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Original Article
Determinants of unhealthy living by gender, age group, and chronic health conditions across districts in Korea using the 2010-2017 Community Health Surveys
Thi Tra Bui, Thi Huyen Trang Nguyen, Jinhee Lee, Sun Young Kim, Jin-Kyoung Oh
Epidemiol Health. 2024;46:e2024014.   Published online January 4, 2024
DOI: https://doi.org/10.4178/epih.e2024014
  • 2,642 View
  • 76 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated the prevalence and determinants of unhealthy living by gender, age, and comorbidities across Korean districts.
METHODS
For 806,246 men and 923,260 women from 245 districts who participated in the 2010-2017 Korean Community Health Surveys, risk scores were calculated based on obesity, physical inactivity, smoking, and high-risk alcohol consumption, each scored from 0 (lowest risk) to 2 (highest risk). A risk score ≥4 was defined as indicating unhealthy living, and weighted proportions were calculated for each district. Using multivariate regression, an ecological model including community socioeconomic, interpersonal, and neighborhood factors was examined by gender, age, and comorbidities.
RESULTS
The mean age-standardized rate of unhealthy living was 24.05% for men and 4.91% for women (coefficients of variation, 13.94% and 29.51%, respectively). Individuals with chronic diseases more frequently exhibited unhealthy lifestyles. Unhealthy lifestyles were associated with educational attainment (β-coefficients: men, -0.21; women, -0.15), high household income (β=0.08 and 0.03, respectively), pub density (β=0.52 and 0.22, respectively), and fast-food outlet density (β=2.81 and 1.63, respectively). Negative associations were observed with manual labor, social activity participation, and hospital bed density. Unhealthy living was positively associated with living alone among women and with being unemployed among middle-aged men. Access to parks was negatively associated with unhealthy living among young men and women. The ecological model explained 32% of regional variation in men and 41% in women.
CONCLUSIONS
Improving the neighborhood built and socioeconomic environment may reduce regional disparities in lifestyle behaviors; however, the impacts may vary according to socio-demographic traits and comorbidities.
Summary
Korean summary
- 시군구 지역단위의 불건강생활(흡연, 음주, 비만, 신체활동 부족 각 0-2점, 합 4점 이상 불건강) 유병률은 여자보다 남자에서 높고, 연령이 높아지면서 감소한다. - 지역사회 환경개선(술집 개수, 패스트푸드점 밀도, 공원 면적, 병상밀도)과 사회경제적 수준 강화(교육수준, 가구소득, 고용)를 통해 생활습관적 건강행태의 지역 격차를 줄일 수 있다. - 이러한 향상 노력의 효과는 지역의 건강상태 수준이나 사회인구학적 특성에 따라 다를 수 있다.
Key Message
• District prevalence rates of unhealthy living were higher among men than women and decreased with advancing age. • Efforts to reduce regional disparities in lifestyle behaviors could benefit from enhancements to the neighborhood environment and the socioeconomic status of the area. • The effectiveness of such improvements may vary based on socio-demographic characteristics and health conditions.
COVID-19: Special Article
Changes in mental health of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior Survey
Bomi Park, Jihee Kim, Jieun Yang, Sunhye Choi, Kyungwon Oh
Epidemiol Health. 2023;45:e2023019.   Published online February 14, 2023
DOI: https://doi.org/10.4178/epih.e2023019
  • 6,927 View
  • 360 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to study the effects of the coronavirus disease 2019 (COVID-19) pandemic on adolescents’ mental health in Korea.
METHODS
We used data from the Korea Youth Risk Behavior Survey 2018-2021 with 227,139 students aged 12-18 years. We estimated the differences in depressive symptoms, suicidal ideation, and stress perception before (2018-2019) and during (2020-2021) the pandemic, as well as before (2019), the first year (2020) of, and the second year (2021) of the pandemic. We also examined whether COVID-19 is statistically associated with mental health.
RESULTS
In both male and female adolescents, the prevalence of depressive symptoms, suicidal ideation, and stress perception was higher in the “not living with family,” “low household economic status,” and “self-rated unhealthy status” subgroups. The prevalence of depressive symptoms and stress perception was higher in middle school students. Adolescents were less likely to experience depressive symptoms (adjusted odds ratio [aOR], 0.86; 95% confidence interval [CI], 0.83 to 0.89), suicidal ideation (aOR, 0.80; 95% CI, 0.76 to 0.83), and stress perception (aOR, 0.76; 95% CI, 0.74 to 0.79) in 2020 than in 2019. However, there were more depressive symptoms (aOR, 1.06; 95% CI, 1.02 to 1.09), suicidal ideation (aOR, 1.15; 95% CI, 1.10 to 1.21), and stress perception (aOR, 1.19; 95% CI, 1.16 to 1.23) in 2021 than in 2020.
CONCLUSIONS
The COVID-19 pandemic had positive impacts on mental health of adolescents in its early stages but has had negative impacts as the pandemic continues. Attention should be paid to adolescents who are particularly vulnerable to the mental health effects of the pandemic.
Summary
Korean summary
The results from a nationally representative data showed that mental health in adolescents was improved in the first year of the COVID-19 pandemic compared to before the COVID-19 pandemic, but it was deteriorated in the second year of the pandemic compared to the first year.
Key Message
본 연구에서는 대규모 건강조사를 이용하여 코로나19가 장기화됨에 따른 영향을 평가하고자 하였다. 2018년-2021년 청소년건강행태조사에 참여한 만 12-18세 청소년 227,139 명을 대상으로 분석한 결과, 코로나19 유행 첫번째 해(2020년)에는 코로나19 유행 이전에 비해 정신건강이 개선되었으나, 코로나19 유행 두 번째 해(2021년)에는 코로나19 유행 첫 번째 해에 비해 청소년 정신건강이 나빠졌다. 또한 가족과 함께 거주하지 않는 경우, 가정 경제 수준이 낮은 경우, 본인이 건강하지 않다고 인지하는 경우에 더 취약하였다.

