise potential at-risk populations by comparing potential health outcomes among hypertensive adults with physical disabilities.Methods: Data of 1551 participants were extracted from the 2017 National Survey of Disabled Persons. Latent classes were analysed using five indicators of self-management: smoking, alcohol consumption, physical activity, diet, and weight control. Determinants of self-management patterns, such as general characteristics, health-related factors, and social relationships, were identified using multinomial logistic regression. Further, health measures, such as health profile, psychological health, and patient experience, were compared.Results: The following three latent classes were identified: "high self-management" group (40.8%), "harmful habitual behaviour" group (20.6%), and "inactive behaviour" group (38.6%). Compared with the high self-management group, the predictors of belonging to the harmful habitual behaviour group were being male, young, and single. Being female, employed, severely disabled, dependent, and unsatisfied with friendships were predictors of the inactive behaviour group. Those in the inactive behaviour group had a poor health-related quality of life, poor subjective health, depression, and unmet medical needs.Conclusions: This study provides evidence that there are mutually exclusive subgroups of patients with hypertension regarding self-management patterns, identifies an array of predictive factors in each latent class membership, and distinguishes a high-risk group by comparing the health measures among patients with hypertension with physical disabilities. Analysing subgroups may assist in identifying and meeting the diverse needs of self-management support in hypertensive patients with physical disabilities. [ABSTRACT FROM AUTHOR]

Background: Food art therapy (FAT) has multiple modalities in which cognition, emotion, and social changes are stimulated. The purpose of this study was to design a multimodal approach to a food art therapy (MM‐FAT) program and identify its effects on cognitive ability, daily living functioning, depression, self‐esteem, self‐efficacy, self‐expression, and social functioning in individuals with mild cognitive impairment (MCI) and mild dementia by employing a mixed methods research design. Methods: The participants included 39 patients from a public dementia care centre in Seoul, Korea. The intervention group, which comprised 20 participants, received 12 MM‐FAT sessions 3 times a week for 4 weeks, and the control group, which included 19 participants, received usual care. The MM‐FAT program was evaluated based on its effectiveness on cognitive, daily living, emotional, and social functioning outcome measures at three time points using repeated measures analysis of variance. Semi‐structured interviews (n = 9) were conducted to evaluate the overall experience of the MM‐FAT program and its outcomes. Results: The findings reveal that MM‐FAT has a positive effect on the cognitive, emotional, and social functioning of individuals with MCI and mild dementia. However, there were no enhancements in individuals' daily living functioning, and the lasting effects of the intervention could not be assessed. Cognition and depression increased significantly at the end of the MM‐FAT program. Self‐expression and self‐efficacy were significantly higher in the MM‐FAT group than in the control group. The semi‐structured interviews revealed improvements in participants' behaviour, communication, and interaction. Conclusion: This mixed methods study focused on individuals with MCI or mild dementia contributes to an understanding of the effectiveness of a FAT program employing a multimodal approach. Despite the COVID‐19 pandemic, the study was able to enrich the effects of MM‐FAT on cognitive, emotional, and social functioning through qualitative findings. [ABSTRACT FROM AUTHOR]

