This study aimed to examine levels of stress and professionalism of nurses who provided nursing care during the 2015 Middle East respiratory syndrome outbreak based on their experience, to investigate the nurses' intention to respond to possible future outbreaks in relation to their experience during the outbreak, and to determine the relationship between the outbreak experience and nursing intention considering stress and professionalism. A self-administered questionnaire was designed based on modifications of related questionnaires, and used to assess levels of stress, professionalism, and nursing intention according to participants' experiences during the outbreak. Multiple regression analysis was used to examine the relationship between the outbreak nursing experience and nursing intention considering stress and nursing professionalism. The overall stress, professionalism, and nursing intention scores for the firsthand experience group were 33.72, 103.00, and 16.92, respectively, whereas those of the secondhand experience group were 32.25, 98.99, and 15.60, respectively. There were significant differences in professionalism and nursing intention scores between the groups (p = .001 and p < .001, respectively). The regression analysis revealed that the regression estimate between stress and nursing intention was B(SE) = -0.08(0.02), beta = -0.21, p < .001 and the regression estimate between professionalism in nursing and nursing intention was B(SE) = 0.05(0.01), beta = 0.23, p < .001. Prior outbreak nursing experience was importantly associated with intention to provide care for patients with a newly emerging infectious disease in the future considering stress and professionalism. Gathering information about nurses' experience of epidemics and regular assessment of job stress and professionalism are required.

Lee YG, et al. Ann Rehabil Med. 2018 Feb;42(1):120-129. https://doi.org/10.5535/arm.2018.42.1.120

Hwang JH, et al. J Korean Med Sci. 2015 Aug;30(8):1017-1024. http://dx.doi.org/10.3346/jkms.2015.30.8.1017

Tobacco companies have designed sophisticated marketing strategies for heated tobacco products (HTPs), and many smokers are exposed to advertisements purporting that HTPs can replace combustible cigarettes. The present study evaluates the relationship between poly-use of tobacco products and intention to quit cigarette smoking in association with smoking intensity, a meaningful indication of one’s interest in quitting cigarette smoking. A total of 36,397 current cigarette smokers who participated in the 2019 Korea Community Health Survey were evaluated. A multivariable logistic regression model was designed. Additionally, smoking-intensity-stratified analyses were conducted. A total of 4.7% of the participants reported planning to quit cigarette smoking within one month. Current dual users of combustible cigarettes and HTPs presented no significantly increased likelihood of intention to quit cigarette smoking regardless of cigarette-smoking intensity. By contrast, light and heavy daily smokers who accompanied e-cigarette use presented significant adjusted odds ratios (aORs) of 1.81 (95% confidence interval (CI): 1.04–3.14) and 1.97 (95% CI: 1.14–3.42), respectively. Occasional and daily smokers who reported using both HTPs and e-cigarettes presented no significance. The results of the present study suggested that a complete replacement of combustible cigarettes with HTPs was unlikely.

Heated tobacco products (HTPs) were first introduced in Korea in June 2017. This study examined the prevalence of current HTP use among Korean adolescents and its association with conventional cigarette (CC) or electronic cigarette (EC) use. The study analyzed nationally representative data (the 2019 Korea Youth Risk Behavior Web-based Survey) from a sample of 57,303 Korean students from grades 7–12. Multinomial logistic regression models were designed to evaluate the association between EC or CC use and HTP use. A total of 2.6% of respondents were current HTP users and 95.9% of them were dual or triple users of CC or EC. The likelihood of HTP use was higher among current CC or EC users and highest among dual users. When the association between each tobacco product and current HTP use was analyzed, the dual use tendency of HTPs and other products steadily increased with the increase of CC or EC smoking frequency. Adolescents who use ECs and/or CCs are likely to use HTPs. Thus, HTPs could be a new public health concern for adolescents in terms of dual or triple use patterns of CC or EC.

Health literacy (HL) is crucial for effective healthcare utilization, but its relationship with private health insurance (PHI) enrollment and medical expenditure in South Korea remains unexplored. This study aimed to examine the associations between HL, PHI enrollment, and annual out-of-pocket (OOP) medical expenditure in South Korea's universal healthcare system. Using data from the 2021 Korea Health Panel Study, we analyzed 5,469 participants aged 19–65. Logistic and multinomial logistic regression models were employed to assess factors influencing PHI enrollment. A Gamma GLM with a log- link function was used to examine the relationship between HL, PHI status, and OOP medical expenditure. Among participants, 70.05% had indemnity insurance coverage, and 88.02% held at least one PHI policy. Individuals with sufficient HL showed higher indemnity insurance enrollment (71.47%) compared to those with inadequate HL (63.17%). In unadjusted analyses, those with sufficient HL were more likely to have indemnity insurance (OR = 1.46, 95% CI: 1.19–1.80) and PHI policies. However, after adjusting for sociodemographic and health-related factors, these associations became non-significant. Individuals with indemnity insurance spent 36% more on OOP medical expenditure compared to those without (p < 0.01), and OOP medical expenditure increased with the number of insurance policies (39.1%, 71.6%, and 107.5% higher for one, two, and three or more policies, respectively, all p < 0.01). Those with sufficient HL spent 18.9% less on OOP medical expenditure compared to those with inadequate HL (p < 0.01). However, after adjusting for other variables, the coefficients lost statistical significance. After adjusting for other variables, higher education levels were associated with lower OOP medical expenditure. While HL initially showed an association with PHI enrollment and reduced OOP medical expenditure, these relationships became non-significant after adjusting for socioeconomic and health-related factors. Higher education levels were associated with lower OOP medical expenditure, suggesting that educational attainment may better explain the observed HL effects. The positive association between PHI and OOP medical expenditure highlights the need for policy attention to ensure sustainable healthcare financing and appropriate medical service utilization in Korea's healthcare system.