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Original Articles

Association between sedentary time and anxiety in Korean adults: insights from the 2021 Korea National Health and Nutrition Examination Survey
So Hyeon Kim, Gyu Lee Kim, Jeong Gyu Lee, Yu Hyeon Yi, Young Jin Tak, Seung Hun Lee, Young Jin Ra, Sang Yeop Lee, Eun Ju Park, Young Hye Cho, Young In Lee, Jung In Choi, Sae Rom Lee, Ryuk Jun Kwon, Soo Min Son
Korean J Fam Med 2026;47(2):135-144.   Published online September 17, 2025
DOI: https://doi.org/10.4082/kjfm.24.0219
Background
Physical inactivity and sedentary behavior influence the prevalence of anxiety disorders. However, there is a lack of research on how these factors affect Korean adults. Therefore, we conducted a large-scale cohort study to investigate the association of physical activity and sedentary behavior with the development of anxiety disorders.
Methods
This cross-sectional study included 5,615 Korean adults aged 19 years and over. This study analyzed data from the Korea National Health and Nutrition Examination Survey VIII (2021). Participants were divided into three groups based on sedentary time (minute per day), and anxiety levels were compared using the Generalized Anxiety Disorder Scale.
Results
The odds ratio (OR) for severe generalized anxiety disorder was higher in the longer sedentary time group (≥480 & <660 minutes and ≥660 minutes) than in the lowest sedentary time group (<480 minutes) (≥480 & <660 minutes: OR, 1.004; 95% confidence interval [CI], 0.463–2.178; ≥660 minutes: OR, 2.233; 95% CI, 1.385–3.599; P=0.001). After adjusting for confounding factors, these correlations remained consistent and statistically significant. Furthermore, subgroup analysis revealed that middle-aged adults, women, high school graduates, individuals living with housemates, and employed individuals had a stronger association with severe anxiety as sitting time increased.
Conclusion
Sitting for more than 11 hours a day is a significant risk factor for the development of severe anxiety. Incorporating regular walking into daily routines and reducing sedentary behaviors could alleviate anxiety in Korean adults.

Citations

Citations to this article as recorded by  
  • Association between sedentary behaviour, sleep duration, physical activity and mental health among teachers in China during COVID-19: a cross- sectional study
    Yexin Ma, Yuntao Xu, Liyou Wu, Jiabao Guo, Binglin Chen
    Frontiers in Public Health.2026;[Epub]     CrossRef
  • 1,564 View
  • 54 Download
  • 1 Web of Science
  • 1 Crossref
Adaptation and validation of the Physical Activity Readiness Questionnaire (PAR-Q)+ 2020 for the Indonesian population: a cross-sectional study
Iswandy Janetputra Turu’ Allo, Arief Wibowo, Badai Bhatara Tiksnadi, Fahmi Nur Hidayatullah, Poundra Adhisatya Pratama, Rizki Bunawan, Nathania Purnomo
Korean J Fam Med 2026;47(1):59-68.   Published online July 18, 2025
DOI: https://doi.org/10.4082/kjfm.24.0288
Background
The Physical Activity Readiness Questionnaire (PAR-Q)+ 2020 has been utilized to measure readiness for physical activity (PA). However, it is unavailable in the Indonesian language. We aimed to adapt and evaluate the validity and reliability of the PAR-Q+ 2020 culturally for the Indonesian population and its application in general and family medicine.
Methods
We conducted a cross-sectional study to adapt the PAR-Q+ 2020 to the Indonesian language. A face validity interview with 20 participants followed the translation and back-translation processes. Subsequently, an online questionnaire was distributed between June and October 2022, with 378 participants responding and a 72.2% response rate for the second test. Cohen’s kappa was calculated to determine the intra-rater reliability of each item. Intra-class correlation (ICC) and Cronbach’s alpha analyses were conducted to examine the first and second parts of the questionnaire and the overall intra-rater reliability and internal consistency of the questionnaire.
Results
The median age of the participants was 27 years (range, 18–61 years), and 63% (n=172) were female. The Cohen’s kappa value of each item ranged from to 0.801–1.000 (almost perfect to perfect agreement). The ICC values for the first and second parts and the overall questionnaire were 0.957, 0.993, and 0.987, respectively. Cronbach’s alpha was adequate for the first part (α=0.958), second part (α=0.993), and overall questionnaire (α=0.987).
Conclusion
The Indonesian version of the PAR-Q+ 2020 demonstrated reliability and preliminary evidence of its validity in measuring individual readiness for PA. Further studies involving a broader population and employing more comprehensive validation methods are necessary to establish its validity and applicability fully.
  • 2,493 View
  • 92 Download
The relationship between diet quality, measured by the recommended food score, and depression, assessed using the Patient Health Questionnaire-9: an observational study in Korea
Sharon Choi, Jung-Sun Lim, Sujeong Han, Jong Seung Kim, Bumjo Oh
Korean J Fam Med 2026;47(1):12-19.   Published online January 8, 2025
DOI: https://doi.org/10.4082/kjfm.24.0204
Background
Depression is a prevalent mental health disorder that presents substantial public health challenges. Emerging evidence underscores the role of dietary patterns in mitigating depressive symptoms. This study investigated the association between diet quality, assessed using the Recommended Food Score (RFS), and depressive symptoms, evaluated with the Patient Health Questionnaire-9 (PHQ-9), in a sample of Korean adults.
Methods
This cross-sectional study analyzed data from 19,786 participants recruited from a general hospital in Korea, all of whom completed the RFS and PHQ-9 assessments. General characteristics and anthropometric indices were recorded. Statistical analyses included chi-square tests and binary logistic regression to calculate odds ratios (ORs) and 95% confidence intervals for depressive symptoms according to RFS scores, adjusting for potential confounders.
Results
Higher RFS scores were associated with reduced odds of depression in univariate (OR, 0.59; P<0.001) and multivariate (OR, 0.72; P<0.001) analyses. Sociodemographic factors, including older age, higher education, marital status, higher income, professional occupation, and regular exercise, were linked to decreased odds of depression. Conversely, female sex, current smoking, and alcohol consumption were associated with increased odds.
Conclusion
The findings reveal an inverse relationship between diet quality and depressive symptoms among Korean adults, emphasizing the potential of dietary improvements in mental health promotion. Sociodemographic factors significantly influence depression risk. Future studies should adopt longitudinal designs incorporating a wider range of variables to elucidate these complex interactions.

Citations

Citations to this article as recorded by  
  • A year of significant progress for the Korean Journal of Family Medicine
    Seung-Won Oh
    Korean Journal of Family Medicine.2026; 47(1): 1.     CrossRef
  • 3,269 View
  • 109 Download
  • 1 Web of Science
  • 1 Crossref
Associations of Alcohol Consumption and Smoking Behaviors with Depressed Mood According to Gender in Korean Young Adults
Jung Won Hwang, Youngmi Eun, Chan-Hee Song
Korean J Fam Med 2023;44(5):274-280.   Published online July 7, 2023
DOI: https://doi.org/10.4082/kjfm.22.0146
Background
Recent studies have reported that chronic mental health problems often emerge in young adulthood. This study elucidated the independent effects of smoking and drinking on depressed mood in young adults by sex.
Methods
We used Data from the Korea National Health and Nutrition Examination Surveys conducted in 2014, 2016, and 2018. A total of 3,391 participants aged 19–35 years, without serious chronic diseases, were recruited for this study. Depression was evaluated using the Patient Health Questionnaire (PHQ-9).
Results
Smoking behavior, current smoking, and number of days smoked were significantly associated with higher PHQ-9 scores in both men and women (all P<0.05). However, past and ever smoking were positively associated with PHQ-9 scores only in women (all P<0.001). Regarding alcohol consumption, the age at which drinking first began was negatively associated with PHQ-9 scores in both men and women (all P<0.001), but the amount of alcohol consumed at 1 time was positively associated with PHQ-9 scores only in women (P=0.013). Men who drank 2–4 times a month and women who had not drunk during the past year had the lowest PHQ-9 scores.
Conclusion
Smoking and alcohol consumption were independently associated with depressed mood in young Korean adults, which was more pronounced in women, and exhibited sex-specific characteristics.

Citations

Citations to this article as recorded by  
  • Articles published in Korean Journal of Family Medicine: impact of COVID-19 on study trends
    Byung Ho Kong, Jae Kyung Choi, San-Sung Lee, Ji Young Kim
    Korean Journal of Family Medicine.2025; 46(5): 316.     CrossRef
  • Comparison of Depression-related Factors among Young Adults Pre- and Post-COVID-19: Focusing on the Early Pandemic Period
    So Hyun Kim
    Journal of Health Informatics and Statistics.2025; 50(4): 370.     CrossRef
  • Women’s Health and Primary Care
    Seung-Won Oh
    Korean Journal of Family Medicine.2024; 45(1): 1.     CrossRef
  • Pharmacotherapy guidelines for smoking cessation in primary healthcare clinics
    Cheol Min Lee, Yu Jin Paek, Yoo Bin Seo, Eon Sook Lee
    Journal of the Korean Medical Association.2024; 67(4): 230.     CrossRef
  • 5,947 View
  • 122 Download
  • 3 Web of Science
  • 4 Crossref
Background
Many people use both combustible cigarette (CC) and electronic cigarette (EC). We compared nicotine dependence among CC, EC, and dual users using questionnaires and urinary cotinine levels.
Methods
Data from the Korea National Health and Nutrition Examination Survey (2014–2017) databases were analyzed; 3,917 CC, EC, and dual users were administered the urinary cotinine test, and 1,045 current CC and dual users completed the Heaviness of Smoking Index (HSI) questionnaires. Weighted geometric means of urine cotinine levels were compared between exclusive CC, exclusive EC, and dual users. The distribution rate, based on time to first cigarette (TTFC), cigarettes per day (CPD), and the HSI was analyzed in two weighted groups, exclusive CC and dual users.
Results
Among those who currently use any type of cigarette, 89.4%, 1.4%, and 9.2% were exclusive CC, exclusive EC, and dual users, respectively. Weighted geometric means of urine cotinine were highest in dual users (1,356.4 ng/mL), followed by exclusive CC (1,270.3 ng/mL), and exclusive EC (867.7 ng/mL) with significant differences between all three groups (P<0.05). There were no statistically significant differences in CPD between exclusive CC and dual users (P=0.626). The proportion of TTFC ≤5 minutes was 21.5% and 29.5% in the two groups, respectively (P=0.010); however, HSI differences in the two groups was marginal (P=0.557).
Conclusion
In this study, the urinary cotinine value could distinguish the three groups, CC, EC, and dual users, but the questionnaire using HSI could not distinguish the three groups.

