1
|
Yoon CG, Jung J, Yoon JH, Lee D, Jeon H, Lee SY. How Is the Suicide Ideation in the Korean Armed Forces Affected by Mental Illness, Traumatic Events, and Social Support? J Korean Med Sci 2021; 36:e96. [PMID: 33876585 PMCID: PMC8055514 DOI: 10.3346/jkms.2021.36.e96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/29/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Suicide is one of the leading causes of death in the military as in the general population. To mitigate such a serious public health problem, identifying the risk or protective factors of suicide behaviors is crucial. METHODS We analyzed the representative data of the 2014 Korean Armed Forces to explore the relationship between past year adverse events (PAE), accumulated lifetime trauma (ALT), mental illness vulnerability, perceived social support, and suicidal ideation in the previous year. RESULTS Among the 6,377 subjects, 3.7% of males and 6.2% of females reported suicidal ideation in the previous year. Multivariate analytic models identified significant associations of PAE and ALT with suicidal ideation with a dose-response pattern. The mental illness vulnerability showed the most significant association with suicidal ideation even after controlling PAE or ALT. We found that perceived social support may be potentially linked with a reduced risk of suicidal ideation. CONCLUSION This Korean military representative data demonstrates mental illness vulnerability; PAE; and lifetime trauma as significant risk factors of suicidal ideation, while perceived social support was found as a potential protective factor. Given the importance of the prevention of suicide in the military, those risk and protective factors may be used to screen soldiers at risk of suicide and provide further support on mental health services as needed.
Collapse
Affiliation(s)
- Chang Gyo Yoon
- Department of Preventive Medicine, Armed Forces Medical Command, Seongnam, Korea
- Preventive Medicine Program, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Jaehun Jung
- Department of Preventive Medicine, Armed Forces Medical Command, Seongnam, Korea
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Jin Ha Yoon
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dawon Lee
- Department of Psychiatry, Armed Forces Capital Hospital, Seongnam, Korea
- Geumcheon Kidari Mental Clinic, Seoul, Korea
| | - Hankaram Jeon
- Department of Psychiatry, Armed Forces Guri Hospital, Armed Forces Medical Command, Guri, Korea
| | - Seung Yup Lee
- Department of Psychiatry, Armed Forces Capital Hospital, Seongnam, Korea
- Department of Psychiatry, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| |
Collapse
|
2
|
Bae E, Park J, Jung E. Unmet Healthcare Needs and Associated Factors Among Korean Enlisted Soldiers. Mil Med 2020; 186:e186-e193. [PMID: 33128566 DOI: 10.1093/milmed/usaa235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/17/2020] [Accepted: 08/17/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The purpose of this study was to explore the rate of unmet healthcare needs among Korean enlisted soldiers and to examine the factors associated with unmet healthcare needs, based on Andersen's Health Service Behavior Model. METHOD This study employed secondary data analysis using the dataset of the military health survey for two years, 2014 and 2015, conducted by the Republic of Korea School of Military Medicine. Of all military health survey participants, 3,636 enlisted soldiers who answered the question "In the last year, have you ever been unable to go to a hospital or a clinic when you wanted to go to a hospital or a clinic?"-the dependent variable in this study-were included in this study. RESULT The rate of unmet healthcare needs among Korean enlisted soldiers was 23.7% (n = 860) in the current study. Among the individual characteristics, on-duty stress (Odds ratio (OR) = 1.59, 95% Confidence Interval (95% CI): 1.25-2.03) and need for treatment by a mental health specialist (OR = 1.40, 95% Confidence Interval (CI): 1.00-1.95) were associated with unmet healthcare needs. Among the contextual characteristics, perception of injury-prevention effort (OR = 0.61, 95% CI: 0.52-0.71), support from superiors (OR = 0.81, 95% CI: 0.71-0.93), and possibility of accident or injury of military unit (OR = 0.73, 95% CI: 0.64-0.82) were significant factors associated with unmet healthcare needs. The subjective health condition which was a proxy of the health outcome was significantly associated with unmet healthcare needs (OR = 1.58, 95% CI: 1.13-2.22). The results indicate that the safety awareness of troops and social support of superiors were the contextual military characteristics associated with unmet healthcare needs of enlisted soldiers. CONCLUSIONS The strengthening of aspect of organizational culture, such as injury-prevention efforts at the military level, or support from superior officers, will contribute to a reduction of the unmet healthcare needs of Korean enlisted soldiers.
