A Multi-component Living Lab on Health Engagement for Advancing Self-care Agency among Migrant Workers in South Korea: A mixed methods study

Youlim Kim,Hyeonkyeong Lee,Sookyung Kim,Junghee Kim 한국지역사회간호학회 2023 지역사회간호학회지 Vol.34 No.4

Purpose: Migrant workers battle to access health services and adapt to a new culture. Self-care agency can be essential for health self-management. This study examines the effects of a health engagement program to improve self-care agency using a living lab approach among migrant workers living in South Korea. Methods: This study used a mixed-methods design, including a non-equivalent pre-post-test control group and three focus group interviews. Participants included 42 migrant workers from nine countries recruited via flyers, posters, and internet bulletins posted by a migrant community organization. During the 12 weeks, only the intervention group participants received four workshops addressing healthy physical activity, healthy dietary habits, effective cultural adaptation, stress management, and two outdoor cultural activities. They also participated in focus group interviews after the second, third, and fourth group activities and discussed the benefits of healthy behaviors and specific ways to implement them in real life. Results: Participants in the intervention group showed an increase in self-care agency, health literacy, and acculturation after the 12-week intervention. Themes were derived based on the lessons from living lab activities, barriers to health behavior practices, and methods to overcome these. Conclusion: This study demonstrated that multi-component intervention using a living lab effectively increased migrants’ participation in health promotion activities by strengthening health in their self-care agency. The qualitative and living lab approach effectively obtained comprehensive results on strategies to enhance healthy behavior engagement.

Korean physician prescription patterns for home oxygen therapy in chronic obstructive pulmonary disease patients

( Youlim Kim ),( Hwan Il Kim ),( Ji Young Park ),( Ji Young Hong ),( Joo-hee Kim ),( Kyung Hoon Min ),( Chin Kook Rhee ),( Sunghoon Park ),( Chang Youl Lee ),( Seong Yong Lim ),( Seung Hun Jang ),( Yo 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.1

Background/Aims: Hypoxemia in chronic obstructive pulmonary disease (COPD) leads to reduced ability to exercise, decreased quality of life, and, eventually, increased mortality. Home oxygen therapy in patients with severe COPD reduces distress symptoms and mortality rates. However, there have been few studies on physicians’ prescription behavior toward home oxygen therapy. Therefore, we investigated the respiratory specialists’ perspective on home oxygen therapy. Methods: In this cross-sectional, study, a questionnaire was completed by 30 pulmonary specialists who worked in tertiary hospitals and prescribed home oxygen therapy. The questionnaire consisted of 28 items, including 15 items on oxygen prescription for outpatients, four for inpatients, and nine on service improvement. Results: All physicians were prescribing less than 2 L/min of oxygen for either 24 (n = 10, 33.3%) or 15 hours (n = 9, 30.3%). All (n = 30) used pulse oximetry, 26 (86.7%) analyzed arterial blood gas. Thirteen physicians had imposed restrictions and recommended oxygen use only during exercise or sleep. Sixteen (53.3%) physicians were educating their patients about home oxygen therapy. Furthermore, physicians prescribed home oxygen to patients that did not fit the typical criteria for long-term oxygen therapy, with 30 prescribing it for acute relief and 17 for patients with borderline hypoxemia. Conclusions: This study identified the prescription pattern of home oxygen therapy in Korea. Respiratory physicians prescribe home oxygen therapy to hypoxemic COPD patients for at least 15 hours/day, and at a rate of less than 2 L/ min. More research is needed to provide evidence for establishing policies on oxygen therapy in COPD patients.

Association Between Oral Health and Airflow Limitation: Analysis Using a Nationwide Survey in Korea

Kim Sun-Hyung,Gu Seonhye,Kim Jung-Ae,Im YoHan,Cho Jun Yeun,Kim Youlim,Shin Yoon Mi,Kim Eung-Gook,Lee Ki Man,Choe Kang Hyeon,Lee Hyun,Yang Bumhee 대한의학회 2023 Journal of Korean medical science Vol.38 No.31

Background: Although poor oral health is a common comorbidity in individuals with airflow limitation (AFL), few studies have comprehensively evaluated this association. Furthermore, the association between oral health and the severity of AFL has not been well elucidated. Methods: Using a population-based nationwide survey, we classified individuals according to the presence or absence of AFL defined as pre-bronchodilator forced expiratory volume in 1 second/forced vital capacity < 0.7. Using multivariable logistic regression analyses, we evaluated the association between AFL severity and the number of remaining teeth; the presence of periodontitis; the Decayed, Missing, and Filled Teeth (DMFT) index; and denture wearing. Results: Among the 31,839 participants, 14% had AFL. Compared with the control group, the AFL group had a higher proportion of periodontitis (88.8% vs. 79.4%), complete denture (6.2% vs. 1.6%), and high DMFT index (37.3% vs. 27.8%) (P < 0.001 for all). In multivariable analyses, denture status: removable partial denture (adjusted odds ratio [aOR], 1.12; 95% confidence interval [95% CI], 1.04–1.20) and complete denture (aOR, 1.52; 95% CI, 1.01– 2.05), high DMFT index (aOR, 1.13; 95% CI, 1.02–1.24), and fewer permanent teeth (0–19; aOR, 1.32; 95% CI, 1.12–1.52) were significantly associated with AFL. Furthermore, those with severe to very severe AFL had a significantly higher proportion of complete denture (aOR, 2.41; 95% CI, 1.11–3.71) and fewer remaining teeth (0–19; aOR, 2.29; 95% CI, 1.57–3.01). Conclusion: Denture wearing, high DMFT index, and fewer permanent teeth are significantly associated with AFL. Furthermore, a reduced number of permanent teeth (0–19) was significantly related to the severity of AFL. Therefore, physicians should pay attention to oral health in managing patients with AFL, such as chronic obstructive pulmonary disease.