Citations

Citations to this article as recorded by  
  • Evaluation of a Community-based Quality Improvement Smoking Cessation Program Using the Ottawa Model During COVID-19
    Salma Mahmoodianfard, Ayah Rashwan, Javad Heshmati, Terefe Gelibo, Mustafa Coja, David Sabapathy, Shamara Baidoobonso, Karen Phillips, Laura MacDonald, Laura Lee Noonan, Kerri-Anne Mullen, Hassan Mir
    CJC Open.2026;[Epub]     CrossRef
  • The effect of heated-cigarette smoking on voice in comparison to combustion-cigarette smoking: self-perceived evaluation
    Abdul-Latif Hamdan, Christophe Abi Zeid Daou, Yara Yammine, Christopher Jabbour, Ibana Carapiperis, Vanessa Helou, Justin Ghadieh, Jerome R Lechien
    The Journal of Laryngology & Otology.2025; 139(2): 129.     CrossRef
  • Protocol for the development of a vaping cessation intervention for young adult veterans
    Neal Doran, Samantha Hurst, Jie Liu, Omar El-Shahawy, Mark Myers, Paul Krebs
    Contemporary Clinical Trials Communications.2024; 39: 101309.     CrossRef
  • Smoking Cessation Treatment in Primary Care
    Hye-ji An, Cheol-Min Lee, Yoo-Bin Seo, Eon-Sook Lee, Yu-Jin Paek
    Korean Journal of Family Practice.2024; 14(4): 184.     CrossRef
  • Optimum Urine Cotinine and NNAL Levels to Distinguish Smokers from Non-Smokers by the Changes in Tobacco Control Policy in Korea from 2008 to 2018
    Eun Young Park, Min Kyung Lim, Eunjung Park, Yoonjung Kim, Dohoon Lee, Kyungwon Oh
    Nicotine & Tobacco Research.2022; 24(11): 1821.     CrossRef
  • Current status of tobacco use, cessation and control policy in Korea
    Cheol Min Lee
    Journal of the Korean Medical Association.2022; 65(12): 789.     CrossRef
  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • Recent Trends of Research and Guidelines on Pharmacotherapy for Smoking Cessation
    Choon-Young Kim
    Journal of the Korean Society for Research on Nicotine and Tobacco.2022; 13(4): 107.     CrossRef
  • Nicotine Dependence of Electronic Cigarette, Dual Combustible and Electronic Cigarette Users
    Jungun Lee
    Korean Journal of Family Medicine.2021; 42(3): 189.     CrossRef
  • Recent Updates of Pharmacotherapy for Smoking Cessation
    Ju Sam Hwang, Cheol Min Lee
    Korean Journal of Family Practice.2021; 11(6): 403.     CrossRef
  • 10,494 View
  • 143 Download
  • 5 Web of Science
  • 10 Crossref

Review Article

The Impact of Heated Tobacco Products on Smoking Cessation, Tobacco Use, and Tobacco Sales in South Korea
Cheol Min Lee
Korean J Fam Med 2020;41(5):273-281.   Published online September 18, 2020
DOI: https://doi.org/10.4082/kjfm.20.0140
Heated tobacco products (HTPs), a hybrid between conventional and electronic cigarettes, were first launched in South Korea in June 2017. Owing to advertisements stating that HTPs are odorless, tar-free, and less harmful to health, the sales of HTPs have grown quickly enough to account for about 10% of the total tobacco market in a year. HTP use by young, highly educated, and high-income groups had a significant impact on both the overall tobacco market over the past 3 years and the smoking and quitting behaviors of smokers. Based on national smoking rate statistics, tobacco sales trends, and the number of visitors to smoking cessation clinics, the following changes have been identified: (1) The decline in current smoking rates has slowed or rose in some groups. (2) The decline in total cigarette sales has slowed but rose again in the first quarter of 2020. (3) The number of visitors to smoking cessation clinics decreased just after the advent of HTPs. These results may be due to the insufficient support of tobacco regulation policies but also coincide chronologically with the appearance of HTPs in South Korea. It is necessary to investigate the usage rate of various tobacco products, including HTPs and e-cigarettes, to examine the health risks of novel tobacco products and provide accurate information to users and policymakers. Finally, tobacco companies are continuously developing new product concepts to escape the regulation of existing cigarettes; thus, comprehensive management measures for all nicotine-containing products are needed.

Citations

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  • Association between single, dual, poly use of tobacco products and smoking cessation in Korean adult smokers
    Heajung Lee, Jaeyong Shin, Jae Woo Choi
    Tobacco Prevention & Cessation.2026; 12(January): 1.     CrossRef
  • Maintaining optimal cardiovascular health metrics and carotid intima-media thickness among Korean adolescents
    Fumie Kaneko, Hokyou Lee, Jee-Seon Shim, Hyeon Chang Kim
    Clinical Hypertension.2025;[Epub]     CrossRef
  • Assessing use of inhalable nicotine products within complex markets: the dilemma of heated tobacco products
    Connor Richard Miller, Steve S Xu, Danielle M Smith, Edward Sutanto, Maciej Lukasz Goniewicz, Anne C K Quah, Geoffrey T Fong
    Tobacco Control.2024; 33(1): 103.     CrossRef
  • The smoking population is not hardening in South Korea: a study using the Korea Community Health Survey from 2010 to 2018
    Boyoung Jung, Jung Ah Lee, Ye-Jee Kim, Hong-Jun Cho
    Tobacco Control.2024; 33(2): 171.     CrossRef
  • Heated Tobacco Product Use and Mental Health: Korean National Health and Nutrition Examination Survey (2018–2020)
    Young-Gyun Seo, Sungkyu Lee, Min Kyung Lim, Yu-Jin Paek
    International Journal of Mental Health and Addiction.2024; 22(3): 979.     CrossRef
  • Perception of heated tobacco products and support for regulations: a cross-sectional study in Hong Kong
    Yongda Socrates Wu, Yee Tak Derek Cheung, Sai Yin Ho, Henry Sau Chai Tong, Vienna Wai Yin Lai, Tai Hing Lam, Man Ping Wang
    Tobacco Control.2024; 33(e1): e132.     CrossRef
  • Heated tobacco products do not help smokers quit or prevent relapse: a longitudinal study in Japan
    Satomi Odani, Kanami Tsuno, Israel T Agaku, Takahiro Tabuchi
    Tobacco Control.2024; 33(4): 472.     CrossRef
  • A Scoping Review of Behavioural Studies on Heated Tobacco Products
    Ian M Fearon, Sarah F Cordery, Martin Fitzpatrick, Sarah Weaver, Matthew Stevenson, Erika Grandolfo, Layla Malt, Keith Thompson, Thomas Nahde
    Cureus.2024;[Epub]     CrossRef
  • Development and validation of a nomogram for predicting COPD: A nationwide population-based study in South Korea
    Seungeun Oh, Hyungkyun Mok, Kyuhee Jo
    Medicine.2024; 103(39): e39901.     CrossRef
  • Association between the dual use of electronic and conventional cigarettes and NAFLD status in Korean men
    Minjung Han, Seogsong Jeong, Jihun Song, Sun Jae Park, Cheol Min Lee, Kiheon Lee, Sang Min Park
    Tobacco Induced Diseases.2023; 21(February): 1.     CrossRef
  • JUUL preference among Korean adult tobacco users and its effect on attempts to quit tobacco: A follow- up survey four months post JUUL launch
    Ju Sam Hwang+, Kiheon Lee+, Choon-Young Kim, Heejin Kim, Sungroul Kim, Cheol Lee
    Tobacco Induced Diseases.2023; 21(March): 1.     CrossRef
  • Electronic device or regulated tobacco product? Learning from the diffusion of heated tobacco products in Spain
    J.M. Martín-Álvarez, A. Almeida, A.A. Golpe, E. Asensio
    Public Health.2023; 219: 61.     CrossRef
  • Is Using Heated Tobacco Products Helpful in Smoking Cessation?
    Young Gyu Cho
    Korean Journal of Family Medicine.2023; 44(3): 127.     CrossRef
  • Comparison of the Smoking Cessation of Heated Tobacco Product Users and Conventional Cigarette Smokers in Korea
    Doyeon Won, Wonyoung Jung, Dongwook Shin
    Korean Journal of Family Medicine.2023; 44(3): 151.     CrossRef
  • The relationship between heated cigarette smoking and blood white blood cell count: a population-based cross-sectional study
    D.-H. Koh
    Public Health.2023; 222: 154.     CrossRef
  • The Need for Policy Changes for Tobacco End Game
    Cheol Min Lee
    Journal of the Korean Society for Research on Nicotine and Tobacco.2023; 14(3): 118.     CrossRef
  • Relationship between heated tobacco product use and allergic rhinitis in Korean adults
    Young-Gyun Seo, Yu-Jin Paek, Joo-Hee Kim, Jwa-Kyung Kim, Hye-Mi Noh
    Tobacco Induced Diseases.2023; 21(November): 1.     CrossRef
  • Characterizing Heated Tobacco Product Use Among Adult Cigarette Smokers and Nicotine Vaping Product Users in the 2018 ITC Four Country Smoking & Vaping Survey
    Connor R Miller, Edward Sutanto, Danielle M Smith, Sara C Hitchman, Shannon Gravely, Hua-Hie Yong, Ron Borland, Richard J O’Connor, K Michael Cummings, Geoffrey T Fong, Andrew Hyland, Anne C K Quah, Maciej L Goniewicz
    Nicotine & Tobacco Research.2022; 24(4): 493.     CrossRef
  • Heated tobacco products for smoking cessation and reducing smoking prevalence
    Harry Tattan-Birch, Jamie Hartmann-Boyce, Loren Kock, Erikas Simonavicius, Leonie Brose, Sarah Jackson, Lion Shahab, Jamie Brown
    Cochrane Database of Systematic Reviews.2022;[Epub]     CrossRef
  • Perceived relative harm of heated tobacco products and electronic cigarettes and its association with use in smoke-free places: A cross-sectional analysis of Korean adults
    Choon-Young Kim*+, Kiheon Lee*+, Cheol Min Lee, Sungroul Kim, Hong-Jun Cho
    Tobacco Induced Diseases.2022; 20(February): 1.     CrossRef
  • Subjective Changes in Tobacco Product Use among Korean Adults during the COVID-19 Pandemic
    Jieun Hwang
    International Journal of Environmental Research and Public Health.2022; 19(6): 3272.     CrossRef
  • Methods of the 2020 (Wave 1) International Tobacco Control (ITC) Korea Survey
    Anne Quah, Sungkyu Lee, Hong Gwan Seo, Sung-il Cho, Sujin Lim, Yeol Kim, Steve Xu, Matthew Grey, Mi Yan, Christian Boudreau, Mary Thompson, Pete Driezen, Geoffrey Fong
    Tobacco Prevention & Cessation.2022; 8(March): 1.     CrossRef
  • Evaluation of Japanese university students' perception of smoking, interest in quitting, and smoking behavior: An examination and public health challenges during the COVID-19 pandemic
    Makoto Aoike, Yukihiro Mori, Kiyoshi Hotta, Yukihiro Shigeno, Yuka Aoyama, Mamoru Tanaka, Hana Kouzai, Hatsumi Kawamura, Masato Tsurudome, Morihiro Ito
    Drug Discoveries & Therapeutics.2022; 16(3): 118.     CrossRef
  • Factors Associated with Quit Intentions among Adult Smokers in South Korea: Findings from the 2020 ITC Korea Survey
    Minjung Han, Donghee Seo, Yeol Kim, Hong Gwan Seo, Sung-il Cho, Sungkyu Lee, Sujin Lim, Susan C. Kaai, Anne C. K. Quah, Mi Yan, Steve S. Xu, Geoffrey T. Fong
    International Journal of Environmental Research and Public Health.2022; 19(17): 10839.     CrossRef
  • Comparison of Tobacco Use and Cessation Behavior between Conventional Cigarette and Heated Tobacco Product Users: Based on the Analyses of the Eighth Korea National Health and Nutrition Examination Survey 2019
    Hyeree Yu, Cheol Min Lee
    Korean Journal of Family Medicine.2022; 43(5): 296.     CrossRef
  • Acute Eosinophilic Pneumonia after Combined Use of Conventional and Heat-Not-Burn Cigarettes: A Case Report
    Bo Hyoung Kang, Dong Hyun Lee, Mee Sook Roh, Soo-Jung Um, Insu Kim
    Medicina.2022; 58(11): 1527.     CrossRef
  • Current status of tobacco use, cessation and control policy in Korea
    Cheol Min Lee
    Journal of the Korean Medical Association.2022; 65(12): 789.     CrossRef
  • Prevalence and predictors of heated tobacco products use among male ever smokers: results from a Korean longitudinal study
    Jeeeun Yi, Cheol Min Lee, Seung-sik Hwang, Sung-il Cho
    BMC Public Health.2021;[Epub]     CrossRef
  • Nicotine Dependence of Electronic Cigarette, Dual Combustible and Electronic Cigarette Users
    Jungun Lee
    Korean Journal of Family Medicine.2021; 42(3): 189.     CrossRef
  • Prevalence and reasons for use of Heated Tobacco Products (HTP) in Europe: an analysis of Eurobarometer data in 28 countries
    Anthony A. Laverty, Constantine I. Vardavas, Filippos T. Filippidis
    The Lancet Regional Health - Europe.2021; 8: 100159.     CrossRef
  • Combined Associations of Changes in Noncombustible Nicotine or Tobacco Product and Combustible Cigarette Use Habits With Subsequent Short-Term Cardiovascular Disease Risk Among South Korean Men: A Nationwide Cohort Study
    Seulggie Choi, Kiheon Lee, Sang Min Park
    Circulation.2021; 144(19): 1528.     CrossRef
  • Bibliometric Analysis of Publications Related to Heated Tobacco Products Reported over the Period 2015-2020
    Min Joo Jeon, Su Mi Lee, Kiheon Lee, Eunbyul Cho, Joo Young Kim, Woo Kyung Bae, Jong Soo Han, Hyejin Lee, Se Young Jung
    Journal of the Korean Society for Research on Nicotine and Tobacco.2021; 12(2): 74.     CrossRef
  • Reasons for Using Heated Tobacco Products among South Korean Adults
    Ji Min Kim, Hong-Jun Cho
    Journal of the Korean Society for Research on Nicotine and Tobacco.2021; 12(2): 53.     CrossRef
  • Are Heated Tobacco Product Users Less Likely to Quit than Cigarette Smokers? Findings from THINK (Tobacco and Health IN Korea) Study
    Cheol Min Lee, Choon-Young Kim, Kiheon Lee, Sungroul Kim
    International Journal of Environmental Research and Public Health.2020; 17(22): 8622.     CrossRef
  • The Change of Tobacco Use Pattern among Adolescents after the Introduction of Novel Tobacco Products
    Cheol Min Lee
    Journal of the Korean Society for Research on Nicotine and Tobacco.2020; 11(2): 84.     CrossRef
  • 18,230 View
  • 164 Download
  • 32 Web of Science
  • 35 Crossref
Original Articles
Background
This study aimed to examine the association between sitting time and handgrip strength in healthy Korean women.
Methods
A total of 5,437 participants were included from the Korea National Health and Nutrition Examination Survey 2014–2016. The overall daily sitting time was estimated using health interview surveys, and handgrip strength was assessed using a digital hand dynamometer. The relationship between sitting time and handgrip strength was calculated with a weighted analysis of covariance after adjusting for confounding variables.
Results
Participants in each age group (19–39, 40–64, ≥65 years) were divided into three categories according to sitting time: ≤5, 6–9, and ≥10 h/d. The handgrip strength tended to decrease as sitting time increased after adjusting for age, body mass index, alcohol intake, cigarette smoking, resistance exercise, aerobic physical activity, household income, education level, hypertension, diabetes mellitus, dyslipidemia, and depression in all age groups (all P<0.001).
Conclusion
We observed the inverse relationship between sitting time and handgrip strength in healthy Korean women.

