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Letters

Advancing holistic health strategies for post-pandemic resilience
Jonathan James O. Canete
Korean J Fam Med 2025;46(2):122-123.   Published online March 19, 2025
DOI: https://doi.org/10.4082/kjfm.25.0022
  • 239 View
  • 15 Download
Unlocking the potential of primary care: addressing systemic challenges in chronic disease prevention
Jose Eric Mella Lacsa
Korean J Fam Med 2025;46(2):120-121.   Published online January 15, 2025
DOI: https://doi.org/10.4082/kjfm.24.0282
  • 426 View
  • 25 Download

Case Report

Quetiapine-induced hypokalemic periodic paralysis in a pregnant woman: a case report
Muhammad Hafiz Mohamed Pauzi, Azidah Abdul Kadir, Syaheedatul Iman Dinsuhaimi, Zainab Mat Yudin, Wan Nazirah Wan Yusuf
Korean J Fam Med 2025;46(2):115-119.   Published online March 19, 2025
DOI: https://doi.org/10.4082/kjfm.24.0301
Quetiapine-induced hypokalemic periodic paralysis (QIHPP) is a rare condition. Herein, we present the case of a 31-year-old pregnant Malay woman diagnosed with bipolar II disorder and QIHPP. She presented to the casualty department with a 2-day history of bilateral lower limb weakness and numbness. Her renal function tests showed moderate hypokalemia (2.5 mmol/L), whereas other investigations were normal. Quetiapine was suspected to be the cause, prompting a psychiatric referral to manage her acute condition. Balancing the risks of untreated QIHPP against the potential relapse of bipolar symptoms from quetiapine discontinuation or dosage reduction poses a significant treatment challenge for pregnant women with QIHPP. Finally, we reduced the quetiapine dosage after careful consideration, leading to the normalization of potassium levels and symptom resolution. Therefore, clinicians should be aware of this side effect when initiating or continuing quetiapine treatment in women of childbearing age or pregnant women with psychiatric disorders. It is crucial to monitor serum electrolytes, especially potassium, following quetiapine administration and warn patients about its potential side effects.
  • 447 View
  • 53 Download

Original Articles

Background
Interest in healthy aging has grown with the increase in the older population. Nutritional intake is crucial in frailty. Therefore, we aimed to investigate the relationship between frailty and multivitamin and mineral supplements (MVMS), which can easily provide micronutrients.
Methods
The Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2018 to 2019 included 3,395 adults aged ≥65 years. Of these, 1,511 who did not consume dietary supplements (DS, non-DS group) and 415 who took MVMS (MVMS group) were included in the study. We modified Fried’s definition of frailty to fit the KNHANES data. Using multivariate logistic regression, we examined the association between MVMS use and frailty, which varied with satisfaction with total energy intake. Additional subgroup analyses were performed based on age, sex, and income.
Results
MVMS reduced most micronutrient deficiencies compared to obtaining nutrients solely through food. The overall analysis revealed no association between MVMS use and frailty (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.52–1.09). However, a subanalysis revealed that participants with a low income (≤25%) who took MVMS had decreased odds for frailty (OR, 0.55; 95% CI, 0.35–0.88) compared with the non-DS group. Furthermore, a significant association between using MVMS and frailty was confirmed in the group with low income and energy intake below the recommended daily allowance, with a low OR of 0.52 (95% CI, 0.30–0.90).
Conclusion
MVMS use was significantly associated with frailty among the low-income and low-daily energy intake groups.
  • 535 View
  • 40 Download
Association of body image distortion with smartphone dependency and usage time in adolescents: a cross-sectional Korean Youth Study
Haein Cho, Junhee Park, Dagyeong Lee, Dong Wook Shin
Korean J Fam Med 2025;46(2):98-106.   Published online May 22, 2024
DOI: https://doi.org/10.4082/kjfm.23.0159
Background
Adolescent dependency on smartphones is the highest among all age groups. Adolescents can be influenced to evaluate their body image by popular ideals about beautiful bodies via smartphone content, which can cause body image distortion. This study aimed to examine the association between body image distortion and smartphone dependency and the duration of smartphone usage among Korean adolescents.
Methods
This study used data from the 16th Korean Youth Risk Behavior Web-Based Survey (2020), and included 42,981 participants, who were grouped according to self-reported duration of smartphone usage and smartphone dependency, as measured by a questionnaire. Body image distortion is defined as an exaggerated subjective body image compared to the actual body image. Multivariable-adjusted logistic regression was used to determine the odds ratios (ORs) with 95% confidence intervals (CIs) of body image distortion on smartphone dependency and usage time after adjusting for various factors related to body image distortion.
Results
Among the 42,981 participants, both moderate and high levels of smartphone dependency were associated with body image distortion in boys (moderate: adjusted OR [aOR], 1.11; 95% CI, 1.01–1.22; high: aOR, 1.18; 95% CI, 1.05–1.32) and girls (moderate: aOR, 1.14; 95% CI, 1.05–1.23; high: aOR, 1.30; 95% CI, 1.18–1.42) compared to the low-level dependency group. However, no significant association was found between smartphone usage duration and body image distortion.
Conclusion
Our study demonstrated that moderate to high levels of smartphone dependency are associated with body image distortion in adolescents. Therefore, it is necessary to establish strategies for checking and managing adolescents’ smartphone dependence.

