Factors increasing the risk for psychosocial stress among Korean adults living in rural areas: using generalized estimating equations and mixed models

Using Wake-Up Tasks for Morning Behavior Change: Development and Usability Study

Background

Early morning behaviors between waking up and beginning daily work can develop into productive habits. However, sleep inertia limits the level of human ability immediately after waking, lowering a person’s motivation and available time for productive morning behavior.

Objective

This study explores a design for morning behavior change using a wake-up task, a simple assignment the user needs to finish before alarm dismissal. Specifically, we set two research objectives: (1) exploring key factors that relate to morning behavior performance, including the use of wake-up tasks in an alarm app and (2) understanding the general practice of affecting morning behavior change by implementing wake-up tasks.

Methods

We designed and implemented an apparatus that provides wake-up task alarms and facilities for squat exercises. We recruited 36 participants to perform squat exercises in the early morning using the wake-up tasks for 2 weeks. First, we conducted a generalized estimating equation (GEE) analysis for the first research objective. Next, we conducted a thematic analysis of the postsurvey answers to identify key themes about morning behavior change with the wake-up tasks for the second objective.

Results

The use of wake-up tasks was significantly associated with both the completion of the target behavior (math task: P=.005; picture task: P<.001) and the elapsed time (picture task: P=.08); the time to alarm dismissal was significantly related to the elapsed time to completion (P<.001). Moreover, the theory of planned behavior (TPB) variables, common factors for behavior change, were significant, but their magnitudes and directions differed slightly from the other domains. Furthermore, the survey results reveal how the participants used the wake-up tasks and why they were effective for morning behavior performance.

Conclusions

The results reveal the effectiveness of wake-up tasks in accomplishing the target morning behavior and address key factors for morning behavior change, such as (1) waking up on time, (2) escaping from sleep inertia, and (3) quickly starting the desired target behavior.

Correlation of physical fitness with psychological well-being, stress, and depression in Korean adults

The purpose of this study was to examine the relationship between physical fitness and psychological well-being, stress, and depression in Korean adults. Participants were 160 adults aged 40-70 years living in the metropolitan area of Incheon. Results were collected from random sample of main measurements from Incheon fitness center of National Fitness Award Project (2019). We assessed participants using physical fitness test (national fitness award), Psychosocial well-being index short form, Perceived Stress Scale, Geriatric Depression Scale. The data were analyzed Pearson and Spearman rank correlation analysis, and linear was conducted using IBM SPSS Statistics ver. 25.0. The re-sults indicated there were statistically significant associations between psychological well-being and agility, quick response; stress and flexibil-ity; depression and strength endurance strength, body fat. In addition, analysis showed that strength, endurance strength, body fat of physical fitness factors could significantly predict depression, flexibility could significantly predict stress, agility and quick response could significant-ly predict psychological well-being.

Mild sleep restriction increases 24-hour ambulatory blood pressure in premenopausal women with no indication of mediation by psychological effects

BACKGROUND

Studies assessing the impact of sleep restriction (SR) on blood pressure (BP) are limited by short study length, extreme SR (<4 hours a night), and lack of attention to psychological distress as a possible mediator.

METHODS

A community-based cohort was assembled with 237 women (age 34.1 ± 13.5 years; body mass index 25.4 ± 5.4 kg/m²), and a randomized, crossover, intervention study was conducted in 41 women (24 completed: age 30.2 ± 6.5 years; body mass index 24.3 ± 2.8 kg/m²) to determine the causal effect of SR on BP. Sleep was maintained as usual (HS) or reduced by 1.5 hours a night (SR) for 6 weeks. In the cohort, associations between sleep and psychosocial factors were evaluated using multivariable models adjusted for demographic and clinical confounders. In the intervention study, in-office BP was measured weekly; ambulatory BP was measured at end point. Psychological factors were assessed at baseline and end point. Mixed-model analyses with total sleep time (TST, main predictor), week and fraction of time spent in physical activity (covariates), and subject (random effect) were performed.

RESULTS

Among the community cohort, higher perceived stress, stressful events and distress, and lower resilience were associated with shorter sleep, worse sleep quality, and greater insomnia symptoms (P < .05). In the intervention, systolic BP increased as TST decreased (TST × week interaction, [coefficient ± standard error] -0.0097 ± 0.0046, P = .036). Wake ambulatory diastolic blood pressure (-0.059 ± 0.022, P = .021) and mean arterial pressure (-0.067 ± 0.023, P = .018) were higher after SR versus HS. Psychological distress variables were not affected by TST and did not mediate the effects of SR on BP.

CONCLUSIONS

These results suggest that SR influences CVD risk in women via mechanisms independent of psychological stressors.

Difference in health status of Korean farmers according to gender

Background

The objective of this study was to compare differences in lifestyle diseases, musculoskeletal pain, psychosocial stress, and self-health awareness according to gender in Korean farmers.

Methods

The study population comprised 436 farmers residing in rural areas in Korea. A self-administered questionnaire was used to survey demographic characteristics, health-related behaviors, and musculoskeletal pain. The psychosocial well-being index short form (PWI-SF) was used to survey psychosocial stress, and the 12-item short form health survey (SF-12) was used to survey self-health awareness. In addition, a clinical examination was performed for each participant, and lifestyle diseases were identified through a health checkup.

Results

Among lifestyle diseases, females showed a significantly higher proportion than males for metabolic syndrome (OR: 4.57 [95% CI, 1.67-12.51]). For musculoskeletal pain, females again showed significantly higher proportion than males for hand pain (OR: 16.79 [95% CI, 3.09-91.30]), and pain in at least one body part (OR: 2.34 [95% CI, 1.16-4.70]). For psychosocial stress, females showed a significantly higher proportion than males for high-risk stress (OR: 3.10 [95% CI, 1.17-8.24]). Among the items in self-health awareness, females showed significantly higher proportion than males for mental component score (MCS) (OR: 3.10 [95% CI, 1.52-6.31]) and total score (OR: 2.34 [95% CI, 1.11-4.90]).

Conclusions

For all items that showed significant differences, females showed higher proportion than males, which indicates that female farmers tended to have poorer overall health than male farmers. Therefore, specialized programs will have to be developed to improve the health of female farmers.

Stress: Prevalence and correlates among residents of a suburban area

BACKGROUND AND OBJECTIVES

Stress is a major concern in the present scenario as it is occurring in a big way involving all age groups. The objectives of this study were estimating the prevalence of stress, assessing the associated stress factors, and symptoms of stress among residents of suburban community.

MATERIALS AND METHODS

The community-based cross-sectional study was conducted in a suburban area in Delhi from June to August 2017. Adults and children aged 14 years and above permanently residing (1 year or more) in the area were included in the study. A sample size of 384 was calculated with the alpha error set to 05% and absolute error 05%, and to cater for refusals, a total of 400 participants were approached. A structured questionnaire was used for the study by interview method. To estimate the prevalence of stress, a standardized scale, depression, anxiety, and stress scale 21 was used.

RESULTS

The mean age of the participants in the study was 36.31 (±15.10), with 51.2% of males and 48.8% of females. Among the children, the leading factors associated with stress were studies (41.2%), poverty (22.1%), and competitions (16.2%). Among the adults, the leading factors were financial problems (35.2%) and children's studies (23.1%). The most common reported somatic symptom during stress was headache (59.8%) and psychological symptom was "unable to sleep" (47.5%). The prevalence of stress was 26% in a subset of sample in this study. There was a statistically significant association of stress with family size, the level of stress decreased with an increase in family size.

CONCLUSION

The study emphasizes the need for effective prevention and management of stress in the community and schools.