Background: Large-scale genomic analyses have provided insight into the genetic complexity of short stature (SS); however, only a portion of genetic causes have been identified. In this study, we identified disease-causing mutations in a cohort of Korean patients with suspected syndromic SS by targeted exome sequencing (TES).Methods: Thirty-four patients in South Korea with suspected syndromic disorders based on abnormal growth and dysmorphic facial features, developmental delay, or accompanying anomalies were enrolled in 2018-2020 and evaluated by TES.Results: For 17 of 34 patients with suspected syndromic SS, a genetic diagnosis was obtained by TES. The mean SDS values for height, IGF-1, and IGFBP-3 for these 17 patients were - 3.27 ± 1.25, - 0.42 ± 1.15, and 0.36 ± 1.31, respectively. Most patients displayed distinct facial features (16/17) and developmental delay or intellectual disability (12/17). In 17 patients, 19 genetic variants were identified, including 13 novel heterozygous variants, associated with 15 different genetic diseases, including many inherited rare skeletal disorders and connective tissue diseases (e.g., cleidocranial dysplasia, Hajdu-Cheney syndrome, Sheldon-Hall, acromesomelic dysplasia Maroteaux type, and microcephalic osteodysplastic primordial dwarfism type II). After re-classification by clinical reassessment, including family member testing and segregation studies, 42.1% of variants were pathogenic, 42.1% were likely pathogenic variant, and 15.7% were variants of uncertain significance. Ultra-rare diseases accounted for 12 out of 15 genetic diseases (80%).Conclusions: A high positive result from genetic testing suggests that TES may be an effective diagnostic approach for patients with syndromic SS, with implications for genetic counseling. These results expand the mutation spectrum for rare genetic diseases related to SS in Korea. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to identify social factors predicting improvement of frailty in community‐dwelling older adults after 2 years using a population‐based cohort study. Methods: We analyzed data from the 2016 and 2018 Korean Frailty and Aging Cohort Study. The participants of this study were 1428 community‐dwelling older adults aged 70–84 years who were recruited from 10 medical centers across different regions. Frailty was measured using the five‐item FRAIL scale, which evaluates fatigue, resistance, ambulation, illness and weight loss. Multilevel logistic regression analysis was used to examine baseline social factors that predict frailty improvement after 2 years by frailty status. Results: In frail older adults, higher participation in social activities (odds ratio [OR] 1.17, 95% confidence interval [CI] 1.02–1.34) was significantly associated with frailty improvement. In pre‐frail older adults, there were no significant social factors predicting the improvement of frailty status; however, other modifiable factors such as high and moderate levels of physical activity (OR 1.17, 95% CI 1.07–1.28, OR 1.13, 95% CI 1.03–1.25, respectively) and low depressive symptoms (OR 0.88, 95% CI 0.84–0.91) were associated with pre‐frail improvements. High levels of physical activity (OR 1.16, 95% CI 1.02–1.33) were also associated with improvements of frailty. Conclusions: Different strategies depending on the level of frailty are necessary to improve frailty status. Timely and appropriate interventions can promote frailty improvement and prevent negative health outcomes in community‐dwelling older adults. Geriatr Gerontol Int 2021; 21: 465–471. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to identify the midlife and later life factors affecting reversion from mild cognitive impairment to normal cognition after 4 years. Methods: We analyzed data from the 2012 and 2016 Korean Longitudinal Study of Aging. The participants of this study were Korean community‐dwelling adults aged ≥45 years who showed mild cognitive impairment in 2012. They were divided into midlife (<65 years) and later life (≥65 years) based on their age in 2012. Cognitive function was assessed by the Korean Mini‐Mental State Examination in 2016. Multiple logistic regression analysis was carried out to determine the factors affecting reversion by age group. Results: Among participants with mild cognitive impairment, 52.0% in midlife and 26.6% in later life reverted to normal cognition after 4 years. In midlife, higher education (OR 1.97, 95% CI 1.15–3.36), fewer chronic diseases (OR 0.78, 95% CI 0.61–0.99), lower levels of depressive symptoms (OR 0.95, 95% CI 0.90–0.99) and higher participation in social activities (OR 1.91, 95% CI 1.27–2.87) were significantly associated with reversion. In later life, higher baseline cognitive function (OR 1.30, 95% CI 1.14–1.47) and higher participation in social activities (OR 1.35, 95% CI 1.02–1.79) were significantly associated with reversion. Conclusions: The reversion rate in midlife was higher than that of later life. More modifiable factors affecting reversion were found in midlife, suggesting that assessment and intervention at an early age should be considered. Geriatr Gerontol Int 2019; 19: 1129–1135. [ABSTRACT FROM AUTHOR]

The original version of the article unfortunately contained a mistake in the review committee number of the National Health Insurance Sharing Service. [ABSTRACT FROM AUTHOR]

Background: Although a general implementation of person-centered care in Korean long-term care delivery systems would be challenging, person-centered care has the potential to improve resident and staff outcomes through changes in current care services. However, little empirical evidence currently supports a positive relationship between person-centered care environments and staff outcomes. Purpose: This study was designed to examine the relationship between person-centered care environments and staff outcomes, including job satisfaction and turnover intention, among care staff in Korean long-term care facilities. Methods: This descriptive, correlational study used data from 235 care staff (94 nursing staff and 141 personal care workers) in 13 long-term care facilities in Korea. Data were collected using structured survey questionnaires, including items related to the person-centered care environment, job satisfaction, and turnover intention. Multilevel linear and logistic regression analyses were performed using Mplus Version 7.0. Results: After controlling for individual (age, education, monthly income, position, shift work, and job tenure) and organizational (type of facility, location, ownership, bed size, and staffing levels) characteristics, a significant relationship was found between the person-centered care environment and job satisfaction and turnover intention among staff in Korean long-term care facilities. Conclusions/Implications for Practice: The study findings indicate that working in a person-centered care environment is key to higher job satisfaction, which is a significant predictor of turnover intention among staff in long-term care facilities. To recruit and retain qualified staff to provide high-quality person-centered care in long-term care facilities, a supportive work environment is crucial. Fostering a person-centered care environment will ultimately improve quality of care for residents. [ABSTRACT FROM AUTHOR]