Korean Journal of Family Medicine最新文献

{"title":"Health literacy and primary care organization.","authors":"Young Min Jee","doi":"10.4082/kjfm.47.5E","DOIUrl":"10.4082/kjfm.47.5E","url":null,"abstract":"","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":"47 5","pages":"389-390"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Tobacco use among older Korean men: a classification and regression tree analysis.","authors":"Sung Seek Moon, Hyeouk Chris Hahm, Jinwon Lee","doi":"10.4082/kjfm.25.0179.R","DOIUrl":"10.4082/kjfm.25.0179.R","url":null,"abstract":"","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":"47 5","pages":"465"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing depression in older adults with chronic illnesses through the SMART Elderly Program: a quasi-experimental study in Central Thailand.","authors":"Phongsakorn Toopboochakorn, Nanthawan Nilpayak, Phornphimon Hotarat, Wanida Jaroensuk, Phannathat Tanthanapanyakorn","doi":"10.4082/kjfm.25.0222","DOIUrl":"10.4082/kjfm.25.0222","url":null,"abstract":"<p><strong>Background: </strong>Depression frequently affects older adults with chronic illnesses, reducing their quality of life. In Thailand, limited access to mental health services increases the need for preventive interventions. The SMART (Smile, Mindfulness, Attitude, Relax, and Thinking) Elderly Program aimed to assess its effectiveness in preventing depression among older adults.</p><p><strong>Methods: </strong>Quasi-experimental research design with a repeated-measures approach was used with two groups. The study included 80 older adults diagnosed by a physician with noncommunicable diseases and a depression score of 7 to 12 on the Thai Geriatric Depression Scale (TGDS), indicating risk for depression. Participants were assigned to two groups through multi-stage sampling. The intervention group (n=40) participated in a 6-week SMART Elderly Program, while the control group (n=40) received standard treatment and a handbook for depression prevention. Evaluations took place through in-person interviews at baseline, post-intervention, and at a 3-month follow-up. Data were analyzed using descriptive statistics and repeated measures analysis of variance.</p><p><strong>Results: </strong>The analysis showed statistically significant differences in knowledge about depression, attitudes toward depression, and TGDS scores between the intervention and control groups at the 3-month follow-up (P<0.001). In the intervention group, these measures also changed significantly from baseline to the 3-month follow-up (P<0.001).</p><p><strong>Conclusion: </strong>The SMART Elderly Program significantly reduced depressive symptoms in older adults with chronic illnesses. These results support its use in community health practice and inform health policy to improve preventive mental health care for older adults.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":"47 5","pages":"405-415"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gold Standards Framework to identify palliative care needs in primary care: a qualitative study of implementation in Brunei Darussalam.","authors":"Jia Xin Chong, Shyh Poh Teo, Asmah Husaini, Munikumar Ramasamy Venkatasalu","doi":"10.4082/kjfm.26.0170","DOIUrl":"https://doi.org/10.4082/kjfm.26.0170","url":null,"abstract":"<p><strong>Background: </strong>The early identification of patients who may benefit from a palliative approach remains challenging in primary care. The Gold Standards Framework (GSF) provides a structured approach to identify patients who may be approaching the end of life; however, its implementation in primary care settings outside the United Kingdom remains poorly understood. To explore general practitioners' experiences of using the GSF prognostic indicator guidance to identify patients with palliative care needs in primary care in Brunei.</p><p><strong>Methods: </strong>This qualitative study was part of a broader mixed-methods project that evaluated the use of the GSF in primary care. Focus group discussions and small-group interviews were conducted with general practitioners who had applied the GSF in routine clinical practice following a structured training workshop. Data were audio-recorded, transcribed verbatim, and thematically analyzed using an inductive approach.</p><p><strong>Results: </strong>Ten general practitioners participated in this study. Four overarching themes were identified: (1) adapting the GSF to primary care practice, (2) structural constraints within primary care, (3) prognostic uncertainty and role discomfort, and (4) system enablers for integrating a palliative approach. While the GSF was perceived as a useful framework, its application required contextual adaptation and was influenced by both clinician- and system-level factors.