Citations

Citations to this article as recorded by  
  • Excessive smartphone use, smartphone dependency and body image distortion in Korean adolescents
    Young Gyu Cho
    Korean Journal of Family Medicine.2025; 46(2): 58.     CrossRef
  • Social Media Use and Body Image Dissatisfaction Among University Students of Health Sciences in Saudi Arabia
    Ihdaa J Abdulwahab, Jumana H Khouja, Noha A Alzahrani, Amina Bargawi
    Cureus.2024;[Epub]     CrossRef
  • 2,212 View
  • 80 Download
  • 2 Crossref
Association between breakfast consumption frequency and chronic inflammation in Korean adult males: Korea National Health and Nutrition Examination Survey 2016–2018
Eun Ji Han, Eun Ju Park, Sae Rom Lee, Sang Yeoup Lee, Young Hye Cho, Young In Lee, Jung In Choi, Ryuk Jun Kwon, Soo Min Son, Yun Jin Kim, Jeong Gyu Lee, Yu Hyeon Yi, Young Jin Tak, Seung Hun Lee, Gyu Lee Kim, Young Jin Ra
Korean J Fam Med 2025;46(2):92-97.   Published online July 5, 2024
DOI: https://doi.org/10.4082/kjfm.23.0151
Background
Skipping breakfast is associated with an increased risk of chronic inflammatory diseases. This study aimed to examine the association between breakfast-eating habits and inflammation, using high-sensitivity C-reactive protein (hs-CRP) as a marker.
Methods
A total of 4,000 Korean adult males with no history of myocardial infarction, angina, stroke, diabetes, rheumatoid arthritis, cancer, or current smoking were included. Data from the 2016–2018 Korea National Health and Nutrition Examination Survey were used for analysis. The frequency of breakfast consumption was assessed through a questionnaire item in the dietary survey section asking participants about their weekly breakfast consumption routines over the past year. Participants were categorized into two groups, namely “0–2 breakfasts per week” and “3–7 breakfasts per week”; hs-CRP concentrations were measured through blood tests.
Results
Comparing between the “infrequent breakfast consumption (0–2 breakfasts per week)” and “frequent breakfast consumption (3–7 breakfasts per week)” groups, the mean hs-CRP was found to be significantly higher in the “infrequent breakfast consumption” group, even after adjusting for age, body mass index, physical activity, alcohol consumption, systolic blood pressure, blood pressure medication, fasting blood glucose, and triglycerides (mean hs-CRP: frequent breakfast consumption, 1.36±0.09 mg/L; infrequent breakfast consumption, 1.17±0.05 mg/L; P-value=0.036).
Conclusion
Less frequent breakfast consumption was associated with elevated hs-CRP levels. Further large-scale studies incorporating adjusted measures of daily eating patterns as well as food quality and quantity are required for a deeper understanding of the role of breakfast in the primary prevention of chronic inflammatory diseases.
  • 1,764 View
  • 72 Download
Association between mothers’ working hours and metabolic syndrome in children and adolescents: data from the Korea National Health and Nutrition Examination Survey, 2016–2020
Myoung-hye Lee, Joo-Eun Jeong, Hoon-Ki Park, Hwan-Sik Hwang, Kye-Yeung Park
Korean J Fam Med 2025;46(2):84-91.   Published online May 8, 2024
DOI: https://doi.org/10.4082/kjfm.23.0157
Background
Prevention and management of metabolic syndrome (MetS) during childhood are crucial. Recently, obesity among children and adolescents has increased with an increase in mothers’ working hours. The present study was conducted to determine the relationship between mothers’ working hours and MetS in their children.
Methods
Data from the 2016–2020 National Health and Nutrition Examination Survey were used, and 2,598 children and adolescents aged 10–18 years were included. Logistic regression analysis was conducted to confirm the association between MetS and mothers’ working hours for each risk factor. Linear regression analysis was conducted to confirm the association between mothers’ working hours and the number of risk factors for MetS.
Results
Abdominal obesity in children was higher when the mothers’ working hours were 53 hours or more (odds ratio [OR], 2.267; 95% confidence interval [CI], 1.21–4.25). In the trend analysis, the OR of children’s abdominal obesity increased significantly as mothers’ working hours increased (P-value <0.05). Additionally, sex-stratified analysis revealed a significant trend between maternal work hours and the presence of MetS in female children (P=0.016). The adjusted OR of the presence of MetS in female children with mothers working 53 hours or more weekly was 6.065 (95% CI, 1.954–18.822).
Conclusion
Mothers’ working hours were highly correlated with the risk of abdominal obesity in their children. The OR of the presence of MetS significantly increased in female children with mothers having longer working hours compared with those with stay-at-home mothers.

