Sang Mi Kim

Aim: This study analyzed determinants of advance-directive (AD) completion for end-of-life preparedness among older Korean adults. Methods: The study used data from 9,796 individuals in the 2023 National Survey of Older Koreans. Complex-sample weighted analyses and multivariate logistic regression were conducted to identify factors associated with AD completion among older Koreans. Sociodemographic, health-status, and death-preparation characteristics were analyzed. Results: Multivariate analysis revealed that the strongest predictors of AD completion were organ- or tissue-donation willingness, educational attainment, and writing a will. Other significant factors included funeral consultation and death-preparation education. Conclusion: These findings suggest that death-preparation behaviors and end-of-life planning activities are significantly associated with AD completion among older Korean adults. Public-health strategies should support targeted education and communication interventions to improve older adults’ engagement in advanced care planning.

Objective This study aimed to examine the current status of psychiatric therapy and anti-craving prescriptions for patients with alcohol-related diseases and to evaluate the impact of these treatments on the prognosis of alcohol-related diseases for drawing implications.Methods Data were analyzed by combining data extracted from one hospital, data of the National Health Insurance Service, and the National Statistical Office mortality data. The rationale for utilizing an integrated data set was that a single dataset from a single hospital was insufficient for comprehending economic factors, mortality rates, and medical information.Results The analysis yielded two principal conclusions. Firstly, concurrent administration of psychiatric therapy and anti-craving prescriptions was demonstrated to be an effective approach in the management of alcohol-related disorders. Secondly, the economic status of patients was found to influence outcomes of psychiatric pharmacotherapy.Conclusion The integration of diverse alcohol-related data for management could facilitate the implementation of personalized prescriptions tailored to specific needs of each patient. This approach has the potential to reduce mortality rates and mitigate societal burdens associated with alcohol-related diseases.

Background/Objectives: Adequate sleep is critical for adolescents’ physical and mental health. However, academic demands and lifestyle habits lead to insufficient sleep among many adolescents. This study examined the relationship between sleep patterns and general characteristics, health behaviors, and mental health among South Korean adolescents. Methods: Data were obtained from the Korea Youth Risk Behavior Survey conducted by the Korea Disease Control and Prevention Agency, involving 21,283 students aged between 13 and 18 years. Self-reported sleep duration was categorized as adequate (8–10 h) or insufficient (less than 8 h on both weekdays and weekends), and 20 independent variables across demographic, socioeconomic, lifestyle, health-related behavioral, and psychological factors were analyzed. Multiple logistic regression analyses were conducted to evaluate the effects of insufficient sleep. Results: Insufficient sleep was more prevalent among female students (odds ratio [OR]: 2.064) and older students (OR: 16.588 for Grade 12 vs. Grade 7) and was associated with higher stress levels (OR: 4.338 for almost always vs. never), suicidal ideation (OR: 1.826), and unhealthy behaviors such as alcohol consumption (OR: 2.009), smoking (OR: 1.998), and smartphone overdependence (OR: 2.313 for severe vs. normal). In contrast, adolescents with adequate sleep reported greater happiness (OR: 4.167 for very much vs. not at all) and better academic performance (OR: 1.377 for very high vs. very low). Conclusions: The findings show that insufficient sleep significantly affects adolescent well-being, highlighting the need for tailored interventions and increased societal awareness. Future research should explore the mechanisms underlying gender differences and weekday–weekend sleep disparities to enhance sleep quality in this population.

The use of mobile-based personal health record (m-PHR) applications at the hospital level has been minimally studied. This study aimed to investigate the relationship between m-PHR use and quality of care. A cross-sectional study design was employed, analyzing data from 99 hospitals. Two data sources were utilized: a previous m-PHR investigation conducted from 26 May to 30 June 2022 and a hospital evaluation dataset on quality of care. The use of m-PHR applications was measured by the number of m-PHR application downloads. Three independent variables were assessed: quality of care in the use of antibiotic drugs, injection drugs, and polypharmacy with ≥6 drugs. A generalized linear model was used for the analysis. The hospitals providing high-quality care, as evaluated based on the rate of antibiotic prescription (relative risk [RR], 3.328; 95% confidence interval [CI], 1.840 to 6.020; p < 0.001) and polypharmacy (RR, 2.092; 95% CI, 1.027 to 4.261; p = 0.042), showed an increased number of m-PHR downloads. Among the hospital covariates, public foundation status and being part of multi-hospital systems were associated with the number of m-PHR downloads (p < 0.05). This exploratory study found a positive relationship between quality of care and m-PHR use. Hospitals providing high-quality care may also excel in various activities, including m-PHR application use.