Citations

Citations to this article as recorded by  
  • Excess mortality during the Coronavirus disease pandemic in Korea
    Changwoo Han, Hoyeon Jang, Juhwan Oh
    BMC Public Health.2023;[Epub]     CrossRef
  • A Comparison of Changes in Health Behavior, Obesity, and Mental Health of Korean Adolescents Before and During the COVID-19 Pandemic: Online Cross-Sectional Study
    Mi-Sun Lee, Hooyeon Lee
    Psychiatry Investigation.2023; 20(11): 1086.     CrossRef
COVID-19: Special Article
Changes in health behaviors and obesity of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior Survey
Chang-Mo Oh, Yangha Kim, Jieun Yang, Sunhye Choi, Kyungwon Oh
Epidemiol Health. 2023;45:e2023018.   Published online February 14, 2023
DOI: https://doi.org/10.4178/epih.e2023018
  • 7,754 View
  • 340 Download
  • 4 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to investigate changes in health behaviors, including cigarette smoking, alcohol drinking, physical activity, dietary behaviors, and obesity, before and during the coronavirus disease 2019 (COVID-19) pandemic using the Korea Youth Risk Behavior Survey (KYRBS) database.
METHODS
KYRBS data from 2015 to 2021 were used in this study. Differences in health behaviors between before (pre-pandemic period: 2018-2019) and during (pandemic period: 2020-2021) the pandemic were examined. Differences were compared using linear regression and the chi-square test considering the complex survey design after adjusting for grade level.
RESULTS
The prevalence of current cigarette smoking and current alcohol drinking significantly decreased in both male and female students during the pandemic compared to the pre-pandemic period. However, the prevalence of obesity significantly increased in both male and female students during the same period. When examining physical activity and dietary behaviors closely related to obesity, fast food consumption increased and fruit consumption decreased during the pandemic in both male and female students, whereas no significant changes in physical activity were observed in either male or female students.
CONCLUSIONS
The deterioration of adolescent dietary behaviors and an increase in the prevalence of obesity can increase the future disease burden, and concerted efforts at the individual and national levels are needed to reduce obesity and promote healthy dietary behaviors.
Summary
Korean summary
이 연구는 한국 청소년건강행태조사자료(KYRBS)를 사용하여 코로나19 유행 전후의 우리나라 청소년들의 흡연, 음주, 신체활동, 식습관, 비만 등의 건강행태의 변화에 대하여 살펴보고자 하였다. 이 연구에서는 2015년부터 2021년까지의 청소년건강행태조사자료를 사용하여, 코로나19 유행 이전 (2018-2019년)과 코로나 유행 이후 (2020-2021년) 기간의 건강행태의 변화에 대하여 조사하였다. 학년레벨을 보정한 후, 복합표본설계를 고려하여 로지스틱 회귀분석과 카이제곱검정을 이용하여 코로나19 유행 이전 (2018-2019년)과 비교하여, 코로나 유행 이후 (2020-2021년) 기간의 건강행태의 변화가 있었는지에 대하여 확인하였다. 그 결과, 코로나19 유행 이전 (2018-2019년)과 비교하여, 코로나19 유행 기간(2020-2021년) 동안에 현재흡연율과 현재음주율이 유의하게 감소하였다. 그러나 동일한 기간 동안에 남학생과 여학생 모두에서 비만율이 유의하게 증가하였는데, 비만율과 관련된 신체활동 및 식습관에 대하여 살펴보았을 때, 신체활동에서는 유의한 변화가 없었던 반면, 남학생과 여학생 모두에서 패스트푸드 섭취는 증가하고 과일섭취가 감소한 것으로 나타났다. 따라서 코로나19 유행기간 동안 흡연율 및 음주율 등의 청소년 건강에 유익한 변화도 있었으나, 비만율도 같이 증가한 것을 확인할 수 있었다. 청소년기의 식습관의 악화 및 비만율의 증가는 미래 우리나라의 질병부담을 증가시킬 수 있기 때문에, 청소년의 비만율을 낮추고 건강한 식습관을 증진시키기 위한 개인 및 사회 차원의 노력이 필요하다.
Key Message
-The current cigarette smoking and current alcohol drinking rates significantly decreased among Korean adolescents during the pandemic period compared to the pre-pandemic period. -On the other hand, the obesity rate increased significantly especially among Korean male adolescents, which is accompanied by changes in dietary habits such as an increase in fast food intake and a decrease in fruit intake.