Collapse
Affiliation(s)
- Eunkyoung Bae
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Jeongok Park
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Eunyoung Jung
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| |
Collapse
|
3
|
Kim HJ, Oh SSY, Choi DW, Won SY, Kim HJ, Ko SC, Jang SI, Park EC. Annual Disease Experience by Type and Correlations with Unmet Healthcare Needs among ROK Military Personnel. Mil Med 2020; 185:e944-e951. [PMID: 32420603 PMCID: PMC7427660 DOI: 10.1093/milmed/usz458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 11/06/2019] [Indexed: 11/30/2022] Open
Abstract
Introduction The National Statistical Yearbook of Defense 2018 issued by the Republic of Korea (ROK) Ministry of National Defense reported that the number of patients using military hospitals steadily increased from 2008 to 2017. However, in the outpatient clinic statistics for years 2015–2017 from the ROK Armed Forces Medical Command, the amount of medical care received from some medical departments, such as the infection medicine, surgery, and anesthesiology departments, decreased. Therefore, the purpose of this study was to observe the differences in incidence of military personnel’s unmet healthcare needs according to number of diseases by type. Materials and Methods The study used data from the Military Health Survey, which was conducted from 2014 to 2015 and included 5162 responses from ROK military personnel. The number of diseases by type and unmet healthcare needs were self-reported. A multiple logistic regression analysis was used to examine the validity of the annual disease experience by type and correlations with unmet healthcare needs. Results Of the 5162 military personnel, 25.2% experienced unmet healthcare needs, and the more people with the number of disease by type, the more likely they were to experience unmet healthcare needs (1: 13.4%, 2: 22.9%, 3: 29.2%, 4: 34.5%, 5: 41.4%). The logistic regression analysis also revealed significant differences (1 = REF, 2 odds ratio (OR) = 1.83, 95% confidence interval (CI): 1.50–2.24; 3 OR = 2.53, 95% CI: 2.05–3.11, 4 OR = 3.10, 95% CI = 2.49–3.85; ≥5 OR = 3.85, 95% CI = 3.08–4.81). In addition, subgroup analysis showed that female military personnel are more likely to experience unmet healthcare needs than are male military personnel. We have also confirmed that working areas and private insurance can affect unmet healthcare needs. Conclusion This study suggests that unmet healthcare needs are influenced by the number of disease by the type of ROK military personnel. It is therefore necessary to strive to reduce the number of military personnel who experience unmet healthcare needs through this data.
Collapse
Affiliation(s)
- Hwi Jun Kim
- Department of Public Health, Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.,Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.,Army Cadet Military School, Training & Doctrine Command, Republic of Korea Army, 177 Munmu-ro, Goesan, Republic of Korea
| | - Sarah So Yeon Oh
- Department of Public Health, Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.,Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Dong Woo Choi
- Department of Public Health, Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.,Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Sun Yeong Won
- Department of Logistic's Management, Ministry of National Defense, 22 Itaewon-ro, Yongsan-gu, Seoul, Republic of Korea
| | - Hae Jung Kim
- Department of Medical, Second Operational Command, Republic of Korea Army, Muyeol-ro, Suseong-gu, Daegu, Republic of Korea
| | - Sung Chan Ko
- Armed Forces Medical School, Ministry of National Defense, 78-501 Jaun-ro, Yuseong-gu, Daejeon, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| |
Collapse
|
4
|
Lee BN, Bae SW, Oh SY, Yoon JH, Roh J, Won JU. Effects of military life on changes in body mass index of enlisted men: a cross-sectional study. BMJ Mil Health 2020; 168:218-223. [PMID: 32409616 PMCID: PMC9132859 DOI: 10.1136/bmjmilitary-2019-001401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/02/2020] [Accepted: 04/02/2020] [Indexed: 12/02/2022]
Abstract
Background Obesity is a serious health problem with an incidence that is increasing rapidly. Enlisted men are a distinctive group characterised by 24-hour community-living and are likely to experience changes in body weight as a result of regular diet and exercise during enlistment. Methods This study reviewed data from the Second Military Health Survey. Changes in body mass index (BMI) before and during military service were analysed using paired t-test. We calculated OR and 95% CI for factors affecting weight improvement during military service through logistic regression. Results The mean BMI in the underweight group increased by 5.87 kg/m2 during service, while that in the normal weight group increased by 1.18 kg/m2. In contrast, the mean BMI in the overweight group decreased by 5.47 kg/m2 during service. The OR for an improved BMI in the subjective good health group compared with the subjective poor health group was statistically significant (OR=1.71, 95% CI 1.02 to 2.87). The OR for an improved BMI was significantly higher in the group with three or more times per week of strength training than in the group with one to two times per week of strength training, and was higher among the marines compared with the Army soldiers (OR=1.48, 95% CI 1.03 to 2.12 and OR=2.15, 95% CI 1.07 to 4.32, respectively). Conclusions Strength training showed a statistically significant increase in BMI during military service. Furthermore, the BMI of men who were underweight before their service increased, while it decreased among those who were overweight.
Collapse
Affiliation(s)
- Bb Ni Lee
- Department of Public Health, Graduate School, Yonsei University, Seodaemun-gu, Seoul, The Republic of Korea
| | - S W Bae
- Department of Public Health, Graduate School, Yonsei University, Seodaemun-gu, Seoul, The Republic of Korea
| | - S Y Oh
- Department of Public Health, Graduate School, Yonsei University, Seodaemun-gu, Seoul, The Republic of Korea
| | - J H Yoon
- Department of Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, The Republic of Korea
| | - J Roh
- Department of Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, The Republic of Korea
| | - J U Won
- Department of Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, The Republic of Korea
| |
Collapse
|