Background: The coronavirus disease 2019 (COVID-19) pandemic has negatively impacted many aspects of life. Measures for preventing the spread of COVID-19 (e.g., school lockdowns, remote and hybrid classes, group and outdoor activity restrictions, and social distancing in the classroom and meal time) could have led to adolescents to experience anxiety and depressive symptoms. Such mental health impacts could increase the risk of suicidal ideation in this population. Moreover, according to a report by the Organization for Economic Co-operation and Development, although the total number of suicide deaths in South Korea decreased in 2021, the suicide rate of those aged 10–29 years increased. One factor affecting the result is adolescent mental health by COVID-19. This study examines the mental health status of South Korean adolescents amid the prolonged COVID-19 pandemic, and identifies and analyzes predictors of suicidal ideation, suicide planning, and suicide attempts. Methods: The study used data from 54,948 adolescents who participated in the 2020 Korea Youth Risk Behavior Web-based Survey. Based on their responses to suicide-related questions, the sample was divided into a healthy group, suicide-ideation group, suicide-planning group, and suicide-attempt group. The descriptive statistics of these groups were then analyzed. An analysis of covariance, post-hoc tests, and multiple logistic regression analysis were performed on the four groups. Results: Overall, 6.9% of the participants reported suicidal ideation, 2.2% reported planning suicide, and 1.9% reported attempting suicide in the previous 12 months. Conclusions: During the prolonged COVID-19 pandemic, there is a strong need for various individualized programs that identify and intervene to support adolescents at risk of suicide by accurately assessing their mental health risk factors, such as stress, sadness and despair, loneliness, and generalized anxiety disorder. Accordingly, it is necessary to develop and distribute a mental health and well-being curriculum, strengthen suicide prevention programs and support services, expand mental health diagnostic tests, and school-based mental health programs.

This study aimed to identify the patient characteristics, comorbidities, risk factors, and means of the self-harm of patients who attempt self-harm in and outside of a hospital, and to determine the characteristics of death by suicide among survival and death patient groups in South Korea. This study used data from the Korean National Hospital Discharge In-depth Injury Survey conducted from 2007 to 2019. In total, 7192 outpatient participants and 43 inpatient participants performed self-harm. Frequency analysis, chi-square tests, Fisher’s exact test, and logistic regression analysis were performed using STATA, version 15.0 (StataCorp), and statistical significance was set at 5%. Thirty-one inpatients who performed self-harm survived, and 12 died. Among male inpatients, the older they were, the higher the rates of self-harm and mortality rates due to falls and poisoning if they had comorbidities and financial problems. In addition, the rate of self-harm attempts within a short period after hospitalization was high. Our evidence of the characteristics of patients who performed self-harm in the hospital and the influencing factors of self-harm can be used as primary data for predicting patients at a high risk of self-harm and for creating preventative policies to reduce the risk of self-harm among inpatients in South Korea.

Lee H, et al. J Korean Med Sci. 2023 Feb;38(7):e52. https://doi.org/10.3346/jkms.2023.38.e52

Self-harm injury among older adults is a pressing problem that demands social attention in South Korea. This study sought to identify the association between physical and mental illness and hospitalization following self-harm injuries, compared to non-self-harm injuries, among older adults living in Korea. We analyzed individuals aged 65 and older who were admitted to hospitals either for self-harm or non-self-harm from a population-based survey of the Korea National Hospital Discharge In-depth Injury Survey (KNHDIS). A logistic regression analysis was performed. Compared with non-self-harm-related hospitalization, self-harm hospitalization was associated with higher odds of depression, other disorders of the nervous system, malignancies, alcohol misuse and dependence, and drug-related dependence. Dementia, anxiety disorder, diabetes, arthritis, cerebral palsy, and other paralytic syndromes had a lower likelihood of leading to self-harm than non-self-harm hospitalization. The findings of this study can inform medical professionals to identify older adults with a heightened risk of self-harming behavior leading to hospitalization.

Tae Yeon Yoon, Hyun Sook Lee, Jung-Woo Son, Sang Mi Kim, and Je Jung Lee. J Korean Acad Child Adolesc Psychiatry 2022;33:59-66. https://doi.org/10.5765/jkacap.220002

Background: The coronavirus disease 2019 (COVID-19) pandemic has negatively impacted many aspects of life. In particular, measures for combatting the spread of the virus, such as quarantining and restrictions on social gatherings, may have led to psychological anxiety and depressive symptoms among adolescents. Such mental health impacts may increase the risk of suicidal ideation. This study aimed to examine mental health among adolescents amid the prolonged COVID-19 pandemic, and identify and analyze predictors of suicidal ideation, suicide planning, and suicide attempts.Methods: Data for 57,925 adolescents who participated in the 2020 Korea Youth Risk Behavior Web-based Survey were used for this research. Based on their responses to suicide-related questions, the sample was divided into a healthy group, suicide-ideation group, suicide-planning group, and suicide-attempt group, respectively. The groups’ descriptive statistics were then analyzed. An analysis of covariance, post-hoc tests, and multiple logistic regression were performed on the four groups.Results: Overall, 6.9% of the participants reported suicidal ideation, 2.2% reported planning suicide, and 1.9% reported attempting suicide in the previous 12 months. Stress, sadness and despair, loneliness, and generalized anxiety disorder were all highest in the suicide-attempt group and lowest in the healthy group. Sex, academic achievement, economic status, impact of COVID-19 on economic status, sleep, alcohol use, drug use, smartphone overdependence, and suicide-associated factors significantly predicted adolescents’ mental health status. Conclusions: Amid the prolonged COVID-19 pandemic, there is a strong need for various individualized programs that identify and intervene to support adolescents with a suicidal risk by accurately assessing their mental health risk factors, such as stress, sadness and despair, loneliness, and generalized anxiety disorder.