</p><p><strong>Conclusion: </strong>The GSF can support the identification of patients with palliative care needs in primary care settings. However, effective implementation requires alignment with local workflows, improved continuity of care, and system-level support, including clear referral pathways and integrated care planning.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between metabolic score for visceral fat and hypertension in Korean adults: a nationwide population-based study.","authors":"Eunbyeol Kang, Ae Hee Kim, A-Ra Cho","doi":"10.4082/kjfm.26.0122","DOIUrl":"https://doi.org/10.4082/kjfm.26.0122","url":null,"abstract":"<p><strong>Background: </strong>Hypertension, one of the major risk factors for cardiovascular disease, is associated with visceral adiposity accumulation. Accordingly, we aimed to investigate the association between the metabolic score for visceral fat (METS-VF), a novel surrogate marker of visceral adiposity, and hypertension in Korean adults.</p><p><strong>Methods: </strong>This cross-sectional study included 27,565 adults from the 2019-2023 Korea National Health and Nutrition Examination Survey. Weighted multivariable logistic regression analyses were performed to examine the association between METS-VF tertiles and hypertension. Discriminatory performance was evaluated using receiver operating characteristic (ROC) curve analysis, and the areas under the ROC curves were compared with those of other adiposity-related indices.</p><p><strong>Results: </strong>The prevalence of hypertension increased significantly across the METS-VF tertiles. After adjustment for potential confounders, the odds ratios and 95% confidence intervals for hypertension were 2.50 (2.04-3.06) in the second tertile and 2.76 (2.09-3.63) in the highest tertile, compared with the lowest METS-VF tertile. Moreover, METS-VF showed greater discriminatory performance for hypertension than the other adiposity-related indices.</p><p><strong>Conclusion: </strong>These findings indicate that METS-VF is strongly associated with hypertension in Korean adults and provides a more comprehensive assessment of cardiovascular risk than conventional adiposity-related indices.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between serum homocysteine levels and mortality stratified by liver fibrosis index: a retrospective cohort study of US adults.","authors":"Huanhuan Yang, Li Du, Guochong Chen, Donghan Su, Liang Wang, Zhihui Li","doi":"10.4082/kjfm.26.0039","DOIUrl":"https://doi.org/10.4082/kjfm.26.0039","url":null,"abstract":"<p><strong>Background: </strong>Elevated serum homocysteine (Hcy) levels have been associated with increased mortality; however, whether this association varies with the liver fibrosis burden remains unclear.</p><p><strong>Methods: </strong>We analyzed 16,541 adults from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2006 with mortality follow-up through December 31, 2019, via the National Death Index linkage. Serum Hcy levels were categorized as <10, 10-15, or >15 μmol/L. Liver fibrosis was assessed using the fibrosis-4 (FIB-4) index. Cox proportional hazard regression models, accounting for the complex survey design, were used to estimate the associations.</p><p><strong>Results: </strong>During a mean follow-up of 182.4 months, 3,740 deaths occurred. Hcy >15 μmol/L was associated with increased all-cause mortality regardless of liver fibrosis status. In contrast, moderate elevations (10-15 μmol/L) were associated with higher mortality only among participants with a higher FIB-4 index (hazard ratio [HR], 1.30; 95% confidence interval [CI], 1.19-1.42), but not among those with a lower FIB-4 index (HR, 1.24; 95% CI, 0.92-1.67). Kaplan-Meier curves showed greater separation across Hcy categories in the high FIB-4 group. Natural cubic spline analyses demonstrated nonlinear associations between Hcy and mortality that differed according to fibrosis status. Cause-specific analyses indicated that these associations were primarily driven by metabolic and other nonmalignant deaths, rather than malignant mortality. The findings were consistent across fibrosis quartiles, subgroup analyses, and sensitivity analyses.</p><p><strong>Conclusion: </strong>The association between serum Hcy levels and mortality differed across liver fibrosis strata. These findings suggest that stricter Hcy thresholds are warranted in populations with a higher risk of liver fibrosis.