Pathogen Distribution in the State of Acute Exacerbation according to GOLD Classification of COPD : A Multicenter Observational Study

( Youlim Kim ),( Myung Goo Lee ),( Yun Su Sim ),( Ji Ye Jung ),( Jeong-woong Park ),( Kyung Hoon Min ),( Jae Ha Lee ),( Byung-keun Kim ),( Deog Kyeom Kim ),( Yeon Mok Oh ),( Seung Won Ra ),( Tae-hyung 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.0

Background Respiratory infection is the most common reason for acute exacerbation of chronic obstructive pulmonary disease (AE-COPD). We aimed to investigate the etiology of the respiratory infection and the pathogen distribution in the acute exacerbation state of COPD according to GOLD classification. Methods From a multicenter cross-sectional study, we identified 467 AE-COPD patients and the pathogen profiles of the respiratory infection were collected from them. The pathogen was confirmed by conventional sputum, paired serology tests for atypical bacteria, and viral diagnostic techniques and classified by GOLD grade. Results All 467 COPD patients were classified into GOLD grade: group A (n=63, 13.5%), group B (n=140, 30.0%), group C (n=40, 8.6%), and group D (n=224, 48.0%). In most patients, no clear causative pathogen was identified for acute exacerbation, and 133 cases with confirmed pathogen were caused by a single pathogen of virus or bacteria. The distribution of the causative pathogen was identified to be different. In the cases of viruses, rhinovirus and coronavirus were found in group B, and rhinovirus and influenza A in group D patients. For bacteria, P. aeruginosa and K. pneumoniae were identified as major pathogen in group B, and P. aeruginosa, K. pneumoniae, S. pneumoniae, E. coli and H. influenzae in group D patients. Conclusions This study suggests that the causative pathogen was shown the various distribution when classified according to the GOLD ABCD classification in COPD patients with acute exacerbation.

The Significance of Standardizing Images by Kernel Conversion of COPD in a Multicenter Cohort

( Youlim Kim ),( Tai Joon An ),( Mira Cho ),( Hyun Lee ),( Kum Ju Chae ),( Kwang Ha Yoo ) 대한결핵 및 호흡기학회 2023 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.136 No.0

Additive Effect of Obesity and Dyslipidemia on Wheezing in Korean Adults: A Nationwide Representative Survey Study

Kim Youlim,Lee Hyun,Park Yeonkyung,정성준,Yeo Yoomi,Park Tai Sun,박동원,김상헌,Kim Tae-Hyung,손장원,윤호주,Moon Ji-Yong 대한천식알레르기학회 2021 Allergy, Asthma & Immunology Research Vol.13 No.5

Besides obesity, there are limited studies regarding the relationship between the individual components of metabolic syndrome and wheezing. It is largely unknown whether the co-existence of other metabolic syndrome components has additive effects on wheezing in the adult population. The association between the individual components of metabolic syndrome and current wheezing was evaluated in adults using data from the Korea National Health and Nutrition Examination Survey from 2008 to 2012. Subjects with metabolic syndrome more frequently had wheezing during the past 12 months (current wheezing) (adjusted odds ratio [aOR] = 1.56; 95% confidence interval [CI] = 1.37–1.77) and wheezing during exercise in the past 12 months (aOR = 1.59; 95% CI = 1.37–1.84). Of the individual metabolic syndrome components, central obesity (aOR = 1.48; 95% CI = 1.31–1.66) and low high-density lipoprotein (HDL) cholesterol (aOR = 1.18; 95% CI = 1.05–1.34) were significantly associated with current wheezing. There were no significant associations between the other components of metabolic syndrome (high triglyceride level, blood pressure, and fasting plasma glucose level) and the presence of current wheezing. In addition, the association was much higher when both central obesity and low HDL cholesterol were present together compared to when either of the conditions was present alone (aOR = 1.67; 95% CI = 1.44–1.94). There is a significant association between metabolic syndrome and current wheezing in Korean adults. Of the components of metabolic syndrome, low HDL cholesterol and central obesity are independently and additively associated with the increased rate of current wheezing.

