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Yuhjin Chung 2 Articles
Relationship Between Shift Intensity and Insomnia Among Hospital Nurses in Korea: A Cross-sectional Study
Yuhjin Chung, Hyunjoo Kim, Dong-Hee Koh, Ju-Hyun Park, Seohyun Yoon
J Prev Med Public Health. 2021;54(1):46-54.   Published online December 22, 2020
  • 3,903 View
  • 203 Download
  • 6 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
This study explored the relationship between shift intensity and insomnia among hospital nurses.
The participants were 386 female hospital nurses who underwent a special health examination for night workers in 2015. The Korean Insomnia Severity Index (ISI), indices of shift work intensity, and other covariates such as amount of exercise, level of alcohol consumption, employment duration, and hours worked were extracted from the health examination data. The indices for shift intensity were (1) number of 3 consecutive night shifts and (2) number of short recovery periods after a previous shift, both assessed over the prior 3 months. Multiple logistic regression analysis adjusted for the aforementioned covariates was performed to evaluate the association of shift intensity with insomnia, defined as an ISI score of ≥8.
The nurses with insomnia tended to be younger (p=0.029), to have worked 3 consecutive night shifts more frequently (p<0.001), to have experienced a greater number of short recovery periods after the previous shift (p=0.021), and to have worked for more hours (p=0.006) than the nurses without insomnia. Among the other variables, no statistically significant differences between groups were observed. Experiences of 3 or more consecutive night shifts (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.29 to 4.20) and 3 or more short recovery periods (OR, 2.01; 95% CI, 1.08 to 3.73) were associated with increased odds of insomnia.
The results suggest that decreasing the shift intensity may reduce insomnia among hospital nurses working rotating shifts.
Korean summary
불면증상의 척도로서 ‘한국판 불면증 심각도 평가척도’를, 교대근무강도의 지표로서 지난 3개월 간의 ‘3회 연속 야간근무 횟수’와 ‘교대근무 이후 짧은 휴식기간’을 사용하여, 대학병원 야간 근무 간호사 386명의 불면증상과 교대근무강도 간의 연관성을 탐색하고자 하였다. 로지스틱 회귀분석 결과, ‘3회 연속 야간근무 횟수’와 ‘교대근무 이후 짧은 휴식기간’은 불면증상의 오즈비 증가와 관련이 있었다. 이 결과는 교대근무강도를 저하시켜야 순환 교대근무 병원 간호사들의 불면증상을 줄일 수 있음을 시사한다.


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Effects of the Out-of-pocket Payment Exemption in the Public Health Center on Medical Utilization of the Korean Elderly
Kiryong Nam, Eunhye Park, Yuhjin Chung, Chang-yup Kim
J Prev Med Public Health. 2020;53(6):455-464.   Published online October 20, 2020
  • 2,956 View
  • 130 Download
AbstractAbstract PDF
The distribution of hospitals in Korea is unbalanced in terms of accessibility. Many local public health centers (PHCs) exempt out-of-pocket payments (OOPs) based on local government laws to increase coverage. However, this varies across administrative regions, as many make this exemption for the elderly, while others do not. This study aimed to evaluate the effects of the OOP exemption at local PHCs among elderly individuals.
This study used online data on Korean national law to gather information on individual local governments’ regulations regarding OOP exemptions. Individual-level data were gathered from the 2018 Community Health Survey and regional-level data from public online sources.
The study analyzed 132 regions and 44 918 elderly people. A statistical analysis of rate differences and 2-level multiple logistic regression were carried out. The rate difference according to whether elderly individuals resided in areas with the OOP exemption was 1.97%p (95% confidence interval [CI], 1.07 to 2.88) for PHC utilization, 1.37%p (95% CI, 0.67 to 2.08) for hypertension treatment, and 2.19%p (95% CI, 0.63 to 3.74) for diabetes treatment. The regression analysis showed that OOP exemption had an effect on hypertension treatment, with a fixed-effect odds ratio of 1.25 (95% CI, 1.05 to 1.48).
The OOP exemption at PHCs can affect medical utilization in Korea, especially for hypertension treatment. The OOP exemption should be expanded to improve healthcare utilization in Korea.

JPMPH : Journal of Preventive Medicine and Public Health