Citations

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  • The Relationship Between Longest-Held Occupation and Hand Function in Older Adults
    Jaden E. Levinson, Rachel N. Logue Cook, Susan H. Brown
    Journal of Occupational & Environmental Medicine.2025; 67(4): e203.     CrossRef
  • Handgrip strength predicts leg power but not cardiorespiratory fitness in children
    Salem Alotaibi, Rizwan Qaisar, M. Azhar Hussain, Osama Aljuhani, Maha H. Alhussain, Diogo Luís Marques, Daniel Almeida Marinho, Shaea A. Alkahtani
    Frontiers in Physiology.2025;[Epub]     CrossRef
  • Impact of a 1‐Month Exergaming Intervention on Blood Glucose, Strength, and Body Composition in Office Workers With Overweight or Obesity
    Jorge A. Aburto-Corona, Roberto Espinoza-Gutiérrez, Bryan Montero-Herrera, Jonathan Cerna, Aracely Serrano-Medina, Jessica Sánchez-Revilla, Lenin T. Barajas-Pineda, Juan J. Calleja-Núñez, Deepali
    International Journal of Computer Games Technology.2025;[Epub]     CrossRef
  • The Association between Sedentary Time and Sarcopenia in Korean Older Adults: A Cross-Sectional Study Based on the 2022-2023 Korea National Health and Nutrition Examination Survey Data
    Minok Shim, Minkyeung Jo
    Korean Journal of Geriatrics & Gerontology.2025; 26(2): 66.     CrossRef
  • Examining factors contributing to the socioeconomic inequalities in handgrip strength among older adults in India: a decomposition analysis
    Manacy Pai, T. Muhammad
    Scientific Reports.2024;[Epub]     CrossRef
  • Association between sedentary behavior and dynapenic abdominal obesity among older adults from low- and middle-income countries
    Lee Smith, Guillermo F. López Sánchez, Masoud Rahmati, Mark A. Tully, Damiano Pizzol, Nicola Veronese, Pinar Soysal, Karel Kostev, Dong Keon Yon, Laurie Butler, Jae Il Shin, Ai Koyanagi
    Aging Clinical and Experimental Research.2024;[Epub]     CrossRef
  • Joint associations of sedentary behavior and domain-specific physical activity on C-reactive protein in Korea
    Sungjin Park, Heeseung Son
    Preventive Medicine.2024; 182: 107944.     CrossRef
  • Joint association of sedentary behavior and physical activity domains with depression in Korean adults: Cross-sectional study combining four biennial surveys (2016–2022)
    Sungjin Park, June-Hee Lee, Rashid Menhas
    PLOS ONE.2024; 19(10): e0312029.     CrossRef
  • Factors Influencing Grip Strength of Depressed Patients: Using Data from the National Health and Nutrition Examination Survey (2018~2019)
    Moonhee Gang, Sukhee Han
    Journal of Korean Academy of psychiatric and Mental Health Nursing.2023; 32(1): 92.     CrossRef
  • Associations of occupational and leisure-time physical activity with self-rated health in Korea
    Sungjin Park, June-Hee Lee
    Preventive Medicine.2022; 158: 107022.     CrossRef
  • Association of Physical Activity and Sedentary Behavior With the Risk of Colorectal Cancer
    Sanghyun An, Sungjin Park
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • Importance of Handgrip Strength as a Health Indicator in the Elderly
    Soo Young Kim
    Korean Journal of Family Medicine.2021; 42(1): 1.     CrossRef
  • Effects of 12 Weeks of Strength Training and Gluten-Free Diet on Quality of Life, Body Composition and Strength in Women with Celiac Disease: A Randomized Controlled Trial
    Alejandro Martínez-Rodríguez, Daniela Alejandra Loaiza-Martínez, Javier Sánchez-Sánchez, Jacobo A. Rubio-Arias, Fernando Alacid, Soledad Prats-Moya, María Martínez-Olcina, Rodrigo Yáñez-Sepúlveda, Nuria Asencio-Mas, Pablo J. Marcos-Pardo
    Applied Sciences.2021; 11(22): 10960.     CrossRef
  • Grip Strength as a Cardiometabolic Marker
    Jungun Lee
    Korean Journal of Family Medicine.2020; 41(5): 271.     CrossRef
  • 7,336 View
  • 134 Download
  • 15 Web of Science
  • 15 Crossref
A Novel Scale for Assessing the Burden of Caregiving for Functionally Compromised Patients: Proposal and Validation
Arun-Kumar Kaliya-Perumal, Anupama Korlakunta, Jacquilyne Kharlukhi, Sarada Devireddy
Korean J Fam Med 2021;42(1):31-37.   Published online January 3, 2020
DOI: https://doi.org/10.4082/kjfm.19.0063
Background
Disability not only burdens the patient, but also the caregiver. To quantify this caregiving burden, we propose a simple four-part questionnaire tool. Our objective is to validate this questionnaire by administering it to caregivers who oversee patients with low back pain and are functionally compromised.
Methods
Twenty-five spouse caregivers who were taking care of in-patients awaiting surgery for various lumbar spine pathologies were shortlisted. The content-validated questionnaire was administered on different occasions during the care recipient’s treatment. Cronbach’s α was calculated to assess internal consistency. Interrelationships between the care recipient’s pain score, extent of functional compromise, and caregiver burden were calculated. The questionnaire’s ability to track changes in the caregivers’ attitudes over time was assessed.
Results
The percentage of caregiver burden before the surgery of the care recipient was 52.5. This increased significantly to 61.1% (P=0.001) 3 days after surgery, but was found to decrease to 32.5% (P<0.001) a month after the surgery; demonstrating the questionnaire’s efficacy to track changes. Cronbach’s alpha of 0.948 signifies the questionnaire’s excellent internal consistency. Pearson’s correlation coefficient (r) between the care recipient’s pain score and caregiver’s burden score was 0.41 (P=0.04), and between the care recipient’s disability score and caregiver’s burden score was 0.9 (P<0.001).
Conclusion
The proposed questionnaire is consistent and can track changes in a caregiver’s attitude over time. It can be adopted for clinical use to assess the burden of caregiving for functionally compromised patients.

Citations

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  • Family functioning and caregiver's perceptions of burden among chronic kidney disease patients
    C Vasantha Kalyani, Priyanka Malhotra, Kusum Kumari
    Journal of Kidney Care.2025; 10(5): 227.     CrossRef
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  • 91 Download
  • 1 Crossref
Association between Types of Usual Source of Care and User Perception of Overall Health Care Service Quality in Korea
Nak-Jin Sung, Jae-Ho Lee
Korean J Fam Med 2019;40(3):143-150.   Published online November 13, 2018
DOI: https://doi.org/10.4082/kjfm.17.0093
Background
Patients’ perceptions of care tend to correlate with the quality of care provided. Different health care systems and service environments may show different associations between types of usual source of care (USC) and overall service quality assessment. We attempted to analyze this association as a benefit of having a USC.
Methods
This study used the 2012 Korea Health Panel data version 1.1 as representative national household survey data. The total number of subjects aged 18 years or more was 12,708. The number of subjects in the final analysis was 10,665. Multiple logistic regression analysis was used to assess the association between types of USC and overall health care service quality. The main outcome variable was users’ ratings of the quality of health care service.
Results
People having a usual doctor (n=1,796) were more likely to positively assess the quality of health care they received than those not having a USC (n=7,920; odds ratio [OR], 1.39; 95% confidence interval [CI], 1.20–1.60) or with those having only a place as a USC without a usual doctor (n=949; OR, 1.29; 95% CI, 1.05–1.58) after adjustment for demographic characteristics and health-related variables.
Conclusion
People having a usual doctor rated overall health care service quality as high, which might be due to benefits of primary care attributes related to usual doctors. Further studies are needed to elucidate the causal relationship. This finding implies that health policies encouraging people to have a usual doctor are needed in Korea.