Citations

Citations to this article as recorded by  
  • Changes in Adolescent Health Behavior and the Exacerbation of Economic Hardship During the COVID-19 Pandemic: A Cross-sectional Study From the Korea Youth Risk Behavior Survey
    Chaeeun Kim, Haeun Lee, Kyunghee Jung-Choi, Hyesook Park
    Journal of Preventive Medicine and Public Health.2024; 57(1): 18.     CrossRef
  • Effects of changes in daily life attributed to COVID-19 on allergic diseases among Korean adolescents
    Miso Park, Mi Ah Han, Jong Park, Seong Woo Choi
    Journal of Asthma.2024; : 1.     CrossRef
  • Exploring Disparities for Obesity in Korea Using Hierarchical Age-Period-Cohort Analysis With Cross-Classified Random Effect Models
    Chang Kyun Choi, Jung-Ho Yang, Sun-Seog Kweon, Min-Ho Shin
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Association of parental depression with adolescent children’s psychological well-being and health behaviors
    Sung-In Kim, Sung Min Kim, Sun Jae Park, Jihun Song, Jaewon Lee, Kyae Hyung Kim, Sang Min Park
    BMC Public Health.2024;[Epub]     CrossRef
  • A Comparison of Changes in Health Behavior, Obesity, and Mental Health of Korean Adolescents Before and During the COVID-19 Pandemic: Online Cross-Sectional Study
    Mi-Sun Lee, Hooyeon Lee
    Psychiatry Investigation.2023; 20(11): 1086.     CrossRef
Original Articles
Socio-demographic inequalities in the uptake of Papanicolaou tests in Peru: analysis of the 2015-2017 Demographic and Family Health Survey
Antonio Barrenechea-Pulache, Emmanuel Avila-Jove, Akram Hernández-Vásquez, Fernando M. Runzer-Colmenares
Epidemiol Health. 2020;42:e2020043.   Published online June 18, 2020
DOI: https://doi.org/10.4178/epih.e2020043
  • 13,508 View
  • 191 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
This study was conducted to analyze the inequalities in Papanicolaou test (also referred to as the Pap smear) uptake according to the socio-demographic characteristics of Peruvian women 30 years to 59 years of age using information from the 2015-2017 Demographic and Family Health Survey (ENDES, acronym in Spanish).
METHODS
This is an analytical, cross-sectional study based on information acquired from the 2015-2017 ENDES surveys. Socio-demographic characteristics were reported using absolute frequencies and weighted proportions with 95% confidence intervals, considering results with a p-value <0.05 as statistically significant. Concentration curves (CCs) and concentration indices (IndCs) were created based on the interaction of the wealth index and uptake of Pap smears, taking into account the different characteristics of the population studied for the measure of inequalities.
RESULTS
All the CCs were distributed below the line of equality. Similarly, all the IndCs were higher than zero, indicating inequality in the uptake of Pap smears, favoring those with a higher wealth index. The highest IndC values were obtained from women aged 50-59 (IndC, 0.293), those who lived in the jungle (IndC, 0.230), and those without health insurance (IndC, 0.173).
CONCLUSIONS
We found socio-demographic inequalities in the uptake of Pap smears in Peru, favoring women with a higher wealth index. More funding is needed to promote cervical cancer screening programs and to create systems that ensure equal access to healthcare in Peru.
Summary