Citations

Citations to this article as recorded by  
  • No, either or both parents with metabolic syndrome: comparative study of its impact on sons and daughters
    Jun-Hong Park, Min Hyung Cho, Hae Sang Lee, Young Suk Shim
    Frontiers in Endocrinology.2025;[Epub]     CrossRef
  • 1,557 View
  • 51 Download
  • 1 Web of Science
  • 1 Crossref
Health information quality of online newspaper articles in Korea
Hangyeol Lee, Seung-Won Oh
Korean J Fam Med 2025;46(2):77-83.   Published online March 7, 2024
DOI: https://doi.org/10.4082/kjfm.23.0197
Background
The Web is an important source of health information, but the quality of such online information is highly variable. This study evaluates the quality of health articles published on Naver News, Korea’s most popular portal, using the Health Information Quality Assessment Tool (HIQUAL).
Methods
We collected 712 health-related articles published on Naver News from May 1 to 7, 2023. After applying exclusion criteria, we selected 116 articles for analysis. Two clinicians independently assessed the quality of these articles using the HIQUAL, which scores articles based on five domains: “reliability,” “usefulness,” “understandability,” “sufficiency,” and “transparency.”
Results
Overall article quality was generally considered recommendable (mean±standard deviation: 7.52±2.00). “Usefulness,” one item of “reliability,” and “understandability” were the three items with the highest levels of satisfaction. “Sufficiency” criteria for costs, risks, and benefits received low scores. Quality scores for articles focused on health risk factors and intervention showed a statistically significant difference.
Conclusion
While the overall quality of health information in Korean online newspaper articles is acceptable, room for improvement remains in some areas, particularly with regard to the fair presentation of costs, risks, and benefits. The study highlights the need for ongoing quality improvement and evaluation initiatives for online health information.
  • 1,688 View
  • 78 Download
Low serum creatinine as well as high serum creatinine is associated with prognosis of patients with cancer in end-of-life
Yoo Jeong Lee, Soon-Young Hwang, Su Hyun Kim, Youn Seon Choi
Korean J Fam Med 2025;46(2):70-76.   Published online October 27, 2023
DOI: https://doi.org/10.4082/kjfm.23.0116
Background
The prognosis of end-of-life patients is challenging, and clinicians have attempted to predict survival more accurately. High serum creatinine (sCr) levels are associated with lower survival rates in patients with various cancers; however, low sCr levels are commonly expected in patients with terminal cancer because of muscle wasting and malnutrition. Therefore, we investigated the prevalence of low and high sCr levels and their association with survival duration in patients with terminal cancer in a palliative care unit.
Methods
We analyzed the medical records of 280 patients admitted to a palliative care unit. Patients were divided into low (<0.5 mg/dL), normal (0.5–1.2 mg/dL), and high (>1.2 mg/dL) sCr groups. Kaplan-Meier survival curves using sCr levels were plotted and compared using the log-rank test. Using stepwise selection, a multivariable Cox proportional hazards model was used to identify the significant prognostic factors.
Results
The median survival durations in the high-, low-, and normal-sCr groups were 9.57 days, 22.26 days, and 27.51 days, respectively. Multivariable Cox proportional hazard model identified that males (hazard ratio [HR], 1.81; 95% confidence interval [CI], 1.16–2.85), poor performance status (HR, 3.43; 95% CI, 1.12–10.54), total parenteral nutrition use (HR, 1.84; 95% CI, 1.09–3.1), high sCr (HR, 2.74; 95% CI, 1.52–4.94), and low sCr (HR, 1.22; 95% CI, 1.07–1.43) were significantly associated with a shorter survival time.
Conclusion
Low and high serum creatinine levels were significantly associated with poor survival in patients with cancer at the end-of-life stage. Therefore, readily available and simple biomarkers may help plan advanced care in palliative care settings.
  • 28,447 View
  • 92 Download

Review Article

The socioeconomic and environmental determinants of metabolic dysfunction-associated steatotic liver disease: understanding inequalities in prevalence and outcomes
Dominika Lorek, Krzysztof Łupina, Wiktoria Bisaga, Dominik Malicki, Weronika Stępień, Laura Kumor, Jakub Janczura
Korean J Fam Med 2025;46(2):61-69.   Published online March 19, 2025
DOI: https://doi.org/10.4082/kjfm.25.0027
Metabolism-associated steatotic liver disease (MASLD) is the most prevalent chronic liver condition worldwide and affects nearly 30% of the global population. While traditionally associated with metabolic risk factors, such as obesity and insulin resistance, increasing attention is being directed toward socioeconomic and environmental determinants that contribute to disparities in MASLD prevalence and outcomes. Low-income populations often experience higher rates of MASLD owing to limited access to healthcare, poor diet quality, and reduced opportunities for physical activity. Conversely, high-income countries are witnessing a paradoxical rise in MASLD cases, driven by sedentary lifestyles and excessive consumption of ultra-processed foods. This review examined the effects of socioeconomic status, education, healthcare access, and environmental exposure on the epidemiology of MASLD. The findings revealed that individuals from lower socioeconomic backgrounds and migrant populations experience a disproportionately higher burden of MASLD due to systemic healthcare barriers, dietary transitions, and occupational exposure. Children and adolescents face increasing susceptibility owing to rising obesity rates, and geographic disparities highlight Europe as the most affected region, followed by Asia and North America. Given the growing public health impact of MASLD, addressing both socioeconomic and environmental determinants is essential. Future efforts should prioritize policy-driven interventions, including equitable healthcare access, lifestyle modifications, and research into novel therapeutic approaches to mitigate the disease burden and improve patient outcomes.
  • 932 View
  • 41 Download

Editorials

Excessive smartphone use, smartphone dependency and body image distortion in Korean adolescents
Young Gyu Cho
Korean J Fam Med 2025;46(2):58-60.   Published online March 19, 2025
DOI: https://doi.org/10.4082/kjfm.46.2E.2
  • 761 View
  • 33 Download
Reflecting on progress and challenges: the Korean Journal of Family Medicine in 2024
Seung-Won Oh
Korean J Fam Med 2025;46(2):55-57.   Published online March 19, 2025
DOI: https://doi.org/10.4082/kjfm.46.2E.1
  • 632 View
  • 33 Download

