Korean Journal of Family Medicine最新文献

Background: Female workers in Indonesia are vulnerable, because they must work to earn a living while still being responsible for domestic problems. This study analyzes the barriers to the use of modern contraceptives by female workers in Indonesia's urban areas.

Methods: This cross-sectional survey looked at 21,696 female workers. We used modern contraceptive use as a dependent variable, and age, education, wealth, known modern contraceptives, number of live births, ideal number of children, and insurance ownership as independent variables. In the final test, we employed binary logistic regression.

Results: The results showed that women at all age categories were more likely than those aged 15-19 years not to use modern contraceptives, except those aged 35-39 years, who showed no difference. All other marital types were more likely to use modern contraceptives than married individuals. Rich female workers were 1.139 times more likely than poor workers not to use modern contraceptives (adjusted odds ratio [AOR], 1.139; 95% confidence interval [CI], 1.026-1.264). Female workers who did not know about modern contraceptives were 4.549 times more likely than those who did not to use modern contraceptives (AOR, 4.549; 95% CI, 1.037-19.953). Female workers with more than two children were 9.996 times more likely than those with two or fewer children not to use modern contraceptives (AOR, 9.996; 95% CI, 9.1890-10.875).

Conclusion: This study identified five factors associated with the non-use of modern contraceptives by female workers in Indonesia's urban areas: young, unmarried, rich, did not know about modern contraceptives, and had more than two children.

Background: The relationship between weight change and quality of life remains controversial. This study aimed to investigate whether changes in body weight among participants in different baseline body mass index categories are associated with physical and mental health functioning.

Methods: We conducted an analysis involving 5,106 adults who participated in the Korean Genome and Epidemiology Study, a cohort comprising Korean adults aged 40 to 69 years. We categorized participants into three groups based on body weight change, and physical and mental health were assessed using the 12-Item Short-Form Health Survey in year 4. We employed logistic regression analysis to assess the association between body weight change and poor functioning at year 4. We also utilized a generalized estimating equation to determine the relationship between weight changes and mental component summary (MCS) scores over the study period for each weight group.

Results: Weight gain in both the normal weight (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.13-3.11; P=0.01) and overweight groups (OR, 1.75; 95% CI, 1.05-2.91; P=0.03) was associated with poor MCS. Normal weight weight-losers were associated with a greater increase (2.69 points; 95% CI, 0.50-4.88) in MCS compared to weightmaintainers. Significant differences in mean MCS were observed for overweight weight-losers, obese weight-gainers, and underweight weight-gainers when compared to weight maintainers in each respective weight group.

Conclusion: Different patterns of relationships between weight change and mental health-related quality of life were observed. Hence, it is crucial to focus on the mental health of middle-aged and older adults when assessing body weight changes.

Background: This study aimed to determine the link between water consumption and abdominal obesity in individuals aged 19 years and above, utilizing a sample from the 8th Korea National Health and Nutrition Examination Survey.

Methods: Participants were divided into two groups based on their water intake: those meeting adequate intake (≥5 cups for men and ≥4 cups for women) and those with inadequate intake (<5 cups for men and <4 cups for women). Multivariate logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for potential confounders.

Results: Compared with the inadequate water intake group, the adequate water intake group showed a lower adjusted OR for abdominal obesity (adjusted OR, 0.874; 95% CI, 0.770-0.992). In the subgroup analysis, the adjusted OR for abdominal obesity in the 19-39 age group was 0.712 (95% CI, 0.520-0.974). However, no significant association was observed in the 40-64 and 65 or higher age groups.

Conclusion: Our findings indicate that sufficient water consumption may be negatively associated with abdominal obesity in adults, particularly among young adults; however, this association may not extend to older age groups.

Background: Obesity is a significant health risk factor for cardiovascular diseases. Dyslipidemia, defined as a low high-density lipoprotein cholesterol (HDL-C) level, is associated with these risks. Recent bioelectrical impedance analysis (BIA) devices offer precise measurements of the percent body fat (PBF). We aimed to determine the association between PBF and HDL-C levels in middle-aged men in Korea.

Methods: We conducted a cross-sectional sstudy of men aged 40-65 years who visited a health examination center. Body composition was analyzed using BIA. Health habits were assessed using a self-administered questionnaire. The participants were divided into four groups based on their PBF: group 1 (<21%), group 2 (21%-23.99%), group 3 (24%-28.99%), and group 4 (≥29%). Logistic regression was used to obtain the odds ratio (OR) between the PBF group and the low HDL-C level and adjusted for other variables.

Results: In this study, 2,685 men were analyzed. The number of individuals diagnosed with low HDL-C levels increased significantly as the group-specific PBF increased. Group 4 showed a 5.5-fold greater association with low HDL-C compared to group 1 (P<0.01), whereas group 3 and group 2 showed an OR of 4.38 and 2.95 (P<0.01 and P<0.01), respectively.

Conclusion: These results suggest that if middle-aged men are able to decrease their body fat by <5%, their HDL-C levels will increase. We suggest that 3%-5% PBF is a useful guideline for general body fat reduction in Korean middle- aged men in primary care.

Background: Adolescence is an essential stage of a child's development, transitioning them into adulthood. During this time, they are vulnerable to various social issues, such as experimenting with alcohol, among others. Although alcohol consumption was proven to be detrimental to physical and cognitive development toward adulthood, and almost one in 10 Malaysian adolescents aged 13 years and above are current drinkers, studies concerning the driving factors are still scarce. This cross-sectional study aimed to determine alcohol use among 244 adolescents in Nabawan, Sabah.