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  • Utilization of usual source of care and health literacy among older adults with hypertension: a retrospective study
    Dahye Hong, Jennifer Ivy Kim, Min Kyung Park, Seolah Yoon, Bada Kang, Michelle Putnam, PhD, MGS, FGSA
    Innovation in Aging.2025;[Epub]     CrossRef
  • Patient perceived service quality profiles of primary health care associated with usual source of care: a latent profile analysis
    Li Zhang, Baokai Wang, Qi Xu
    Frontiers in Medicine.2025;[Epub]     CrossRef
  • Fatores determinantes no reconhecimento de uma fonte usual de cuidado por adolescentes brasileiros
    Maísa Mônica Flores Martins, Nília Maria de Brito Lima Prado, Ana Luiza Queiroz Vilasbôas, Rosana Aquino
    Ciência & Saúde Coletiva.2024;[Epub]     CrossRef
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    Maísa Mônica Flores Martins, Nília Maria de Brito Lima Prado, Ana Luiza Queiroz Vilasbôas, Rosana Aquino
    Ciência & Saúde Coletiva.2024;[Epub]     CrossRef
  • Ações intersetoriais e o reconhecimento de uma fonte de cuidado da atenção primária por adolescentes brasileiros
    Maísa Mônica Flores Martins, Nília Maria de Brito Lima Prado, Leila Denise Alves Ferreira Amorim, Ana Luiza Queiroz Vilasbôas, Rosana Aquino
    Cadernos de Saúde Pública.2024;[Epub]     CrossRef
  • Types of usual sources of care and their association with healthcare outcomes among cancer survivors: a Medical Expenditure Panel Survey (MEPS) study
    Ambrish A. Pandit, Chenghui Li
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    Jongnam Hwang, Sujin Kim
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Validity of Alcohol Use Disorder Identification Test-Korean Revised Version for Screening Alcohol Use Disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Criteria
Jung Wei Chang, Jong Sung Kim, Jin Gyu Jung, Sung Soo Kim, Seok Joon Yoon, Hak Sun Jang
Korean J Fam Med 2016;37(6):323-328.   Published online November 18, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.6.323
Background

The Alcohol Use Disorder Identification Test (AUDIT) has been widely used to identify alcohol use disorder (AUD). This study evaluated the validity of the AUDIT-Korean revised version (AUDIT-KR) for screening AUD according to Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria.

Methods

This research was conducted with 443 subjects who visited the Chungnam National University Hospital for a comprehensive medical examination. All subjects completed the demographic questionnaire and AUDIT-KR without assistance. Subjects were divided into two groups according to DSM-5 criteria: an AUD group, which included patients that fit the criteria for AUD (120 males and 21 females), and a non-AUD group, which included 146 males and 156 females that did not meet AUD criteria. The appropriate cut-off values, sensitivity, specificity, and positive and negative predictive values of the AUDIT-KR were evaluated.

Results

The mean±standard deviation AUDIT-KR scores were 10.32±7.48 points in males and 3.23±4.42 points in females. The area under the receiver operating characteristic curve (95% confidence interval, CI) of the AUDIT-KR for identifying AUD was 0.884 (0.840–0.920) in males and 0.962 (0.923–0.985) in females. The optimal cut-off value of the AUDIT-KR was 10 points for males (sensitivity, 81.90%; specificity, 81.33%; positive predictive value, 77.2%; negative predictive value, 85.3%) and 5 points for females (sensitivity, 100.00%; specificity, 88.54%; positive predictive value, 52.6%; negative predictive value, 100.0%).

Conclusion

The AUDIT-KR has high reliability and validity for identifying AUD according to DSM-5 criteria.

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    Accident Analysis & Prevention.2020; 144: 105651.     CrossRef
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Discrepancy between Self-Reported and Urine-Cotinine Verified Smoking Status among Korean Male Adults: Analysis of Health Check-Up Data from a Single Private Hospital
Youngju Kim, Yoon-Jung Choi, Seung-Won Oh, Hee-Kyung Joh, Hyuktae Kwon, Yoo-Jin Um, Sang Hyun Ahn, Hyun Joo Kim, Cheol Min Lee
Korean J Fam Med 2016;37(3):171-176.   Published online May 26, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.3.171
Background

Enquiry into smoking status and recommendations for smoking cessation is an essential preventive service. However, there are few studies comparing self-reported (SR) and cotinine-verified (CV) smoking statuses, using medical check-up data. The rates of discrepancy and under-reporting are unknown.

Methods

We performed a cross-sectional study using health examination data from Healthcare System Gangnam Center, Seoul National University Hospital in 2013. We analyzed SR and CV smoking statuses and discrepancies between the two in relation to sociodemographic variables. We also attempted to ascertain the factors associated with a discrepant smoking status among current smokers.

Results

In the sample of 3,477 men, CV smoking rate was 11.1% higher than the SR rate. About 1 in 3 participants either omitted the smoking questionnaire or gave a false reply. The ratio of CV to SR smoking rates was 1.49 (95% confidence interval [CI], 1.38–1.61). After adjusting for confounding factors, older adults (≥60 years) showed an increased adjusted odds ratio (aOR) for discrepancy between SR and CV when compared to those in their twenties and thirties (aOR, 5.43; 95% CI, 2.69–10.96). Educational levels of high school graduation or lower (aOR, 2.33; 95% CI, 1.36–4.01), repeated health check-ups (aOR, 1.45; 95% CI, 1.03–2.06), and low cotinine levels of <500 ng/mL (aOR, 2.03; 95% CI, 1.33–3.09), were also associated with discordance between SR and CV smoking status.

Conclusion

Omissions and false responses impede the accurate assessment of smoking status in health check-up participants. In order to improve accuracy, it is suggested that researcher pay attention to participants with greater discrepancy between SR and CV smoking status, and formulate interventions to improve response rates.

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  • Association between smoking cessation and depressive symptoms according to cessation duration, pack-years, and tobacco product type: a nationwide cross-sectional study in Korea
    Jungyeon Kim, Eunsu Lee, Dahee Hwang, Ah Jung Ko, Eun-Cheol Park
    Frontiers in Public Health.2026;[Epub]     CrossRef
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    Seong-Uk Baek, Jin-Ha Yoon
    Journal of Public Health.2025; 47(3): 610.     CrossRef
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    Minjung Han, Heewon Kang, Hae-ryoung Chun, Sung-il Cho
    Tobacco Induced Diseases.2025; 23(July): 1.     CrossRef
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    Seong-Uk Baek, Jin-Ha Yoon
    Postgraduate Medical Journal.2025;[Epub]     CrossRef
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    Yewan Park, Danbee Kang, Dong Hyun Sinn, Hyunsoo Kim, Yun Soo Hong, Juhee Cho, Geum-Youn Gwak
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    Seong‐Uk Baek, Won‐Tae Lee, Min‐Seok Kim, Myeong‐Hun Lim, Jin‐Ha Yoon, Jong‐Uk Won
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    Cheol Min Lee
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    Sehun Kim, Si-Hyuck Kang, Donghoon Han, Sun-Hwa Kim, Hee-Jun Kim, JIN-Joo Park, Youngjin Cho, Yeonyee E. Yoon, Kyung-Do Han, Il-Young Oh, Chang-Hwan Yoon, Jung-Won Suh, Hae-Young Lee, Young-Seok Cho, Tae-Jin Youn, Goo-Yeong Cho, In-Ho Chae, Dong-Ju Choi,
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    Eun Jung Byun, Jinyoung Heo, Sang Hyun Cho, Jeong Deuk Lee, Hei Sung Kim
    BMJ Open.2017; 7(7): e016409.     CrossRef
  • False Replies on Smoking Rate Surveys and an In-Hospital Smoking Cessation Clinic
    Jungun Lee
    Korean Journal of Family Medicine.2016; 37(3): 135.     CrossRef
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Correlation between Overactive Bladder Syndrome and Obsessive Compulsive Disorder in Women
Keun-Soo Ahn, Hyun-Pyo Hong, Hyuk-Jung Kweon, Ah-Leum Ahn, Eun-Jung Oh, Jae-Kyung Choi, Dong-Yung Cho
Korean J Fam Med 2016;37(1):25-30.   Published online January 27, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.1.25
Background

Overactive bladder syndrome is characterized by urinary urgency, usually accompanied by Frequent urination and nocturia, with or without urgent urinary incontinence. There must be the absence of causative infection or pathological conditions. Overactive bladder syndrome is related to mental disorders, particularly depression and anxiety. However, obsessive-compulsive symptoms are investigated much less frequently. The purpose of the present study was thus to assess obsessive-compulsive symptoms in overactive bladder syndrome patients.

Methods

Fifty-seven women patients with overactive bladder syndrome and fifty-seven women without it (age matched control group) were prospectively enrolled. They completed the overactive bladder syndrome-validated 8-question screener and the Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire at the same time they visited the clinic. Patients were compared with controls on the Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire and its checking, tidiness, doubting, and fear of contamination components.

Results

Patients showed more obsessive traits than controls on the Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire total score (P=0.006) and on the checking subscale (P=0.001). Odds ratio for the overactive bladder syndrome group's obsessive-compulsive symptoms traits (score≥14) was 5.47 (P=0.001). The Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire total score was associated with the overactive bladder syndrome-validated 8-question screener score in patients (P=0.03).

Conclusion

Obsessive-compulsive symptoms may constitute an important aspect of the psychiatric profile of overactive bladder syndrome patients. The severity of obsessive-compulsive symptoms seems to be related to the degree of the overactive bladder syndrome severity. Clinicians may consider screening women with overactive bladder syndrome for obsessive-compulsive symptoms.

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    Iranian Journal of Psychiatry and Behavioral Sciences.2021;[Epub]     CrossRef
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Development of a Simple Tool for Identifying Alcohol Use Disorder in Female Korean Drinkers from Previous Questionnaires
Yu Ri Seo, Jong Sung Kim, Sung Soo Kim, Seok Joon Yoon, Won Yoon Suh, Kwangmi Youn
Korean J Fam Med 2016;37(1):18-24.   Published online January 27, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.1.18
Background

This study aimed to develop a simple tool for identifying alcohol use disorders in female Korean drinkers from previous questionnaires.

Methods

This research was conducted on 400 women who consumed at least one alcoholic drink during the past month and visited the health promotion center at Chungnam National University Hospital between June 2013 to May 2014. Drinking habits and alcohol use disorders were assessed by structured interviews using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnostic criteria. The subjects were also asked to answer the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-Consumption, CAGE (Cut down, Annoyed, Guilty, Eye-opener), TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), TACE (Tolerance, Annoyed, Cut down, Eye-opener), and NET (Normal drinker, Eye-opener, Tolerance) questionnaires. The area under receiver operating characteristic (AUROC) of each question of the questionnaires on alcohol use disorders was assessed. After combining two questions with the largest AUROC, it was compared to other previous questionnaires.

Results

Among the 400 subjects, 58 (14.5%) were identified as having an alcohol use disorder. Two questions with the largest AUROC were question no. 7 in AUDIT, "How often during the last year have you had a feeling of guilt or remorse after drinking?" and question no. 5 in AUDIT, "How often during the past year have you failed to do what was normally expected from you because of drinking?" with an AUROC (95% confidence interval [CI]) of 0.886 (0.850–0.915) and 0.862 (0.824–0.894), respectively. The AUROC (95% CI) of the combination of the two questions was 0.958 (0.934–0.976) with no significant difference as compared to the existing AUDIT with the largest AUROC.