Letter

Artificial intelligence implementation in the management of patients with tuberculosis
Erlina Wijayanti, Ummi Azizah Rachmawati, Citra Fitri Agustina
Korean J Fam Med 2025;46(1):52-53.   Published online January 20, 2025
DOI: https://doi.org/10.4082/kjfm.24.0268
  • 991 View
  • 43 Download

Case Report

Hemicrania continua with rhinosinusitis: a case report
Dae Hyun Kim, Yoonseo Lee
Korean J Fam Med 2025;46(1):48-51.   Published online January 20, 2025
DOI: https://doi.org/10.4082/kjfm.24.0178
Hemicrania continua (HC) is an indomethacin-responsive headache, characterized by unilateral and continuous headaches with cranial autonomic symptoms. Various pathologies, including sinus-related conditions, are associated with HC. Here, we report the case of a 62-year-old man with HC and rhinosinusitis. The patient complained of a unilateral continuous headache with ipsilateral cranial autonomic symptoms, conjunctival injection, and eyelid edema for 20 months. HC was identified as a potential diagnosis based on the symptom criteria, and a response to indomethacin confirmed the diagnosis. Trigeminal autonomic cephalalgia should be considered in patients with unilateral headaches and cranial autonomic symptoms.
  • 999 View
  • 35 Download

Original Articles

Testing the reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index using Fitbit devices: a cross-sectional analysis
Si-Yeon Lee, Ja-Eun Choi, Ji-Won Lee, Yaeji Lee, Jae-Min Park, Kyung-Won Hong
Korean J Fam Med 2025;46(1):42-47.   Published online April 22, 2024
DOI: https://doi.org/10.4082/kjfm.23.0166
Background
Sleep disorders and insomnia are prevalent worldwide, with negative health outcomes. The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report assessment tool for evaluating sleep quality, comprising seven subdomains. The Korean version of the PSQI (PSQI-K) has been tested for reliability and validity in small sample sizes but lacks large-scale validation using objective measures.
Methods
This study was conducted with 268 Korean adults attending health check programs. Participants completed the PSQI-K questionnaire and wore Fitbit devices (Fitbit Inc., USA) to ascertain sleep parameters. Reliability was analyzed using the Cronbach’s α coefficient, and construct validity was determined through factor analysis. Criteria validity was assessed by correlating their index scores with Fitbit sleep parameters. We identified the optimal cutoff for detecting sleep disorders.
Results
The Cronbach’s α coefficient was 0.61, indicating adequate internal consistency. Factor analysis revealed three factors, explaining 48.2% of sleep quality variance. The index scores were negatively correlated with Fitbit sleep efficiency, total sleep time, and number of awakenings (P<0.05). The optimal cutoff point for identifying sleep disorder groups was ≥6.
Conclusion
The PSQI-K demonstrated good reliability and validity when correlated with Fitbit sleep parameters, offering a practical screening tool for identifying sleep disorders among Korean adults. Cutoff scores can help identify patients for sleep interventions. However, further large-scale studies are required to validate these findings.

Citations

Citations to this article as recorded by  
  • Association of work ability with job burnout and sleep quality among biosafety laboratory personnel in Xinjiang, China: a cross-sectional study
    Keke Ju, Ruikai Wu, Jing Yu, Lei Ding, Mengjie Xia, Jiwen Liu, Yaoqin Lu
    Frontiers in Public Health.2025;[Epub]     CrossRef
  • Validation of the Korean version of the Sleep Hygiene Practice Scale in a Non-Clinical Population
    Dongyeop Kim, Ji Young Yun, Hye Ah Lee, Pamela Song, Heeyoung Ahn, Chien-Ming Yang, Jee Hyun Kim
    Behavioral Sleep Medicine.2024; 22(6): 791.     CrossRef
  • The relationship between sleep quality and happiness among preclinical students in a medical school
    Rusdiah Ruzanna Jusoh, Kavimitha G Krishnasamy, Saila Dharishinee Alagu, Pretha Mohan, Jeslyn Tan Guan Qian, Elayevenee Elanthevan, Muhammad Zulfiqah Sadikan, Haryati Ahmad Hairi
    Journal of Education Technology in Health Sciences.2024; 11(3): 92.     CrossRef
  • 2,741 View
  • 103 Download
  • 2 Web of Science
  • 3 Crossref
Association between obstructive sleep apnea and glaucoma
Yoonchae Zoh, Jae Moon Yun
Korean J Fam Med 2025;46(1):35-41.   Published online March 25, 2024
DOI: https://doi.org/10.4082/kjfm.23.0162
Background
Obstructive sleep apnea (OSA) and glaucoma are major global health challenges. However, the probable association between them is yet to be fully elucidated. This study aimed to investigate the association between OSA and glaucoma.
Methods
Data for this cross-sectional study were obtained from the eighth Korea National Health and Nutrition Examination Survey (2019–2021). From among 9,495 individuals who completed the STOP-Bang questionnaire on OSA (for those aged ≥40 years) and provided their glaucoma prevalence/intraocular pressure (IOP) data, 8,741 were selected for glaucoma prevalence analysis. A total of 754 individuals aged 80 years or older or those with missing confounding variable data were excluded. A separate subgroup of 8,627 individuals was selected for IOP analysis after excluding 114 individuals who use glaucoma eye drops. The study employed linear and logistic regression analyses with Stata/MP ver. 17.0 (Stata Corp., USA) to understand the relationship between the risk of OSA assessed using the STOP-Bang score and key glaucoma indicators, adjusted for confounders. Statistical significance was set at a P-value <0.05.
Results
The average±standard deviation [SD] age of the glaucoma prevalence study group was 56.59±10.48, and 42.98% were male. Notably, every unit increase in the STOP-Bang score was associated with a greater risk of glaucoma (odds ratio, 1.097; P=0.044). In the IOP subgroup, the average±SD age was 56.49±10.45 years, with 42.88% being males. The linear regression showed a statistically significant relationship between the STOP-Bang score and IOP after adjusting for confounding variables (β=0.171, P<0.001).
Conclusion
Our findings revealed a significant positive association between OSA risk, as measured using the STOP-Bang score, and both the likelihood of glaucoma and high IOP.

