Kyumin Kim

Background and Objective It is important to consider dysfunctional beliefs about sleep when conducting cognitive-behavioral therapy for insomnia. The purpose of this study was to examine the reliability and validity of a Dysfunctional Beliefs about Sleep-2 items (DBS-2) scale in a general population and clinical sample.Methods Our study examined the reliability and validity of the DBS-2 scale in the general population (group I, n = 374) and in a clinical sample of subjects with insomnia disorders (group II, n = 105). An online survey targeting the general population was conducted over the course of January 10–18, 2022, and a retrospective study of medical records was conducted among a clinical sample of insomnia patients who visited the Asan Medical Center Sleep Clinic for the first time between September of 2021 and May of 2022. The internal consistency reliability of the DBS-2 scale was measured using split-half coefficients, and factor analysis was used to determine its validity. Using the Insomnia Severity Index (ISI) and the Dysfunctional Beliefs and Attitudes about Sleep-16 items (DBAS-16), convergence validity was explored.Results Split-half coefficients for the DBS-2 were 0.862 and 0.855 in the general population and a clinical sample of insomnia disorder. DBS-2 overall report score was significantly correlated with ISI (r = 0.26, p < 0.001) and DBAS-16 (r = 0.43, p < 0.001) in the general population, and correlated with ISI (r = 0.45, p < 0.001) and DBAS-16 (r = 0.50, p < 0.001) in the clinical sample. Both groups of subjects had an optimal cut-off score of 13 for the DBS-2 scale.Conclusions We found that the DBS-2 scale, a two-item ultra-brief rating scale, could accurately measure dysfunctional beliefs about sleep in the general population and a clinical sample of insomnia patients.

Kim H, et al. J Korean Med Sci. 2022 Sep;37(36):e272. https://doi.org/10.3346/jkms.2022.37.e272

Purpose Literature is scarce regarding cancer care utilization during the massive outbreak of coronavirus disease 2019 (COVID-19) in the Republic of Korea. We investigated functional impairments in mental health and their relationships with depression, anxiety regarding the viral epidemic, and disruptions in healthcare service utilization among cancer patients in the COVID-19 pandemic era.Materials and Methods We used an online survey with questions related to the disturbances faced by patients with cancer in utilizing healthcare services in the pandemic era. Current mental health status was assessed using the Work and Social Adjustment Scale (WSAS), Stress and Anxiety to Viral Epidemics-6 (SAVE-6) scale, Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI), Brief Resilience Scale (BRS), Cancer-Related Dysfunctional Beliefs about Sleep Scale (C-DBS), and Fear of COVID-19 over Cancer (FCC).Results Among the 221 responders, 95 (43.0%) reported disruptions in healthcare service utilization during the COVID-19 pandemic. Logistic regression analysis revealed that functional impairment in the mental health of these patients was expected due to disruptions in healthcare service utilization, high levels of depression, anxiety regarding the viral epidemic, fear of COVID over cancer, and low resilience. Mediation analysis showed that patient resilience and cancer-related dysfunctional beliefs about sleep partially mediated the effects of viral anxiety on functional impairment.Conclusion In this pandemic era, patients with cancer experience depression, anxiety regarding the viral epidemic, and disruptions in healthcare service utilization, which may influence their functional impairments in mental health.

Objective We aimed to explore the influence of public workers’ distress or viral anxiety on their level of depression and work engagement during the coronavirus disease (COVID-19) pandemic. Additionally, we ascertain the mediation effect of resilience and public service motivation on this association.Methods A total of 300 public workers participated in this online survey. Their demographic characteristics and responses to survey items were collected using the Stress and Anxiety to Viral Epidemics–6 items Scale, the Patient Health Questionnaire–9 items Scale, the Public Service Motivation (PSM) Scale, the Nine-item Utrecht Work Engagement Scale, the Korean Occupational Stress Scale–Short Form, and the Brief Resilience Scale.Results Work engagement of public workers was expected by PSM (β=0.28, p<0.001), resilience (β=0.30, p<0.001), and work-related stress (β=-0.40, p<0.001) (F=57.4, p<0.001). Depression was expected by fewer years of employment (β=-0.12, p=0.02), viral anxiety (β= 0.21, p<0.001), and low resilience (β=-0.42, p<0.001) (F=22.1, p<0.001). Resilience and PSM partially mediated the effects of work-related stress on work engagement. Depression was influenced by COVID-19–induced viral anxiety, and their resilience—but not PSM—mediated the association.Conclusion Public workers’ resilience and PSM partially mediated the effects of work-related stress on work engagement. The influence of viral anxiety on public workers’ depression was mediated by their resilience but not PSM.