Conclusion

The above results suggest that the simple tool consisting of questions no. 5 and no. 7 in AUDIT is useful in identifying alcohol use disorders in Korean female drinkers.

Citations

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    Danijela Dozet, Larry Burd, Svetlana Popova
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  • 1 Web of Science
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Validity and Reliability of the Korean Version of Neighborhood Physical Activity Questionnaire
Woo Kyung Bae, Belong Cho, Ki Young Son
Korean J Fam Med 2015;36(3):135-140.   Published online May 22, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.3.135
Background

Given that a substantial number of daily activities take place in neighborhoods, a convenient and effective method for measuring the physical activity of individuals is needed. Therefore, we tested the validity and reliability of the Korean version of the Neighborhood Physical Activity Questionnaire (K-NPAQ), which was developed through translation and back-translation of the NPAQ.

Methods

The K-NPAQ was administered twice, with a 1-week interval, to participants in the study who were recruited at a health promotion center. We assessed energy expenditure and compliance using an accelerometer and an activity diary. The Kappa statistic and Spearman correlation coefficient were used to evaluate the test-retest reliability of the K-NPAQ, and the Spearman rank correlation was used to assess the validity.

Results

Of the 122 participants, 43 were excluded owing to a lack of compliance. The Kappa values for all items that were used to assess walking or cycling within or outside the neighborhood were >0.424; 0.251-0.902 for 5 items related to the purpose of the physical activity; 0.232-0.912 for most items related to the number of times and the duration for each types of physical activity. The total energy expenditure and the energy expenditure in the neighborhood were significantly correlated with the K-NPAQ and the accelerometer, with correlation coefficients of 0.192-0.264.

Conclusion

The K-NPAQ is a valid and reliable tool for measuring physical activity in the neighborhood, and it can be used for individual education and counseling in order to augment physical activity in specific neighborhood environments.

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    Corneel Vandelanotte, Mitch J. Duncan, Rob Stanton, Richard R. Rosenkranz, Cristina M. Caperchione, Amanda L. Rebar, Trevor N. Savage, W. Kerry Mummery, Gregory S. Kolt
    BMC Public Health.2019;[Epub]     CrossRef
  • Self-reported physical activity within and outside the neighborhood: Criterion-related validity of the Neighborhood Physical Activity Questionnaire in German older adults
    Malte Bödeker, Jens Bucksch, Birgit Wallmann-Sperlich
    Measurement in Physical Education and Exercise Science.2018; 22(1): 61.     CrossRef
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    Levi Frehlich, Christine Friedenreich, Alberto Nettel-Aguirre, Jasper Schipperijn, Gavin R. McCormack
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Reliability and Validity of Alcohol Use Disorder dentification Test-Korean Revised Version for Screening At-risk Drinking and Alcohol Use Disorders
Chang-Gi Kim, Jong Sung Kim, Jin-Gyu Jung, Sung-Soo Kim, Seok-Joon Yoon, Hae-Sun Suh
Korean J Fam Med 2014;35(1):2-10.   Published online January 23, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.1.2
Background

There needs to be an amendment to the Korean version of the Alcohol Use Disorder Identification Test (AUDIT) with regards to the recent change in percent alcohol by volume (ABV) Korean liquor. This study was performed to suggest a cutoff value, reliability and validity of AUDIT-Korean revised version (AUDIT-KR), which reflect the change of the ABV of Korean alcohol.

Methods

The subjects were 435 peoples (210 males and 225 females), who visited the Chungnam National University Hospital for a comprehensive medical examination. The respondents completed the AUDIT-KR. At-risk drinking and alcohol use disorders had been evaluated by diagnostic interview. The Cronbach's alpha value, the receiver operating characteristic curve, the appropriate cutoff value, sensitivity and specificity of the AUDIT-KR were evaluated.

Results

There were 190 at-risk drinkers (111 males and 79 females), and 66 people with alcohol use disorders (48 males and 18 females). The cutoff value of the AUDIT-KR for at-risk drinking was 3 points (sensitivity 93.69% and specificity 78.79%) for males and 3 points (sensitivity 92.40% and specificity 78.08%) for females. The cutoff value for alcohol use disorders was 10 points (sensitivity 100.00% and specificity 89.51%) for males and 8 points (sensitivity 100.00% and specificity 93.71%) for females. Cronbach's alpha of the AUDIT-KR was 0.885.

Conclusion

The above results suggest that the AUDIT-KR shows a high reliability and validity in identifying at-risk drinking and alcohol use disorders.

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Relationship between Family Adaptability, Cohesion and Adolescent Problem Behaviors: Curvilinearity of Circumplex Model
Ju Youn Joh, Sun Kim, Jun Li Park, Yeon Pyo Kim
Korean J Fam Med 2013;34(3):169-177.   Published online May 24, 2013
DOI: https://doi.org/10.4082/kjfm.2013.34.3.169
Background

The Family Adaptability and Cohesion Evaluation Scale (FACES) III using the circumplex model has been widely used in investigating family function. However, the criticism of the curvilinear hypothesis of the circumplex model has always been from an empirical point of view. This study examined the relationship between adolescent adaptability, cohesion, and adolescent problem behaviors, and especially testing the consistency of the curvilinear hypotheses with FACES III.

Methods

We used the data from 398 adolescent participants who were in middle school. A self-reported questionnaire was used to evaluate the FACES III and Youth Self Report.

Results

According to the level of family adaptability, significant differences were evident in internalizing problems (P = 0.014). But, in externalizing problems, the results were not significant (P = 0.305). Also, according to the level of family cohesion, significant differences were in internalizing problems (P = 0.002) and externalizing problems (P = 0.004).

Conclusion

The relationship between the dimensions of adaptability, cohesion and adolescent problem behaviors was not curvilinear. In other words, adolescents with high adaptability and high cohesion showed low problem behaviors.

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Occupational Stress and Physical Symptoms among Family Medicine Residents
So-Myung Choi, Yong Soon Park, Jun-Hyun Yoo, Go-Young Kim
Korean J Fam Med 2013;34(1):49-57.   Published online January 28, 2013
DOI: https://doi.org/10.4082/kjfm.2013.34.1.49
Background

The purpose of this study was to examine the levels of occupational stress and physical symptoms among family medicine residents and investigate the effect of subscales of occupational stress on physical symptoms.

Methods

A self-administered questionnaire survey of 1,152 family medicine residents was carried out via e-mail from April 2010 to July 2010. The response rate was 13.1% and the R (ver. 2.9.1) was used for the analysis of completed data obtained from 150 subjects. The questionnaire included demographic factors, resident training related factors, 24-items of the Korean Occupational Stress Scales and Korean Versions of the Wahler Physical Symptom Inventory.

Results

The total score of occupational stress of family medicine residents was relatively low compared to that of average workers. The scores of 'high job demand', 'inadequate social support', 'organizational injustice', and 'discomfort in occupational climate' were within the top 50%. Parameters associated with higher occupational stress included level of training, on-duty time, daily patient load, critical patient assigned, total working days, night duty day, sleep duration, and sleep quality. The six subscales of occupational stress, except for 'Job insecurity', had a significant positive correlation with physical symptom scores after adjustment had been made for potential confounders (total score, r = 0.325 and P < 0.001; high job demand, r = 0.439 and P < 0.001).

Conclusion

After the adjustment had been made for potential confounders, the total score of occupational stress and six subscales in family medicine residents showed a significant positive correlation with physical symptom scores.

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Effect of Sunlight Exposure on Serum 25-Hydroxyvitamin D Concentration in Women with Vitamin D Deficiency: Using Ambulatory Lux Meter and Sunlight Exposure Questionnaire
Sang-Hoon Lee, Soo-Jung Park, Kwang-Min Kim, Duck-Joo Lee, Woo-Jae Kim, Rae-Woong Park, Nam-Seok Joo
Korean J Fam Med 2012;33(6):381-389.   Published online November 27, 2012
DOI: https://doi.org/10.4082/kjfm.2012.33.6.381
Background

Vitamin D is an important factor in human health. Yet, vitamin D deficiency is very common. We aimed to confirm serum 25-hydroxyvitamin D (25OHD) concentration change after sunlight exposure and to elucidate the relationship between the amount of sunlight exposure and serum 25OHD level change by ambulatory lux meter and sunlight exposure questionnaire.

Methods

Twenty healthy young women were enrolled. They were educated to obtain 20 minutes of sunlight exposure during weekdays from October to November, 2010, during which they were to wear an ambulatory lux meter on an arm. All subjects completed a one-week recall sunlight exposure questionnaire at the end of the study. Before and after sunlight exposure, serum 25OHD level was measured.

Results

Mean pre-exposure serum 25OHD concentration was 11.01 ng/mL. The mean change of pre- and post-exposure 25OHD level was -0.62 ng/mL, but it was not statistically significant. The mean personal sunlight exposure recorded by ambulatory lux meter, 292.6 lux/s, showed no significant relationship with average change of 25OHD and average weekly sunlight exposure score, 11.9, calculated by the sunlight exposure questionnaire. However, the mean change of serum 25OHD level and weekly sunlight exposure score showed significant negative correlation (r = -0.469, P = 0.037).

Conclusion

Change of serum 25OHD concentration after four weeks of sunlight exposure was not statistically significant in women with vitamin D deficiency. However, serum 25OHD concentration change was significantly negatively correlated with the sunlight exposure score by the questionnaire.

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Reliability and Validity of Korean Version of Questionnaire for Weight Bias Measurement.
Eun Mi Kim, Kayoung Lee, Kyu Man Hwang, Jun Su Kim, Tae Jin Park
Korean J Fam Med 2010;31(6):461-471.   Published online June 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.6.461
Background
Korean versions of Fat Phobia Scale (short form) (F-scale), Beliefs About Obese Persons Scale (BAOP), and Attitudes Toward Obese Persons Scale (ATOP) which are scales of rating weight bias were assessed to find out the reliability and validity.Methods: Korean versions of F-scale, BAOP, and ATOP were completed twice by 165 adults (85 males, 80 females; 73 hospital staffs, and 92 teachers). Validity was tested using Spearman correlation and factor analysis. Reliability was analyzed using test-retest analyses (Spearman Rho value).Results: Using factor analyses, F-scale comprised of three factors explaining 55.20% of the total variance, BAOP two factors explaining 53.3% of the total variance, and ATOP six factors explaining 61.61% of the total variance. Spearman correlation between F-scale and ATOP was -0.28 to -0.36 (P < 0.05), suggesting that people who worried about being obese tended to have negative attitudes against obesity. The correlation between F-scale and BAOP was -0.25 to -0.27 (P < 0.05), meaning that people who worried about being obese had a tendency to blame obesity on environmental factors. Cronbach's alpha coefficients were 0.79 to 0.90 for F-scale, 0.34 to 0.38 for BAOP and 0.82 to 0.87 for ATOP. Spearman Rho values were 0.47 for F-scale, 0.50 for BAOP, and 0.47 for ATOP (P < 0.05). The scores of each scale were not related to subjects' sex, BMI, body perception, and weight control efforts, while for ATOP scores older subjects were more likely to have a negative view for obesity (P < 0.05).Conclusion: The Korean version of F-scale, ATOP and BAOP could be considered as a tool to evaluate weight-bias however, further study is needed for appropriate application.