Citations

Citations to this article as recorded by  
  • Reversing Aging and Improving Health Span in Glaucoma Patients: The Next Frontier?
    Shibal Bhartiya, Tanuj Dada, Karthikeyan Mahalingam
    Journal of Current Glaucoma Practice.2024; 18(3): 87.     CrossRef
  • 2,839 View
  • 115 Download
  • 1 Crossref
Changes in the prevalence of metabolic syndrome before and after the COVID-19 pandemic according to household income levels
Hyunjung Kang, Dagyeong Lee, Junhee Park, Su-Min Jung
Korean J Fam Med 2025;46(1):27-34.   Published online April 25, 2024
DOI: https://doi.org/10.4082/kjfm.23.0171
Background
Since the World Health Organization’s pandemic declaration in March 2020, Korea has witnessed shifts in lifestyle behaviors, impacting habits tied to socioeconomic status and contributing to metabolic syndrome (MetS). To investigate this issue, the current study aimed to investigate changes in MetS prevalence, particularly based on income levels before and after the coronavirus disease 2019 (COVID-19) pandemic.
Methods
This study used data from the 8th Korea National Health and Nutrition Examination Survey (2019–2020). A total of 6,840 individuals aged 30–65 years were included in this study. Household income was divided into high (≥75th percentile), middle (25–75th percentile), and low (≤25th percentile). A multivariable logistic regression analysis was performed to explore the interaction between this association before and after the COVID-19 pandemic.
Results
A statistically significant difference was found in the prevalence of MetS before and after the COVID-19 pandemic (26.7% to 30.2%, P=0.001). These changes differed based on income levels. The increase in the prevalence of MetS was statistically significant in the low- and high-income groups but not in the middle-income group (low: 8.0%p increase [P=0.039], middle: 1.0%p increase [P=0.522], high: 6.4%p increase [P<0.001]). The interaction between household income and the COVID-19 pandemic on MetS was statistically significant (P for interaction=0.032).
Conclusion
This study revealed that P for interaction between household income, MetS, and the period before and after the COVID-19 pandemic was significant. Changes in physical activity and eating habits during the COVID-19 pandemic may have contributed to these differences.
  • 2,035 View
  • 68 Download
Unhealthy alcohol use: screening and behavioral counseling interventions
Wonyoung Jung, Seung-Won Oh, Se-Hong Kim, Soo Young Kim
Korean J Fam Med 2025;46(1):20-26.   Published online November 12, 2024
DOI: https://doi.org/10.4082/kjfm.24.0115
Background
Despite the increase in daily alcohol intake in recent decades and the implementation of national health screenings, effective management strategies for alcohol consumption remain outdated. This review evaluates intervention studies on screening and behavioral counseling for unhealthy alcohol use, with the aim of enhancing the effectiveness of interventions and improving health outcomes.
Methods
On the basis of the GRADE (Grading of Recommendations Assessment, Development, and Evaluation)- ADOLOPMENT framework, systematic reviews and randomized controlled trials were examined to investigate the effectiveness of screening and counseling interventions in reducing unhealthy alcohol use. Five key questions were generated, and an evaluation and quality assessment of existing systematic reviews and new evidence related to each key question were conducted.
Results
Updating the U.S. Preventive Services Task Force and Cochrane 2018 reviews, we identified five new randomized trials that evaluated screening and counseling interventions for unhealthy alcohol use. For Key Question 2, the sensitivity and specificity of the new screening studies were consistent with those of prior research. Brief interventions were confirmed to reduce alcohol use (Key Question 4a), although additional research is required for a wider array of health outcomes. One study highlighted the benefits of counseling interventions for newborn health indicators in pregnant women (Key Question 4b). No new evidence was found regarding the harms of screening (Key Question 3) or alcohol use reduction interventions (Key Question 5).
Conclusion
This review supports the continued use of brief interventions to reduce alcohol consumption in highrisk groups and highlights the need for culturally tailored research in Korea.
  • 1,686 View
  • 64 Download
Tobacco cessation: screening and interventions
Yoo-Bin Seo, Sang-Wook Song, Sung-Goo Kang, Soo Young Kim
Korean J Fam Med 2025;46(1):12-19.   Published online October 29, 2024
DOI: https://doi.org/10.4082/kjfm.24.0034
Background
Tobacco use has been the leading cause of disease and death in South Korea. Early detection of tobacco use and evidence-based interventions play pivotal roles in facilitating tobacco cessation.
Methods
In accordance with the earlier iterations of the Lifetime Health Maintenance Program (2009) and recent recommendations from the United States Preventive Services Task Force (USPSTF; 2021), two themes were chosen for investigation: the identification of and intervention for tobacco use. The USPSTF recommendations were formulated by conducting an overview of reviews. In this study, literature searches and quality assessments of reviews were conducted.
Results
The findings highlighted the efficacy of physician-led identification and advising in promoting tobacco cessation, with robust evidence supporting the implementation of behavioral and pharmacological interventions. These interventions significantly increased the likelihood of successful cessation compared with usual care. Digital interventions, such as internet- or mobile-based interventions, showed additive effects for quitting.
Conclusion
Identification and targeted interventions are essential for tobacco cessation. By leveraging evidencebased strategies and enhancing access to resources, healthcare providers can empower individuals to achieve successful tobacco cessation and improve overall health outcomes.
  • 1,731 View
  • 79 Download