Kikyoung Yi, Joohee Lee, Sungook Yeo, Kyumin Kim, Seockhoon Chung. Clin Psychopharmacol Neurosci 2022;20:364-72. https://doi.org/10.9758/cpn.2022.20.2.364

Objective The aim of this study was to explore the factors that can influence the severity of insomnia in the general population. We also aimed to examine whether sleep effort mediates the association between dysfunctional beliefs about sleep or the discrepancy between desired time in bed and desired total sleep time (DBST) and insomnia severity in individuals.Methods A total of 387 participants enrolled in this e-survey study. The symptoms were rated using the insomnia severity index (ISI), Patients Health Questionnaire-9 items, Dysfunctional Beliefs about Sleep-2 items, Glasgow Sleep Effort Scale, and Stress and Anxiety to Viral Epidemics-6 items. In addition, we defined a new sleep index named the DBST index. A linear regression analysis was performed to explore the factors predicting ISI scores, and mediation analysis was implemented to explore whether persistent preoccupation with sleep mediated the influence of dysfunctional beliefs about sleep and DBST on insomnia severity.Results A linear regression analysis investigated depression (β=0.17, p<0.001), sleep effort (β=0.50, p<0.001), dysfunctional beliefs about sleep (β=0.13, p=0.001), and DBST (β=0.09, p=0.014) (adjusted R2=0.50, F=65.7, p<0.001). Additionally, we observed that persistent preoccupation with sleep partially mediated the influence of dysfunctional beliefs about sleep and DBST on insomnia severity.Conclusion Depression, preoccupation with sleep, dysfunctional beliefs about sleep, and DBST influenced the insomnia severity of the general population. We also observed that a persistent preoccupation with sleep partially mediated the influence of dysfunctional beliefs about sleep and the DBST index on insomnia severity.

Lee J, et al. J Korean Med Sci. 2022 May;37(21):e157. https://doi.org/10.3346/jkms.2022.37.e157

Background and Objective The aim of this study is to explore the usefulness of the Stress and Anxiety to Viral Epidemic-3 items (SAVE-3) scale as a tool for assessing work-related stress in healthcare workers.Methods There were 389 participants and all remained anonymous. The SAVE-9, the Patient Health Questionnaire-4, the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS-MP), the perceived stress scale (PSS), and single item insomnia measure were used. After checking whether the SAVE-3 scale is clustered into a sole factor from SAVE-9 scale based on principal component analysis with promax rotation, confirmatory factor analysis (CFA) was done on the 3 items of the SAVE-3 to examine the factorial validity for a unidimensional structure.Results The SAVE-3 was clustered with factor loadings from 0.664–0.752, and a CFA revealed that 3 items of the SAVE-3 cohered together into a unidimensional construct with fit for all of indices (comparative fit index = 1.00; Tucker Lewis index = 1.031; standardized root-mean-square residual = 0.001; root-mean-square-error of approximation = 0.00). The SAVE-3 scale showed acceptable reliability (Cronbach’s α = 0.56 and McDonald’s ω = 0.57) in this sample. A high SAVE-3 score correlated significantly with younger age (r = -0.12, p = 0.02), a high PSS score (r = 0.24, p < 0.001), a high total score for the MBI-HSS-MP (r = 0.35, p < 0.001) and all of its subscales (emotional exhaustion, r = 0.40, p < 0.001; personal accomplishment, r = -0.14, p < 0.005; depersonalization, r = 0.39, p < 0.001), and poor sleep quality (r = 0.15, p < 0.001).Conclusions Taken together, the data suggest that SAVE-3 is a reliable, valid, and usable scale for measuring work-related stress in healthcare workers during the COVID-19 epidemic.

Objective We aimed to investigate the effect of nursing professionals’ resilience on their mental health, work-related stress, and anxiety in response to the COVID-19 pandemic.Methods We conducted an online survey in the Asan Medical Center and Ulsan University Hospital, South Korea. We extracted data of 824 nursing professionals who consented to participate, including demographic variables and the Stress and Anxiety to Viral Epidemics-9 (SAVE-9), PHQ-9, GAD-7, and Brief Resilience Scale scores.Results Resilience was negatively correlated with Patient Health Questionnaire-9 (PHQ-9) (rho=-0.23), Generalized Anxiety Scale-7 items (GAD-7) (rho=-0.25), Stress and Anxiety to Viral Epidem-ics-6 items (SAVE-6) (rho=-0.15), and Stress And anxiety to Viral Epidemics-3 items (SAVE-3) (rho=-0.13, all, p<0.001). Logistic regression analysis adjusting age, marital status, and years of employment revealed that high level of general anxiety [adjusted odds ratio (aOR)=1.40, 95% confidence interval (CI)=1.31–1.50], work-related stress during viral epidemics (aOR=1.16, 95% CI=1.03–1.29), and a low level of resilience (aOR=0.91, 95% CI=0.85–0.97) were expecting variables for the depression of healthcare workers.Conclusion Nursing professionals’ level of resilience may be associated with low level of work-related stress and anxiety induced by a viral epidemic. We need to explore further the possibility of resilience as coping strategy of healthcare workers in this pandemic era.

Chung S, et al. J Korean Med Sci. 2021 Nov;36(47):e319. https://doi.org/10.3346/jkms.2021.36.e319