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  • The Effects of Obesity Stress, Weight Bias, and Heath Care on BMI in Soldiers of Non-combat Area
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The Relating Factor and Quality of Life of Overactive Bladder in Adults.
Seun Ah Kim, Eun Hae Kim, Hyun Jin Do, Youl Lee Lym, Jae Kyung Choi, Hee Kyung Joh, Hyuk Jung Kweon, Dong Yung Cho, Tong Wook Kim
Korean J Fam Med 2009;30(11):872-879.   Published online November 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.11.872
Background
Overactive bladder syndrome (OAB) is a common disorder in primary care that affects negatively on the quality of life of outpatients. However, little information is available on related factors and the quality of life in adults with overactive bladder. The purpose of this study was to fi nd related factors of overactive bladder and to measure the quality of life in adults with overactive bladder. Methods: Among the people who visited a hospital in Seoul and Chung-ju for a health xamination or primary care between October 1 and December 31, 2008, we selected 327 participants over 20 years old. We measured their Overactive Bladder Questionnaire (OAB-q), took medical history and reviewed their demographic data. The relationship between OAB, other independent variables and health related quality of life (HRQL) were analyzed. Results: Of 327 respondents, the prevalence of OAB in adults was 38 (11.6%). The factors related to OAB were age (P = 0.007), history of prescription for congestive heart failure (P = 0.023), benign prostatic hyperplasia (BPH) (P = 0.002), and depression (P = 0.008). OAB was signifi cantly associated with BPH medication (P = 0.042; OR = 8.757) and depression medication (P = 0.005; OR = 9.977) in multivariable logistic regression analysis. In each T-test analysis, OAB decreased in HRQL. Conclusion: OAB is a common disorder in adults, history of BPH medication and depression medication is more common in OAB. The symptoms that were suggestive of OAB were affected negatively on the quality of life in adults. Effective health care polices and prompt management of OAB should be implemented.

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  • The Effect of Korean Medical Treatment on the Overactive Bladder Syndrome with Coughing: Case Report
    Ju-hyun Oh, Yu-ra Lee, Jin-young Song, Geon-sik Kong, Jin-hun Park, So-won Kim, Man-ho Kang, Hyung-chul Lee, Guk-hyeon Eom, Woo-sub Song
    The Journal of Internal Korean Medicine.2020; 41(5): 724.     CrossRef
  • Sex Difference in Associations between Severity Level of Overactive Bladder and Perceived Stress, Depression in Korean Patients
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    Journal of Health Informatics and Statistics.2019; 44(1): 14.     CrossRef
  • Factors Influencing Overactive Bladder Symptom Severity in Community Residents
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    Journal of muscle and joint health.2016; 23(1): 39.     CrossRef
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Validity and Reliability of Korean Version of International Physical Activity Questionnaire (IPAQ) Short Form.
Ji Yeon Oh, Yun Jun Yang, Byung Sung Kim, Jae Hun Kang
J Korean Acad Fam Med 2007;28(7):532-541.   Published online July 10, 2007
Background
This study was performed to evaluate the reliability and the validity of the Korean version of IPAQ short form. Method: Sixty-nine volunteer adults completed the questionnaires twice at 1 week interval, and the second one was compared to the results of Actical in order to test validity. Results: The Korean version of IPAQ was accepted as a proper one by the IPAQ developers. Spearman Rho coefficients and Kappa values of test-retest reliability were 0.427∼0.646 (median 0.542) and 0.365∼0.620 (median 0.471), respectively. The Kappa values were above 0.4 in 5 out of 7 questionnaires. The more physically active by the short form questionnaire, the higher the measured value of the Actical (P=0.039). Spearman Rho coefficient was 0.267 for the correlation between the results of the questionnaire and measured values by Actical. Conclusion: The reliability and the validity of the IPAQ short form were proven. Follow-up studies are needed. (J Korean Acad Fam Med 2007;28:532-541)
  • 11,291 View
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Prevalence of Mental Disorders in Family Practice Centers in Korea and the Utility of a Diagnostic Tool.
Young Sik Kim, Yeong Sook Yoon, Jeong Yeol Oh, Hee Tak Ryu, Dae Hyun Kim, Young Sung Suh, Byung Sung Kim, Yun Jin Kim, Sang Wook Song, Jungkwon Lee
J Korean Acad Fam Med 2005;26(11):699-705.   Published online November 10, 2005
Background
: A considerable portion of patients in primary care are thought to have mental disorders in Korea. But they are not easily noticed and are thus underdiagnosed and approached improperly. This study was done to assess the prevalence of common mental disorders in a hospital-based family practice and to evaluate the utility of a diagnostic tool, the Patient Health Questionnaire (PHQ).

Methods : Ten or more patients each day were systematically selected in family practice clinics for two weeks in a university and a community hospital-based family practice clinics in Seoul, Korea. Routine care was delivered as a control during the first week and the PHQ was administered to patients during the second week and the physicians were allowed to review the PHQ just before making clinical decisions. Physicians were asked to answer whether they recognized patients' with mental disorders before reviewing the PHQ.

Results : The prevalence of mental disorders was higher in the test group than the control except for eating disorders and other anxiety disorders (P<0.05)(test vs. control group): major depressive disorders 1.75% vs. 3.8%, other depressive disorders 6.8% vs. 11.4%, panic disorders 0.6% vs. 2.3, somatoform disorders 3% vs. 5%, alcohol abuse 2.2% vs. 8.7%, and any mental disorders 20.9% vs. 29.4%. In the test group, the percentage (95% confidence interval in parenthesis) of newly diagnosed mental disorders after physicians' review of the PHQ were 66% (49∼82) in major depressive disorders, 70% (50∼90) in panic disorders, 70% (56∼83) in somatoform disorders, 84% (75∼92) in alcohol abuse, and 68% (62∼74) in any mental disorders. Patients' response to the PHQ was overall very receptive.

Conclusion : One-week prevalence of common mental disorders in the hospital-based family practice was 29.4% and the PHQ tool was efficient to help the family physicians recognize hidden mental disorders.
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Primary Care Physicians Attitudes Toward Medically Unexplained Symptoms.
Seung Yeop Cheong, Cheol Hwan Kim, Eun Ju Sung, Ho Cheol Shin, Yong Woo Park, Yu Il Kim, Eun Jung Lee, Jung Il Jang
J Korean Acad Fam Med 2005;26(1):15-21.   Published online January 10, 2005
Background
: The medically unexplained symptoms present one of the most common problems in medical practice and the role of primary care physicians is becoming greater to manage them. Our goal was to investigate how the primary care physicians conceive and deal with patients complaining of medically unexplained symptoms (MUS).

Methods : A group of 840 primary care physicians, 524 internist and 316 family physicians in Seoul were surveyed. The questionnaire regarding the perception and the way of consultation about MUS was posted by mail.

Results : A total of 180 questionnaires were collected via mail and fax. Ten of them were uncompleted, and the response rate was 22%. Over half of the respondents felt that the consultation of MUS was difficult and they were concerned about the possibility of overlooking some of organic problems (57.6%). Average consultation rate of MUS in daily practice was 14%. The anxiety toward failure of treatment was the most common concern during the MUS consultation. Seventeen percent answered they knew the efficient method to deal with MUS patients. Respondents complained of the deficiency of contents and experiences to deal with MUS during the period of training (80%). More family physicians compared to internists perceived patients with MUS to have personality problems and they often tended to prescribe psychotropic drugs. Family physicians also answered that the training courses provided proper knowledge and contents regarding MUS consultation more than the internists.

Conclusion : MUS consultation imposes a burden on primary care physicians. Therefore, continuing education not only for residency but for post graduates should be considered for effective management for MUS.
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Identification of Related Factors of Female Sexual Function in Family Medicine Outpatients.
Sang Yeon Suh, Taek Soo Shin, Taiwoo Yoo, Bong Yul Huh
J Korean Acad Fam Med 2003;24(8):721-730.   Published online August 10, 2003
Background
: Female sexual function is influenced by much more factors than that of male and has a close relationship with psychosocial factors. A satisfying sex life has a high correlation to a happy married life. A questionnaire provides easy access to private matters and in a multidimensional manner. The objective of this study was to identify the factors related to female sexual function to help sexual adjustment in marriage.

Methods : A hundred married women living with their spouses, who visited an outpatient clinic of family medicine department of a university hospital in Seoul were studied. After filling out the self-administered questionnaire, a face-to-face interview was done on all study subjects. For multivariate analysis of the related factors, the outcome variables were a binary response of the normal female sexual cycle ?drive, lubrication, orgasm, and satisfaction.

Results : The multivariate analysis showed that the household income was a significant factor related to Drive (Odds Ratio: OR=0.6, 95% Confidence Interval: CI 0.4∼0.9). Age was a significant factor related to Insufficient Lubrication (OR=1.1, 95% CI 1.0∼1.3). Insufficient foreplay was a risk factor for Insufficient Lubrication (OR= 2.4, P=0.052). In multivariate analysis of the Orgasm related factors, the perceived health status showed an OR of 7.1 (95% CI 1.5∼32.6) and both marital satisfaction and open communication showed an OR of 6.0 (95% CI 1.3∼26.8) and an OR of 5.8 (95% CI 1.2∼28.2), respectively. The significant related factors to Satisfaction were in order of importance of sex life, education, and open communication, with an OR of 3.6 (95% CI 1.7∼7.6), 2.5 (95% CI 1.1∼5.9), and 2.0 (95% CI 1.0∼3.8), respectively.

Conclusion : The positively related factors to female sexual function were good perceived health status, high marital satisfaction, placing importance in sex life, and open communication regarding sexual matters. Increasing age and household income were found to be factors adverse to female sexual function.
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The Development of Female Sexual Function Questionnaire in Family Medicine Outpatients.
Sang Yeon Suh, Tai Woo Yoo, Bong Yul Huh
J Korean Acad Fam Med 2003;24(2):172-182.   Published online February 10, 2003
Background
: Currently, the high quality of life associated with women's rights is strongly supported and has become an important social issue. As a result, there is an increasing need for studies concerning female sexual function. The objectives of this study was to develop a questionnaire to evaluate sexual function evaluation in Korean women.

Methods : A total of 100 married women, who visited an outpatient clinic of family medicine department of a university hospital in Seoul, were studied. After filling out the self-administered questionnaire, a face-to- face interview was done on all study subjects. The items of this questionnaire were adopted from questionnaires with proven validity and reliability. Factor analysis was done and Crohnbach's alpha was calculated.

Results : The items of this questionnaire were classified into 5 parts: Drive, Excitement, Sexual activity, Satisfaction, and Spouse. The total variance was 51.5%. The total Crohnbach's alpha was 0.82. The internal consistency was high. Study subjects were able to complete this questionnaire within 10 minutes.

Conclusion : The validity and reliability of this female sexual function questionnaire was found to be acceptable. This questionnaire can be utilized as a diagnostic adjunctive tool and feedback for treatment through further studies.
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The Reliability and Validity of Korean Version of Questionnaire for Nicotine Dependence.
Hee Kyoung Ahn, Hwa Jin Lee, Do Sik Jung, Seon Yeong Lee, Seong Won Kim, Jae Heon Kang
J Korean Acad Fam Med 2002;23(8):999-1008.   Published online August 10, 2002
Background
: Although the Fagerstrom Tolerance Questionnaire (FTQ) and the Fagerstrom Test for Nicotine Dependence (FTND), which are the tools to measure Nicotine Dependence, have a high internal reliability and a high test-retest reliability, they have not been tested domestically. A Korean-Version Questionnaire for Nicotine Dependence was assessed to find out the internal reliability, test-retest reliability and validity.