Review Article

Variables in the projection of physician demand and supply in primary care
Dae Hyun Kim, Yoonseo Lee
Korean J Fam Med 2025;46(1):4-11.   Published online December 24, 2024
DOI: https://doi.org/10.4082/kjfm.24.0153
Primary care services improve healthcare outcomes and limit unnecessary specialty care. Thus, it is essential to monitor primary care physician demand and supply projections to suggest evidence-based healthcare reforms and promote better healthcare delivery. This study evaluates 28 demand variables, 50 supply variables, and 26 additional variables associated with the demand and supply projections of physicians by reviewing scenarios from other countries, including Taiwan, Singapore, Japan, and the United States of America. The results indicate that Korea uses less diverse demand and supply indicators and suggest the need to implement variables used in the other four countries to improve projection modeling.

Citations

Citations to this article as recorded by  
  • What is the optimal number of physicians for a sustainable healthcare system?
    Seung-Won Oh
    Korean Journal of Family Medicine.2025; 46(1): 1.     CrossRef
  • 1,718 View
  • 68 Download
  • 1 Web of Science
  • 1 Crossref

Editorial

What is the optimal number of physicians for a sustainable healthcare system?
Seung-Won Oh
Korean J Fam Med 2025;46(1):1-3.   Published online January 20, 2025
DOI: https://doi.org/10.4082/kjfm.46.1E
  • 1,331 View
  • 45 Download

Letters

Implementation of Precision Medicine in Primary Care: A Struggle to Improve Disease Prevention
Erlina Wijayanti, Zwasta Pribadi Mahardhika
Korean J Fam Med 2024;45(6):359-361.   Published online November 20, 2024
DOI: https://doi.org/10.4082/kjfm.24.0165
  • 1,093 View
  • 31 Download
Integrating Machine Learning for Personalized Fracture Risk Assessment: A Multimodal Approach
Sheikh Mohd Saleem, Shah Sumaya Jan
Korean J Fam Med 2024;45(6):356-358.   Published online November 20, 2024
DOI: https://doi.org/10.4082/kjfm.24.0134
  • 1,012 View
  • 21 Download

Original Articles

Community Pharmacists’ Identifying and Counseling of Breastfeeding Women: A Study from Jordan
Mea’ad Mansour Harahsheh, Tareq Lewis Mukattash, Samah Fawzi Al-shatnawi, Rana Kamal Abu-Farha, Deirdre M. D’Arcy, Anan Sadeq Jarab, Sawsan Hammad Abuhammad
Korean J Fam Med 2024;45(6):346-355.   Published online April 22, 2024
DOI: https://doi.org/10.4082/kjfm.23.0103
Background
This study explored the approaches of Jordanian community pharmacists to identifying and counseling breastfeeding mothers regarding medication usage.
Methods
This cross-sectional study used self-administered questionnaires. A convenience sample (n=381) of Jordanian community pharmacists was recruited through social media. The responses were statistically analyzed using IBM SPSS ver. 25.0 (IBM Corp., USA).
Results
The majority of recruited pharmacists were female (n=329, 86.4%). Asking every woman was Jordanian pharmacists’ preferred approach to identifying breastfeeding women (n=211, 55.4%). The study showed that around one-third of the pharmacists (n=128, 33.6%) reported that they currently experienced queries regarding medication use during breastfeeding on a daily basis. Additionally, the majority (n=325, 85.3%) of pharmacists reported feeling confident, and 67.2% of them (n=256) reported feeling comfortable while giving advice to breastfeeding women. The surveyed pharmacists relied on different resources during their course of practice to answer queries related to medicine usage by breastfeeding mothers.
Conclusion
Community pharmacists have continuous interactions with breastfeeding women. Pharmacists require reliable and updated data access to answer queries related to medication use while breastfeeding.

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  • Reflecting on progress and challenges: the Korean Journal of Family Medicine in 2024
    Seung-Won Oh
    Korean Journal of Family Medicine.2025; 46(2): 55.     CrossRef
  • 1,876 View
  • 60 Download
  • 1 Web of Science
  • 1 Crossref
Background
Sickness presenteeism (SP) refers to the phenomenon where employees attend work while sick, a decision that impacts both their physical and mental well-being and can lead to burnout. This study aimed to determine the prevalence of and factors influencing SP among Thai and foreign teachers following the end of the coronavirus disease 2019 public health emergency of international concern (PHEIC).
Methods
A sample of 400 individuals was analyzed using chi-square tests and logistic regression to obtain odds ratios (ORs) and 95% confidence intervals (CI).
Results
Post-PHEIC, a significant proportion of teachers (51.9%) perceived an increase in their workload, and 62.1% reported having taken health-related leave of absence. The prevalence of SP was high (35.0%). Factors significantly associated with SP (P<0.05) included being younger than 37 years (OR, 1.825; 95% CI, 1.108–3.006), facing monthly financial challenges (OR, 1.627; 95% CI, 1.028–2.575), doing school-related work on holidays (OR, 1.920; 95% CI, 1.180–3.122), and experiencing sleep disturbances owing to work-related stress (OR, 1.910; 95% CI, 1.203– 3.033). No discernible difference existed in SP rates between Thai and foreign teachers.
Conclusion
As a course of action, we recommend the provision of appropriate financial planning resources for teachers. Policywise, school events and activities should be scheduled on working days to ensure that teachers maintain a work-life balance. Additionally, task allocation that caters to individual strengths and limitations can mitigate the effects of SP.