Characteristics and Prognosis of Hospitalized Patients at High Risk of Deterioration Identified by the Rapid Response System: a Multicenter Cohort Study

Kim Sang Hyuk,Hong Ji Young,Kim Youlim 대한의학회 2021 Journal of Korean medical science Vol.36 No.32

We aimed to investigate the characteristics and prognosis of high risk hospitalized patients identified by the rapid response system (RRS). A multicentered retrospective cohort study was conducted from June 2019 to December 2020. The National Early Warning Score (NEWS) was used for RRS activation. The outcome was unexpected intensive care unit (ICU) admission within 24 hours after RRS activation. The 11,459 patients with RRS activations were included. We found distinct clinical characteristics in patients who underwent ICU admission. All NEWS parameters were associated with the risk of unexpected ICU admission except body temperature. Body mass index, pulmonary disease, and cancer are related to the decreased risk of unexpected ICU admission. In conclusion, there were differences in clinical characteristics among high risk patients, and those differences were associated with unexpected ICU admissions. Clinicians should consider factors relating to unexpected ICU admission in the management of high risk patients identified by RRS.

Theoretical evaluation of Cox’s interaction model of client health behavior for health promotion in adult women

( Youlim Kim ),( Hyeonkyeong Lee ),( Gi Wook Ryu ) 한국여성건강간호학회 (구 여성건강간호학회) 2020 여성건강간호학회지 Vol.26 No.2

This study aimed to evaluate Cox’s interaction model of client health behavior (IMCHB) as used in studies on women’s health. Using keyword combinations of “women” and “IMCHB” or “interaction model of client health behavior,” we searched the PubMed, MEDLINE, Embase, and RISS databases for studies on the promotion of women’s health published from January 2009 to April 2019. Finally, 11 studies were selected and evaluated according to seven criteria for theory evaluation, which combined Fawcett’s theory evaluation criteria and Chinn and Kramer’s criteria. We found that the IMCHB corresponds to a verifiable practical level of a middle-range theory, although it may be partially abstract. It contains all four concepts of the metaparadigm of nursing, in terms of a holistic philosophical approach. A theoretical evaluation demonstrated that the IMCHB has significance, generality, testability, empirical adequacy, and pragmatic adequacy for nursing practice and research. However, the lack of clear conceptual definitions and the presence of complex relationships among concepts resulted in a lack of internal consistency and parsimony. According to an in-depth verification through a review of the literature, the IMCHB has been used as a health promotion intervention strategy for various populations of women and has led to useful results in nursing practice. The IMCHB was confirmed to be a suitable theory for experimental and clinical research. Future research can build on this middle-range theory for women’s health research and practice.

Effect of Culturally Adaptive Social Cognitive Intervention on Adherence of Walking for Korean Chinese Middle-Aged Women Workers

Youlim Kim,Hyoeun Jang,Junghee Kim,Mikyeong Cho,Mikyung Lee,Hyeonkyeong Lee 한국간호과학회 2019 한국간호과학회 학술대회 Vol.2019 No.10

Long-term exposure to PM 2.5 AND imaging phenotypes IN CODA COHORT

( Youlim Kim ),( Woo Jin Kim ),( Chang Youl Lee ),( Sung Ok Kwon ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-

Background: Ambient PM is causing respiratory symptoms at all age, and reducing lung function and can go to chronic pulmonary disease. Recent studies have shown that short-term exposure to PM affects the acute exacerbation of respiratory disease, but there is not much evidence about association between longterm exposure and lung function or lung development. The purpose of this study is to examine the association between long-term exposure to air pollution (PM2.5) and decline of lung imaging phenotype in dust exposed Korean living near cement factories. Methods: In the COPD in Dusty Areas (CODA) study, we performed a cross-sectional analysis which was recruited from 2012 to 2014. Using the chest CT scan, we measured the emphysema index and mean wall area aided by an in-house software program developed by the Korean obstructive lung disease study group. We used a satellite-based model to estimate the long-term PM2.5 concentration at each participant’s address. Results: Of the first 504 eligible participants, 400 participants were analyzed. Most were men (N= 301, 75.3%), and the mean age was 71.7 years. The emphysema index of the whole group was 6.63±0.70 and the mean wall area was 68.8±5.2. In relation between image measurement and PM2.5 concentration, there was no significant difference in the whole group, but there were shown some meaningful results when subgroup analysis was performed in the normal group and the COPD group. In normal lung function group, there was a significant association between long-term PM2.5 exposure and emphysema index: 1-year (ß=0.758, p=0.021), 3-year (ß=0.629, p=0.038), and 5-year (ß=0.544, p=0.045). There was no significant result between long-term PM2.5exposure and mean wall area: 1-year (ß= -0.389, p=0.832), 3-year (ß= -3.677, p=0.170), and 5-year (ß= -3.769, p=0.124). Conclusions: This study suggests that PM2.5 has the long-term effect on lung imaging phenotype in normal lung function group.