Methods : The research subjects were adult smokers of ages between 19 and 77 among hospital visitors, hospital staffs, inpatients and outpatients. The smokers had their carbon monoxide measured after responding to the questionnaire. The questionnaire consisted of Nicotine Dependence (FTQ & FTND), the history of smoking, the variables related to Nicotine Dependence, and factors that influence carbon monoxide(CO) measurement. Micro II smokerlyzer (Bedfont Instruments Ltd, England) was used to analyze CO concentration in expired air. The method used for measuring CO concentration was to deeply inhale and hold one's breath for 15 seconds and measure CO concentration while exhaling.

Results : The total number of subjects was 205 (199 males, 6 females) consisting of 124 hospital visitors, 67 hospital staff, 8 inpatients, and 6 inpatients. The average FTQ was 4.68 and the average FTND was 3.95. Cronbach's alpha, which indicates the internal reliability, was 0.6679 for FTQ and 0.6913 for FTND. The correlation coefficient which indicates test-retest reliability was 0.783 for FTQ and 0.880 for FTND. The correlation coefficient which indicates the relationship between the level of Nicotine Dependence and expired air CO concentration was 0.484 for FTQ and 0.563 for FTND. The correlation coefficient of the smoking period was 0.247 for FTQ and 0.252 for FTND.

Conclusion : This Korean-Version Questionnaires for Nicotine Dependence (FTQ & FTND) were both satisfactory from the aspects of reliability and validity. It was concluded that the Korean-Version of FTND was a reliable method to reflect the level of nicotine dependence of smokers from the fact that the reliability and validity of FTND was higher than that of FTQ.
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The Impact of the Change of Leisure Time Physical Activities on Body Weight.
Sang Yeon Suh, Su Young Kim, Taiwoo Yoo
J Korean Acad Fam Med 2002;23(5):599-612.   Published online May 31, 2002
Background
: The risk of overweight and obesity to health is well know. Physical activity is important in the treatment of obesity in terms of healthy body composition and maintenance of body function. This study is a follow-up study to identify the impact of changes of leisure time physical activities on body weight.

Methods : The study subjects were people who visited a health examination center in Seoul at least twice between 1995 and 2000. Seven hundred people who completed physical activity questionnaires each time they visited were included. Three hundred eighty two of them were men, and 318 were women. The questionnaire was Baecke physical activity questionnaire, consisted of items for work activities, sports activities, and non-sports leisure activities. Each index of activities was calculated.

Results : Ninety seven people (13.9%) reduced their weights more than 5% of initial body weights. Twenty eight people (4.0%) gained their weights more than 5% of initial body weights. In five hundred and seventy five people (82.1%) their body weights were changed within 5% of initial body weights. Non-sports leisure time indices increased greatly and were significantly more than sports indices in reduced weight group. Non-sports leisure time indices were not changed significantly in gained weight group. The dose-response relationship existed between changed body weight (kg) and difference of leisure time indices. The multivariate analysis showed that female was a significant factor related to reducing weight (odds ratio=4.5, 95% confidence interval 2.7~7.5). Increase of non-sports leisure indices showed borderline significance (odds ratio=1.4, 95% confidence interval 0.9~2.0).

Conclusion : To increase non-sports leisure activities for the purpose of reducing body weight is actively recommendable. Such activities performed on a daily basis may have impact on reducing weight through repeatability and ease of access.
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Folk remedies in Korean rheumatoid arthritis patients.
Sang Rae Lee, Sun Young Shin, Soo Hyun Lew, Hyun Joon Kim, Bang Bu Youn
J Korean Acad Fam Med 2002;23(2):205-214.   Published online February 1, 2002
Background
: A lot of "Folk Remedies" on rheumatoid arthritis treatment prevail in Korea, but they have never been evaluated or investigated systemically. Therefore we studied folk remedies used in rheumatoid arthritis patients.

Methods : We delivered 12 questionnaires to 106 rheumatoid arthritis out-patients of family medicine, internal medicine, and orthopedics, located in Seoul and Kyungki area. These questionnaires addressed to demographic characteristics, duration of rheumatoid arthritis, current treatments, kind of folk remedies experienced, decision to choose folk remedies and its subjective effects, and volition to try new folk remedies.

Results : There were up to 27 kinds of folk remedies used by 77 people (72.8% of total). Lower education level was proved to be correlated with folk remedies experience. Most patients began their remedies introduced by relatives or close friends(83.1%). Many patients on folk remedies were skeptical about its effect, but they were still willing to try new folk medicine(80.6%).

Conclusion : Many rheumatoid arthritis patients experienced folk remedies and were skeptical about its effects, but they were still willing to try new folk medicine. Therefore, education on folk remedies is needed.
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Reliability and validity of anxiety screening scale.
Ji Yeon Lim, Seung Hoon Lee, Yeon Soon Cha, Hye Soon Park, Sung Sunwoo
J Korean Acad Fam Med 2001;22(8):1224-1232.   Published online August 1, 2001
Background
: Anxiety is a common disorder, but its diagnosis is often overlooked. Although there are several evaluating instruments, they are difficult to use in busy outpatient clinics because of its length. Furthermore, scales developed for screening are insufficient in the standardization. The purpose of this study is to measure reliability and validity of scale that can efficiently detect the anxiety patients in busy primary care setting.

Methods : With translation and assistance from psychiatrist, the questionnaire was developed. From March to July 2000, anxiety and control group at the department of family medicine in Seoul Joongang Hospital were tested with the questionnaire. After one week later, test was retaken. Reliability was verified by calculating Kappa value. Also validity was validity was verified by comparing the scores between the anxiety group and the control group. Then sensitivity and specificity were evaluated, and the cutoff point was determined.

Results : Kappa values were ranging from 0.65 to 0.88. For each cutoff point 3,4,5 and 6 in validity. As the purpose was screening, we determined score 5 as the best cutoff points.
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The comparision of the quality of life between the well controlled hypertension group and the uncontrolled hypertension group.
Young Mook Kim, Hyun Rim Choi, Do Young Park, Jong Bum Lim, Chang Won Won, Byung Sung Kim, Yong Woo Park
J Korean Acad Fam Med 2001;22(4):565-574.   Published online April 1, 2001
Background
: Hypertension is an important as well as common disease in primary practice, so family physicians should concern about it. It is well known that if hypertension were well controlled, it could lower cardiovascular complications. However, there are few studies on the impact of hypertension affecting the quality of life. Therefore, we carried out this study to compare the quality of life in the hypertensive patients by whether it is well controlled or not.

Methods : The authors surveyed the quality of life using the questionnaire named as CMC Health Survey Version 1.0 for the hypertensive patients. The subjects had no complications and no other diseases, and aged 40 or more, and visited doctors at the Department of Family Medicine, Kyung-Hee University Hospital or the Department of Internal Medicine, Sungmin Hospital from May 1 to Aug 31, 1998. We categorized the subjects into the two groups of the well-controlled group(SBP<140mmHg and DBP<90 mmHg) and the uncontrolled group(SBP≥140mmHg or DBP ≥ 90mmHg) and compared the quality of life and lifestyle.

Results : The total number of subjects was 119, that of well-controlled group was 69, and that of the uncontrolled group was 50. Mean systolic and diastolic blood pressure was 133.1±7.5mmHg and 85.3±5.2 mmHg in the well-controlled group, 159.2±7.4 mmHg and 100.2±5.5 mmHg in the uncontrolled group. The comparison of the distribution of age, sex, education, occupation, and monthly income between the two groups showed no difference. The comparision of the lifestyle between two groups by Alameda-7 questionnaire showed no difference, too. As for the comparison of quality of life between two groups, the well-controlled group had significantly higher scores in the domain of physical function, social function, general health, vitality(above P<0.01), emotional function, role limitation, and health perception(above P<0.05) than uncontrolled group. However, the scores of the domain of change in health, satisfaction, bodily pain were not significantly different between two groups. After covariated by obesity, the comparison of quality of life between two groups showed similar results.

Conclusion : We confirmed that the well-controlled group had better quality of life than the uncontrolled group. So family physicians should consider the quality of life when they consult the patients with hypertension.
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The development of the Korean family function assessment tool.
Ji Ho Choi, Ho Cheol Shin, Hyun Lim Choi, Byung Sung Kim, Jang Won Won
J Korean Acad Fam Med 2000;21(8):994-1005.   Published online August 1, 2000
Background
: As the effect of the families on the individual’s health and disease is profound, it is very important to care patients based on the understanding of their families. The family function assessment tool to evaluate the families objectively and easily is necessary for this purpose. Many instruments have been developed in other countries and we have used these instruments without verification. Therefore, there is a question whether they are appropriate to the Korean families. The family function is especially important to the family with adolescents because adolescents are characterized by psychological instability. My purpose of this research is to develop an instrument to assess the function of the Korean families and this research is made on the Korean families with adolescents.
1,600 middle and high school students and 1,600 of their parents were selected for this study. They were asked to describe 5 kinds of each good and bad family relationship to collect primary basic data. These data were arranged to items based on the established scales and subscales. Secondary basic data were collected from another 200 students and their 200 parents to complement the items. Preliminary instrument items were selected by the frequency of the responses and the judgment of the author. Through discussions with experts, the preliminary instrument was established. Accessibility was tested and factor analysis was done for the preliminary instrument. After this process,, the main instrument was formulated.
For the primary basic data, 2,382 people answered (response rate 74.4%) and 10,267 responses and 298 kinds of items were collected. There was no additional item from the secondary data collection. The preliminary instrument was made of 58 items selected from 298 items. It takes 8 minutes to complete this instrument in average and 97% of the subjects had no difficulty in completing it. The main test instrument, developed after factor analysis, was made of 7 scales with 40 items.
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Reliability and validity of Korean templer's death anxiety scale, death depression scale and sense of symbolic immortality scale.
Mi Ryung An, Ye Kyung So, Byung Su Ko, Young Eun Choi, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 2000;21(7):893-900.   Published online July 1, 2000
Background
: Means to measure death anxiety, death depression and sense of symbolic immortality with approved validity and reliability does not yet exist in Korea.

Methods : Existing English questionnaires such as Templer Death Anxiety Scale (TDAS), Death Depression Scale (DDS), Sense of Symbolic Immortaligy Scale (SSIS) were translated into Korean by 5 translators, and then reviewed by 3 non-participants of translation for collegial summary and this summary was counter-translated again by another 2 non-participants. Another 3 non-participants of translation and counter-translation were chosen to examine the two sentences of each item. Then reexamination was done by retranslating and counter-translating the parts with errors. After pretest on ordinary people. The completed questionnaires were given to medical students, residents and nurses of a university hospital. Pastors and missionaries were selected as comparison group.

Results : Kuder-Richardson or Cronbach-α that represent internal consistency of TDAS, DDS and SSIs was 0.69, 0.84 and 0.78. The three sentences that lowered internal consistency of SSIS was deleted. BDI and DDS showed a positive correlation (0.32, P=0.02), suggesting proved construct validity. Correlation coefficient that proves construct validity of TDAS and DDS was 0.54 (P<0.01), of SSIS and TDAS -0.23(P=0.04), of SSIS and DDS -0.29(P=0.01). The TDAS and DDS(P<0.01), DDS and BDI(P=0.02) have shown a positive correlation were shown. There was significant difference in the score of SSIS(P<0.01). The same results in cases where the 3 sentences was deleted.