Methods: This study assessed the associations between alcohol use and three potential factors: demographic, environmental, and psychological. Respondents who were selected through stratified proportionate random sampling answered a set of assessment tools.

Results: Results showed that 30.7% (95% confidence interval [CI], 24.91-36.48) of Nabawan adolescents use alcohol. Analysis revealed that older age adolescents 18 years and 19 years, respectively (adjusted odds ratio [aOR], 3.93; P=0.021; aOR, 5.38; P=0.003), having parents (aOR, 4.11; P=0.001) and peers (aOR, 11.57; P<0.001) who consume alcohol were significantly associated with alcohol use. Unexpectedly, good parental monitoring (aOR, 2.46; P=0.019) and discussing serious problems with parents (aOR, 3.86; P=0.001) were significantly associated with alcohol use.

Conclusion: Conclusively, policies on alcohol-related harm reduction and prevention should be developed, especially school-based programs, programs addressing family functioning, and parent-child communication, among others, should be further looked into. Future research on the school environment, adolescents' drinking motives, and the development of practical adolescent-friendly alcohol screening tools are recommendations for improvements.

Background: Establishing cost-effective informal care services for lonely older adults living at home in developing countries can be an innovative approach for improving their well-being. This study investigated the effectiveness of an informal home care support intervention program (HoSIP) reducing the loneliness and improving quality of life of lonely community-dwelling older adults.

Methods: This quasi-experimental pre-post study employed a non-randomized control group design with a 12-week intervention period and three follow-up points at the end of the HoSIP. Questionnaires were used to measure feelings of loneliness (20-item UCLA Loneliness Scale), quality of life (Control, Autonomy, Self-Realization and Pleasure Scale), general health (12-item General Health Questionnaire), social network (six-item Lubben Social Network Scale), social support (12-item Multidimensional Scale of Perceived Social Support), and self-care ability (17-item Self-care Ability Scale for the Elderly). Repeated-measures analysis of variance was used to gauge the effect of the intervention program over time and in comparison to the control group. Data analyses were performed using the IBM SPSS Statistics software (IBM Corp., USA).

Results: We found a significant relationship between the outcome variables, including feelings of loneliness (P<0.001) and quality of life (P<0.001), at different stages of measurement. Despite the positive feasibility results, the implementation of the HoSIP faced challenges due to a lack of facilities (e.g., place restriction for holding educational classes, educational facilities like computers, video projector, and whiteboard at daycare center) and the absence of supporting organizations.

Conclusion: Utilizing the existing capabilities of older adults to provide online and face-to-face care services can be a cost-effective way to improve their quality of life and reduce loneliness. The process of facilitating such informal care services for lonely older adults should be managed by either governmental or non-governmental organizations to reduce the rate of social isolation among this vulnerable population.

Background: Malnutrition is common among children under 5 years of age in Indonesia, with the rates varying between urban and rural areas. The minimum acceptable diet (MAD) assesses nutrient quality and quantity. This study aimed to identify the potential variables for MAD in 6-23-month-old children in both urban and rural Indonesia.

Methods: We used the data from the 2017 Indonesia Demographic and Health Survey to conduct this nationally representative study. A total of 4,688 children aged 6-23 months were included in the study. MAD was classified using the 2017 World Health Organization global nutrition monitoring framework. The determinants of MAD were analyzed using multiple logistic regression.

Results: Overall, 45% of children aged 6-23 months received the required MAD, with 47.4% receiving the MAD in urban areas and 35.7% in rural areas. Children's age, fathers' age, parents' education level, mothers' employment, and wealth index were strongly linked to MAD in both rural and urban homes. The factor specifically related to MAD in urban areas was mother living with her husband. For rural households, mothers' involvement in decisionmaking and a minimum of four antenatal care (ANC) visits significantly increased the likelihood of their children's MAD status.

Conclusion: MAD status was determined by increased child age, higher parent education, younger father, working mother, and higher wealth index in children aged 6-23 months in both urban and rural settings. Mothers living with a spouse determined the MAD status only in urban areas. More frequent ANC visits and mother participation in household decisions were other factors related to MAD status in rural areas.

Background: Atherosclerotic cardiovascular disease (ASCVD) is a major health concern, and lipoprotein(a) (Lp(a)) is an independent risk factor. However, there is limited evidence regarding Lp(a) and the risk of ASCVD in Asian populations. This study aimed to assess the predictive value of changes in coronary artery calcification (CAC) for ASCVD risk associated with Lp(a) level.

Methods: Participants (n=2,750) were grouped according to their Lp(a) levels, and the association between Lp(a) and CAC progression was examined. CAC progression was defined as the occurrence of incident CAC or a difference ≥2.5 between the square root (√) of baseline and follow-up coronary artery calcium scores (CACSs) (Δ√transformed CACS). To adjust for differences in follow-up periods, Δ√transformed CACS was divided by the follow- up period (in years).

Results: Over an average follow-up of 3.07 years, 18.98% of participants experienced CAC progression. Those with disease progression had notably higher Lp(a) levels. Higher Lp(a) tertiles correlated with increased baseline and follow-up CACS, CAC progression (%), and Δ√transformed CACS. Even after adjustment, higher Lp(a) levels were associated with CAC progression. However, annualized Δ√transformed CACS analysis yielded no significant results.

Conclusion: This study demonstrated an association between elevated Lp(a) levels and CAC progression in a general population without ASCVD. However, longer-term follow-up studies are needed to obtain meaningful results regarding CAC progression. Further research is necessary to utilize Lp(a) level as a predictor of cardiovascular disease and to establish clinically relevant thresholds specific to the Korean population.