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  • Reflecting on progress and challenges: the Korean Journal of Family Medicine in 2024
    Seung-Won Oh
    Korean Journal of Family Medicine.2025; 46(2): 55.     CrossRef
  • Comprehensive Health Strategies for the Post-pandemic Era: Integrating Physical Health, Psychological Resilience, Lifestyle Choices, and Occupational Well-being
    Su Hwan Cho
    Korean Journal of Family Medicine.2024; 45(6): 303.     CrossRef
  • 2,005 View
  • 70 Download
  • 2 Web of Science
  • 2 Crossref
The Effect of Psychological Resilience on Cognitive Decline in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study
Sunwoo Kim, Chang Won Won, Sunyoung Kim, Jung Ha Park, Miji Kim, Byungsung Kim, Jihae Ryu
Korean J Fam Med 2024;45(6):331-336.   Published online March 25, 2024
DOI: https://doi.org/10.4082/kjfm.23.0145
Background
Chronic stress is associated with an increased risk of cognitive impairment and Alzheimer’s disease. This study aimed to assess whether better coping with stress, as assessed using the Brief Resilience Scale (BRS), is associated with slower cognitive decline in community-dwelling older adults.
Methods
This study used 2018/2019 data and 2-year follow-up data from the Korean Frailty and Aging Cohort Study. Of the 3,014 total participants, we included 1,826 participants (mean age, 77.6±3.7 years, 51.9% female) who completed BRS and Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Battery and the Korean version of the Frontal Assessment Battery (FAB).
Results
Higher BRS score at baseline was associated with a lesser decline in the Mini-Mental State Examination score over 2 years after adjusting for age, sex, years of education, smoking status, hypertension, diabetes, and depression (B, 0.175; 95% confidence interval, 0.025–0.325) for 2 years, which represents global cognitive function. Other cognitive function measurements (Word List Memory, Word List Recall, Word List Recognition, Digit Span, Trail Making Test-A, and FAB) did not change significantly with the BRS score at baseline.
Conclusion
These findings suggest that better stress-coping ability, meaning faster termination of the stress response, may limit the decline in cognitive function.

Citations

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  • The Association between Frailty, Quality of Life and Resilience in Community-dwelling Retirement Village Residents
    Katherine Bloomfield, Zhenqiang Wu, Annie Tatton, Cheryl Calvert, Joanna Hikaka, Michal Boyd, Dale Bramley, Martin J. Connolly
    Journal of the American Medical Directors Association.2024; 25(11): 105256.     CrossRef
  • Comprehensive Health Strategies for the Post-pandemic Era: Integrating Physical Health, Psychological Resilience, Lifestyle Choices, and Occupational Well-being
    Su Hwan Cho
    Korean Journal of Family Medicine.2024; 45(6): 303.     CrossRef
  • 2,548 View
  • 93 Download
  • 3 Web of Science
  • 2 Crossref
Non-Insulin-Based Indices of Insulin Resistance for Predicting Incident Albuminuria: A Nationwide Population-Based Study
Hea Lim Choi, Juyeon Yang, Hye Sun Lee, Ji-Won Lee
Korean J Fam Med 2024;45(6):324-330.   Published online March 25, 2024
DOI: https://doi.org/10.4082/kjfm.23.0138
Background
Studies have shown that incident albuminuria is associated with insulin resistance (IR); however, an IR marker that best predicts the prevalence of albuminuria has not yet been established. This study explored the association between IR and incident albuminuria using various IR indices, including the homeostasis model assessment of IR (HOMA-IR), metabolic score for IR (METS-IR), and triglyceride-glucose (TyG) index, and compared their predictive abilities for the prevalence of albuminuria.
Methods
A total of 4,982 Korean adults from the 2019 Korea National Health and Nutritional Examination Survey were analyzed. The odds of albuminuria were determined using the quartiles of the IR indices. Receiver operating characteristic (ROC) curves were used to calculate the area under the ROC curve and predictability. The cutoff values for albuminuria detection were also computed.
Results
An increase in the quartiles of all three IR indices was associated with incident albuminuria, even after full adjustment for covariates (HOMA-IR: odds ratio [OR], 1.906; 95% confidence interval [CI], 1.311–2.772; P=0.006; METS-IR: OR, 2.236; 95% CI, 1.353–3.694; P=0.002; TyG index: OR, 1.757; 95% CI, 1.213–2.544; P=0.003). The area under the ROC curve for incident albuminuria based on the HOMA-IR, METS-IR, and TyG indices was 0.594 (95% CI, 0.568–0.619), 0.633 (95% CI, 0.607–0.659), and 0.631 (95% CI, 0.606–0.656), respectively. The optimal cutoff values for predicting albuminuria were 2.38, 35.38, and 8.72 for the HOMA-IR, METS-IR, and TyG indices, respectively.
Conclusion
The METS-IR and TyG indices outperformed HOMA-IR in predicting incident albuminuria.