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the knowledge divide: a national cross-sectional analysis of urban-rural disparities in the stunting knowledge index among mothers/caregivers in Indonesia.","authors":"Rika Rachmawati, Nazarina, Budi Setyawati, Aya Yuriestia Arifin, Salimar, Noviati Fuada, Dwi Hapsari Tjandrarini, Dwi Sisca Kumala Putri, Siti Masitoh, Yuni Asri, Syaiful Mizan","doi":"10.4082/kjfm.26.0020","DOIUrl":"https://doi.org/10.4082/kjfm.26.0020","url":null,"abstract":"<p><strong>Background: </strong>Indonesia continues to encounter a significant public health crisis due to stunting. Maternal knowledge is the key driver of nutritional practices and outcomes. This study aimed to develop a maternal/caregiver stunting knowledge index (SKI), analyze disparities in urban-rural knowledge, and identify the key determinant factors driving these disparities.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data points from the 2024 Indonesian Nutritional Status Survey, involving 294,538 mothers and caregivers. Data regarding stunting knowledge, sociodemographic, maternal, and caregiver characteristics, child characteristics, area of residence, and variables related to maternal health knowledge and utilization were collected via interviews conducted with mothers. Height-for-Age Z-score (HAZ) was calculated using age and height measurements. Knowledge level was measured using a constructed SKI categorized as low, moderate, or high. Chi-square tests and multivariate logistic regression were used to identify the predictors of low SKI and risk(s) for stunting.</p><p><strong>Results: </strong>The prevalence of low SKI scores was significantly higher in rural areas, and maternal education was the strongest determinant of low SKI scores in both regions. In rural areas, limited access to formal health information (e.g., lack of a Maternal and Child Health book) was a major predictor. Low SKI was associated with higher odds for stunting risk (urban: adjusted odds ratio [aOR], 1.617; rural: aOR, 1.576), whereas high awareness of the long-term impacts of stunting provided a significant protective effect.</p><p><strong>Conclusion: </strong>Urban-rural knowledge disparities were concentrated among caregivers with lower education and limited health service utilization. Interventions should be tailored regionally, targeting caregivers with low education levels and emphasizing the long-term consequences of stunting to promote preventive behaviors.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal effects of diabetes and alcohol intake on Dupuytren's disease: a two-sample Mendelian randomization study in UK Biobank and FinnGen.","authors":"Heng Tian, Ling Hong, Wenlai Guo, Quanzhe Liu","doi":"10.4082/kjfm.26.0046","DOIUrl":"https://doi.org/10.4082/kjfm.26.0046","url":null,"abstract":"<p><strong>Background: </strong>Dupuytren's disease (DD) is associated with metabolic and lifestyle traits. However, these associations remain uncertain because exposures frequently cluster, and conventional studies are vulnerable to residual confounding and reverse causation.</p><p><strong>Methods: </strong>A two-sample Mendelian randomization (MR) analysis using genetic instruments for diabetes, obesity-related, smoking, and alcohol-related traits from genome-wide association studies of large European ancestry was conducted. Summary statistics of DD were obtained from UK Biobank and FinnGen and combined using meta-analysis. Multiplicative random-effects inverse variance weighted MR was used as the primary method, with complementary sensitivity analyses to test robustness.</p><p><strong>Results: </strong>Genetic liability for diabetes was associated with a higher risk of DD (meta-analyzed odds ratio [OR], 1.0157; 95% confidence interval [CI], 1.0070-1.0245; P<0.001). Genetically predicted alcohol intake was also positively associated with DD (alcohol intake OR, 1.0150; 95% CI, 1.0087-1.0212; P<0.001; drinks per week OR, 1.0062; 95% CI, 1.0015-1.0110; P=0.0103). However, we found no convincing evidence that obesity traits or smoking intensity had causal effects on DD. Sensitivity analyses were directionally consistent, the instruments were adequately strong, and there was no substantial evidence of horizontal pleiotropy for the main associations. Although the observed effect sizes were modest, consistent with the multifactorial nature of DD, supporting directional risk associations rather than large individual-level effects.