Conclusion : Korean versions of TDAS, DDS and SSIS were reliable and valid.
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Development and validation of a screening questionnaire for detection of adolescent psychiatric problems in primary care.
woo Sung Sun, Young Sik Kim, Chang Wha Lee, Gwang Soo Uh
J Korean Acad Fam Med 2000;21(7):884-892.   Published online July 1, 2000
Background
: Because of many physical, psychological, and social stresses, adolescence is a vulnerable period to psychiatric disorders. But in Korea, there is actually not enough time for primary care physicians to screen such patients during ordinary medical interviews. Therefore this research was done to develop and validate a brief screening questionnaire for the detection of adolescent patients with psychiatric problems.

Methods : Three family physicians in charge of their own adolescent clinics developed a five-item questionnaire for screening adolescents with psychiatric problems by reviewing related literature with consultation by a psychiatrist. After performing a pretest and gathering second opinions from other psychiatrists and nurse-teachers, final questionnaire was redeveloped. Verification of its reliability by using test-retest method and internal consistency by calculating Cronbach's alpha coefficient was done. Also inspection of its validity by comparing the scores of psychiatric patient group to normal group was done. And finally the discrimination point was obtained.

Results : For reliability Kappa value or new questionnaires ranged from 0.33 to 0.63. One item was dropped because of its negative influence to the internal consistency and the discrimination power. With the four final items, we estimated the validity for distinguishing psychiatric patients from the normal group by calculating the sensitivity and specificity of each cutting point of scores. For the each cutting point 1, 2, and 3, sensitivity was 85%, 75%, 40%, respectively, and specificity was 27%, 62%, 84%, respectively. We considered score 1 as the best cutting point because the purpose of the questionnaire was screening rather than diagnosis.

Conclusion : A brief four-item screening questionnaire(SAPPO. Screening method of Adolescent Psychiatric Problems in Outpatient clinic) was developed and its reliability and validity was estimated.
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The relationship between nutrient intake and bone mineral density by use of a semiquantitative food frequency questionnaire.
Seong Woong Jeong, Song Yee Han, Kyung Mi Kim, Sang Yeoup Lee, Yun Jin Kim
J Korean Acad Fam Med 2000;21(4):523-532.   Published online April 1, 2000
Background
: To determine the relationship between nutrient intake and bone mineral density (BMD), we have investigated this issue by the use of a semiquantitative food-frequency questionnaire.

Methods : A total 312 women aged 33-77 was divided into two groups, 187 premenopausal and 125 postmenopausal women, Dietary intake was assessed with a food-frequency questionnaire. DMD was assessed with dual-energy X-ray absorptiometry at the lumbar spine (lumbar vertebrae 2-4). Pearson correlation and partial correlation coefficients were calculated for each nutrient at the lumbar spine MBD.

Results : The mean age of the 32 participants was 48 years, and their mean body mass index (BMI) was 23.7±2.8 kg/m² . Forty percent of the women were in postmenopausal state. The mean lumbar BMD was 1.117g/cm2. Age was negatively correlated with BMD in postmenopausal women, but smoking and exercise were not correlated with BMD. In premenopausal women, nutrient intakes were not associated with BMD. A significant association was found between intakes of fat, iron, vitamin A, vitamin C and BMD in postmenopausal women, but after adjusting for age, body mass index, energy intake, smoking, exercise, and use of hormone replacement therapy, there was no association.

Conclusion : There was no significant association between nutrient intakes and BMD of the lumbar spine.
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A study on developing minimum requirement guidelines for standard questionnaire translation, validation using delphi method.
Soo Young Kim, Myung HO Hong
J Korean Acad Fam Med 2000;21(4):457-470.   Published online April 1, 2000
Background
: A standard questionnaire is usually characterized by a set of questions, a scoring method, and psychometric properties. But many studies suggested that previously translated standard questionnaire in Korea had bee used without testing translation validity, scoring system and psychometric properties.

Methods : After developing a preliminary delphi questionnaire from references by a researcher, it was modified from pretest procedure, which was performed to 6 family physicians who had experiences in translating standard questionnaires. Some experts were chosen among authors of standard questionnaire, translation articles in four questionnaire related journals and others were recommended by other experts.

Results : The total number of experts was 53 including 22 family physicians, 15 psychiatrists, 2 psychologists, 8 faculties of preventive medicine and 6 faculties of nursing. The response rates were 85%, 87%, 92% on 1st, 2nd, 3rd delphi round, respectively, and the total response rate was 69%. According to Delphi surveys, minimal requirements for a standard questionnaire translation were translation by two translators, pretest techniques, consideration of age·sex·education level in pretest procedure, reliability validation, validity validation and 0.5 or more of correlation coefficient level in convergent validity validation. Minimal requirement for reliability coefficients was 0.7 or more, but the results did not reach adequate consensus.

Conclusion : Developing minimum requirement guidelines for standard questionnaire translation using Delphi method can be done.
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The development of Korean health related Quality of Life Scale.
Jae Young Shim, Jung Kwon Lee, Soo Young Kim, Jang Won Won, Sun Woo Sung, Hoon Ki Park, Ho Cheol Shin
J Korean Acad Fam Med 1999;20(10):1197-1208.   Published online October 1, 1999
Background
: The status of development of instruments to asses the health related quality of life' reflecting Korean's own language expression and culture is still far from satisfaction, despite their importance in building basic date for health promotion, evaluation of effectiveness of treatment, health policy and so on.

Methods : Symptom descriptions in both ill and healthy conditions were collected from 292 Koreans based on definition and domains of 'health related quality of life' which was established by 7 family physicians. The collected results were categorized into each domain and edited to be used as questions. Questions of health change and spiritual health domains were added. A selection of most pertinent items were pursued through the internal consistency analysis on 417 patients. Pretest was performed on 20 ordinary people to see if they think selected questions were understandable and related to their quality of life.

Results : A total of 1934 symptom descriptions were collected and categorized into 44 of 7 domains including physical function, mental health, social function, pain, role, vitality, and health perception. Two items of health change and 3 items of spiritual health domain were added. Among those 49 items, 45 items of 9 domains were selected after discarding 4 items lowering internal consistency coefficient. Some items were corrected for more precise meaning, concise meaning, concise sentence, proper expression and word order, and nuance after pretest.

Conclusion : We developed a Korean health related Quality of Life Scale(KoQoLS) reflecting Korean's own language expression and culture.
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The quality of life in the menopausal women.
Ka Young Lee, Tae Jin Park
J Korean Acad Fam Med 1999;20(7):894-905.   Published online July 1, 1999
Background
: This study was performed to document the reliability and validity of the Korean version of the Women’s Health Questionnaire (WHQ), and evaluate the quality of life experienced during menopause.

Methods : The subjects of this study were 161 women (premenopause 61, peri/postmenopause 100) between the aged of 40 and 65 years who visited the office of Family Medicine department in Pusan Paik Hospital. The instruments consisted of the WHQ, the Nottingham Health Profile(NHP), the Self-rating Anxiety Scale(SAS), and the Self-rating Depression Scale (SDS). We evaluated the internal consistency of the instruments and the correlations between the WHQ and other scales. Then, we compared the scales between the premenopausal women and the peri/postmenopausal women. Finally, we found predictable variables explaining the quality of life.

Results : The Cronbach’s α value showed 0.8060 for the WHQ. The correlation coefficient of the WHQ was 0.724 with the NHP, 0.760 with the SAS, and 0.704 with the SDS. The peri/postmenopausal women perceived more severely than the premenopausal women in the WHQ areas of sexual functioning (P=0.003), vasomotor symptoms (P=0.004), and sleep(P=0.0222) as well as in the NHP areas of physical mobility(P=0.005), sleep(P=0.001), and total score(P=0.002). However stress level was more important predictor of scores of questionnaires than peri/postmenopausal status in stepwise multiple regression analysis.

Conclusion : This data suggest that we should pay attention to stress level, sociodemographic status when we consider the quality of life in the menopausal women.
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The Relationship Between Nutritional Assessment and Obesity Index.
Mi Jung Oh, Duck Sang Kim, Seock Hwan Lee
J Korean Acad Fam Med 1998;19(1):68-76.   Published online January 1, 1998
Background
: Obesity has been accepted as the risk factor of major chronic diseases in our society. And nutritional assessment is the important issue in respect to obesity evaluation. A self-administrated semiquantitative food frequency questionnaire of which validity is recognized is used in nutritional assessment. But the relationship between nutritional assessment resulted from the questionnaire and the obesity index has not been built until now, so we studied about this relationship.

Methods : Among 324 adults who had visited health screening center from June '95 to August '96, 270 adults were evaluated except who had any chronic disease such as diabetes mellitus, pulmonary tuberculosis, thyroid disease by screening data or low calorie diet for aimed weight loss or inadequate questionnaire. Nutritional intake was assessed by the self-administrated semiquantitative food frequency questionnaire. We evaluated the activity grade, obesity indices such as body mass index(BMI), waist to hip ratio(WHR), percent body fat using bioelectrial impedance fatness analyzer and serum total cholesterol, HDL-cholesterol, triglyceride. Then we examined the correlation between obesity indices and nutritional variables each other. We analyzed these results using Pearson's correlation coefficient.

Results : We evaluated for a group of 164 men and 106 women whose mean age was 43.9 years, mean BMI was 23.2kg/m², mean WHR was 0.85 and mean percent body fat was 21.2%. Correlation coefficient between calorie intake to recommended calorie ratio(ICRCR) and BMI was 0.13(P<0.05), WHR was 0.11(P≥0.05), and percent body fat was 0.07(P≥0.05). Fats intake to recommended fats ratio(IFRFR) and obesity indices didn't show the significant correlation between them. We could not find the significant correlation between cholesterol intake and serum total cholesterol, triglyceride but the significant negative correlation between cholesterol intake and serum HDL-cholesterol(r=-0.14) was found.

Conclusion : Only BMI among obesity indices and ICRCR showed low(r=0.13) correlation coefficient although it is significant. Our results show that obesity is the complex syndrome influenced by genetic, social, psychological, medical variables besides nutritional impacts.
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A study on family function of the patients with psychiatric disorders.
Hyung Joon Kim, Goang Eun Jung, Hyuk Jung Kweon, Hee Cheol Kang, Bang Bu Youn
J Korean Acad Fam Med 2000;21(5):645-659.
BACKGROUND
Psychiatric disorders have been known to occur by the interaction of biologic, psychologic and social factors. A family can affect the occurrence of psychiatric disorders as a primary social factor. On the other hand, psychiatric disorders can affect family function. There fore, we studied to compare family function between the families of psychiatric inpatients and those of normal persons, using Family APGAR and FACES III.
METHODS
Between July 1, 1999 and August 31, 1999, we examined the subject group as 40 relatives to visit psychiatric inpatient and the control group as 40 persons whose family members did not have chronic diseases or psychiatric disorders, using questionnaire of socio-demographic factors and family function.
RESULTS
Family APGAR scores in subject group were lower than those of control group, but not statistically different. But the degrees of 'Partnership' of the Family APGAR in subject group were significantly lower than those of control group.(P<0.05) Adaptability scores of FACES III in two groups were not different. Cohesion scores of FACES III in subject group were lower than those of control group but not statistically different. The Family APGAR scores in the families of the schizophrenics were significantly lower than those of control group. The duration of psychiatric disorders did not affect family function.
CONCLUSION
The family function of subject group was worsened but not statistically different. But in the families of the schizophrenics, the Family APGAR scores were significantly lower than those of control group. Therefore, we should consider serious family dysfunction in the families of schizophrenics.
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