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  • The U-shape relationship between insulin resistance-related indexes and chronic kidney disease: a retrospective cohort study from National Health and Nutrition Examination Survey 2007–2016
    Ruihua Shen, Ling Lin, Zexuan Bin, Xi Qiao
    Diabetology & Metabolic Syndrome.2024;[Epub]     CrossRef
  • 2,370 View
  • 58 Download
  • 1 Web of Science
  • 1 Crossref
Association between Combustible Cigarettes and Noncombustible Nicotine or Tobacco Products and Generalized Anxiety Disorder Based on Data from the 8th Korea National Health and Nutrition Examination Survey 2021
Sungkwon Cho, Joo-Hyun Park, Do-Hoon Kim, Hangseok Choi, Youngdoo Park, Hyun-Jin Kim, An-Na Lee, Junghwa Shin, Jaesun Ha
Korean J Fam Med 2024;45(6):317-323.   Published online March 25, 2024
DOI: https://doi.org/10.4082/kjfm.23.0172
Background
Despite the increasing prevalence of anxiety disorders in Korea, there have been no nationwide studies on the association between tobacco status and generalized anxiety disorder (GAD). Furthermore, despite the increasing number of people using noncombustible nicotine or tobacco products (NNTPs), the association between NNTP use and GAD remains unclear. Therefore, this study investigated the association between tobacco use and GAD.
Methods
This nationwide study used data from the 8th Korea National Health and Nutrition Examination Survey (2021) and included 5,454 adults aged ≥19 years who self-reported on the tobacco use and mental health sections. Multivariable logistic regression analysis was performed to investigate the odds ratios (ORs) of GAD (Generalized Anxiety Disorder-7 score ≥10) according to tobacco status among Korean adults. The severity of anxiety was assessed using the Generalized Anxiety Disorder-7 scale.
Results
Compared to never tobacco users, the ORs of GAD for combustible cigarette smokers and NNTP users were 2.74 (95% confidence interval [CI], 1.66–4.50) and 2.11 (95% CI, 1.16–3.83), respectively. The OR of GAD for former tobacco users was 1.63 (95% CI, 0.98–2.72).
Conclusion
Tobacco use (combustible cigarettes and NNTP) was positively associated with GAD. However, in former tobacco users, there was no significant association with GAD when compared with never tobacco users. Given the OR of GAD among tobacco users, it is crucial to pay attention to screening for GAD and implement appropriate early interventions.

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  • Comprehensive Health Strategies for the Post-pandemic Era: Integrating Physical Health, Psychological Resilience, Lifestyle Choices, and Occupational Well-being
    Su Hwan Cho
    Korean Journal of Family Medicine.2024; 45(6): 303.     CrossRef
  • 3,033 View
  • 117 Download
  • 1 Crossref
Review Article
Long COVID: A Comprehensive Overview of the Signs and Symptoms across Multiple Organ Systems
Zachary Isaac Merhavy, Tiana Junor, Aranice Gonzalez, Samantha Michelle De Filippis, Sarah Oveisitork, Eliu Rivera, Ifeanyi Ndukwu, Kanika Bhatara
Korean J Fam Med 2024;45(6):305-316.   Published online November 20, 2024
DOI: https://doi.org/10.4082/kjfm.24.0085
Long coronavirus disease (COVID), also known as the post-acute sequelae of coronavirus disease 2019 (COVID-19) (PASC), is a significant concern since the end of the COVID-19 pandemic, as it still manifests in individuals with persistent symptoms and complications beyond the acute phase of infection. Defining this disease is challenging, as it manifests as a spectrum of symptoms varying in severity among individuals who have previously tested positive for COVID-19. Long COVID is more prevalent in hospitalized COVID-19 patients and presents in various ways, ranging from pulmonary to extrapulmonary symptoms. This literature review examines the current body of research on long COVID with a focus on its effects on the cardiovascular, hematological, respiratory, renal, and neurological systems with systematically analyzed, peer-reviewed articles retrieved from the PubMed database. There have been several proposed pathophysiological mechanisms by which severe acute respiratory syndrome coronavirus 2 affects the aforementioned organ systems; however, research on the definite mechanisms is lacking, especially when considering the management of long COVID in the perioperative setting. The impact of post-COVID sequelae necessitates individualized management strategies tailored to each symptomatic profile, particularly in patients with comorbidities. The COVID-19 pandemic affected millions of people and had a profound impact on those who developed PASC, lowering their quality of life and increasing potential surgical risks. However, there is still uncertainty regarding the specific risk factors for long COVID and who is most susceptible to it. Further research is required to fill these gaps and explore potential avenues for preventing PASC.

Citations

Citations to this article as recorded by  
  • Reflecting on progress and challenges: the Korean Journal of Family Medicine in 2024
    Seung-Won Oh
    Korean Journal of Family Medicine.2025; 46(2): 55.     CrossRef
  • The Development and Initial Validation of the Memorial Symptom Assessment Scale-Long COVID (MSAS-LC): A Promising Tool for Measuring Long COVID
    Sadie B. Sommer, Mary S. Dietrich, Julie V. Barroso
    International Journal of Environmental Research and Public Health.2025; 22(5): 728.     CrossRef
  • Comprehensive Health Strategies for the Post-pandemic Era: Integrating Physical Health, Psychological Resilience, Lifestyle Choices, and Occupational Well-being
    Su Hwan Cho
    Korean Journal of Family Medicine.2024; 45(6): 303.     CrossRef
  • 1,874 View
  • 49 Download
  • 1 Web of Science
  • 3 Crossref
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