</p><p><strong>Conclusion: </strong>This MR study supported diabetes liability and higher alcohol intake as causal risk factors for DD, whereas genetically proxied obesity and smoking traits showed no clear causal effects. These findings suggest that better glycemic management and lower alcohol exposure may help reduce the risk of DD.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between high-sensitivity C-reactive protein, regular exercise, and handgrip strength in Korean older adults: a nationwide cross-sectional study.","authors":"Seong Soo Park, Yejin Kim, Hong Ji Song, Kyung Hee Park, Young-Gyun Seo, Yu-Jin Paek, Hye-Ji An, Hye-Mi Noh","doi":"10.4082/kjfm.25.0324","DOIUrl":"https://doi.org/10.4082/kjfm.25.0324","url":null,"abstract":"<p><strong>Background: </strong>Dynapenia increases the risk of frailty, disability, and mortality in older adults. Chronic inflammation and physical inactivity are considered major contributors. This study examined the associations of high-sensitivity C-reactive protein (hs-CRP) levels and regular exercise with dynapenia in older Korean adults.</p><p><strong>Methods: </strong>We analyzed data from 4,935 adults aged ≥65 years who participated in the 2015-2018 Korea National Health and Nutrition Examination Survey. Dynapenia was defined as handgrip strength <28 kg in men and <18 kg in women. Serum hs-CRP levels were categorized as <1, 1-3, and >3 mg/L. Multivariable logistic regression was used to evaluate the associations of hs-CRP levels and exercise with dynapenia.</p><p><strong>Results: </strong>The prevalence of dynapenia was 27.4%. Participants with dynapenia had higher adjusted mean hs-CRP levels than those without (1.60 mg/L vs. 1.25 mg/L, P=0.008). Compared with hs-CRP <1 mg/L, hs-CRP >3 mg/L was independently associated with dynapenia (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.26-2.10). Lack of resistance exercise (OR, 1.99; 95% CI, 1.52-2.61) and aerobic exercise (OR, 1.45; 95% CI, 1.20-1.75) were also independently associated with dynapenia. Participants with both hs-CRP >3 mg/L and no regular exercise had higher odds of dynapenia (OR, 2.69; 95% CI, 1.89-3.83) compared with those with hs-CRP <1 mg/L who exercised regularly.</p><p><strong>Conclusion: </strong>Elevated hs-CRP levels and lack of regular exercise were independently associated with dynapenia, suggesting that reducing systemic inflammation and promoting regular exercise may help preserve muscle strength in older adults.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between physical activity patterns and depressive symptoms in Korean adults: a nationwide crosssectional study.","authors":"Soyoung Kim, Esther Kim, Sung-Il Cho","doi":"10.4082/kjfm.25.0384","DOIUrl":"https://doi.org/10.4082/kjfm.25.0384","url":null,"abstract":"<p><strong>Background: </strong>Recently, the \"weekend warrior\" pattern, characterized by meeting recommended physical activity (PA) guidelines within one or two weekly sessions, has received increasing attention. However, its association with mental health outcomes remains unclear. This study aimed to examine the relationship between PA patterns and depressive symptoms.</p><p><strong>Methods: </strong>This study analyzed data from 26,424 adults from the Korea National Health and Nutrition Examination Survey conducted in 2014, 2016, 2018, 2020, and 2022. PA was assessed by a self-reported questionnaire and classified according to World Health Organization guidelines for moderate-to-vigorous PA. Participants were categorized as inactive (<150 min/ wk), weekend warriors (≥150 min/wk over 1-2 days), or regularly active (≥150 min/wk over ≥3 days). Depressive symptoms were defined as a Patient Health Questionnaire-9 score ≥5. Associations were examined using multivariable logistic regression, stratified by sex and age.</p><p><strong>Results: </strong>Prevalence of depressive symptoms among participants was 19.3%. The weekend warrior PA pattern was not significantly associated with depressive symptoms. Contrarily, the regularly active PA pattern was inversely associated with depressive symptoms (odds ratio [OR], 0.72; 95% confidence interval [CI], 0.66-0.79); this association remained significant after multivariable adjustment (OR, 0.81; 95% CI, 0.74-0.89). In stratified analyses by sex and age group, the regularly active group consistently showed an inverse association with depressive symptoms, whereas no significant association was observed for the weekend warrior PA pattern.</p><p><strong>Conclusion: </strong>Regularity of physical activity may be more important for mental health than total activity volume alone.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}