Citations

Citations to this article as recorded by  
  • Socioeconomic disparities in Papanicolaou test utilization in Western Iran
    Bahare Safari-Faramani, Roya Safari-Faramani, Farid Najafi, Davoud Khorasani Zavareh, Ali Kazemi Karyani, Mitra Darbandi
    BMC Public Health.2024;[Epub]     CrossRef
  • Reasons for never receiving a pap test among Brazilian women: National health survey
    Claudia Fernandes Rodrigues, José Victor Afonso Coutinho, Camila Drumond Muzi, Raphael Mendonça Guimarães
    Public Health Nursing.2021; 38(6): 963.     CrossRef
Determinants of early initiation of breastfeeding in Peru: analysis of the 2018 Demographic and Family Health Survey
Akram Hernández-Vásquez, Horacio Chacón-Torrico
Epidemiol Health. 2019;41:e2019051.   Published online December 25, 2019
DOI: https://doi.org/10.4178/epih.e2019051
  • 13,739 View
  • 285 Download
  • 7 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Early initiation of breastfeeding (EIBF) is one of the most cost-effective strategies to reduce neonatal mortality. We sought to determine the prevalence and determinants of EIBF in Peru.
METHODS
We performed a cross-sectional analytical study of the 2018 Peruvian Demographic and Family Health Survey as a secondary data source. In total, 19,595 children born during the 5 years prior to the survey were included in the study. The dependent variable (EIBF status), socio-demographic variables, and pregnancy-related variables were analyzed using a multivariate logistic regression model to identify the determinants of EIBF.
RESULTS
The prevalence of EIBF in the study population was 49.7%. Cesarean deliveries were associated with a lower likelihood of EIBF (adjusted odds ratio [aOR], 0.06; 95% confidence interval [CI], 0.05 to 0.07) than were vaginal deliveries. Newborns born at public health centers (aOR, 1.37; 95% CI, 1.15 to 1.65) had a higher rate of EIBF than those not born at public or private health centers. Women from the jungle region (aOR, 2.51; 95% CI, 2.17 to 2.89) had higher odds of providing EIBF than those from the coast. Mothers with more than a secondary education (aOR, 0.65; 95% CI, 0.55 to 0.76) were less likely to breastfeed during the first hour of the newborn’s life than women with primary or no education.
CONCLUSIONS
More than half of Peruvian children do not breastfeed during the first hour after birth. The major determinants of EIBF status were the delivery mode and the region of maternal residence. Strategies are needed to promote early breastfeeding practices.
Summary

Citations

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  • Sociodemographic determinants associated with breastfeeding in term infants with low birth weight in Latin American countries
    Carlos Javier Avendaño-Vásquez, Magda Liliana Villamizar-Osorio, Claudia Jazmin Niño-Peñaranda, Judith Medellín-Olaya, Nadia Carolina Reina-Gamba
    World Journal of Clinical Pediatrics.2024;[Epub]     CrossRef
  • Prevalence of essential newborn care in home and facility births in the Peruvian Amazon: analysis of census data from programme evaluation in three remote districts of the Loreto region
    Stefan Reinders, Magaly M. Blas, Melissa Neuman, Luis Huicho, Carine Ronsmans
    The Lancet Regional Health - Americas.2023; 18: 100404.     CrossRef
  • Factors associated with breastfeeding initiation time in a Baby-Friendly Hospital
    Siddika Songül Yalçin
    Revista de Salud Pública.2023; 25(1): 1.     CrossRef
  • Strong Negative Association between Cesarean Delivery and Early Initiation of Breastfeeding Practices among Vietnamese Mothers—A Secondary Analysis of the Viet Nam Sustainable Development Goal Indicators on Children and Women Survey
    Tam Thi Thanh Nguyen, Kimihiro Nishino, Lan Thi Huong Le, Souphalak Inthaphatha, Eiko Yamamoto
    Nutrients.2023; 15(21): 4501.     CrossRef
  • The effect of skin-to-skin contact on early initiation of breastfeeding among women in Vietnam
    Hoang Thi Nam Giang, Le Tho Minh Hieu, Do Thi Thuy Duy, Mai Thi Phuong, Tran Dinh Trung
    Pediatrics & Neonatology.2023;[Epub]     CrossRef
  • Effects of maternal education on early initiation and exclusive breastfeeding practices in sub-Saharan Africa: a secondary analysis of Demographic and Health Surveys from 2015 to 2019
    Wako Golicha Wako, Zelalem Wayessa, Anteneh Fikrie
    BMJ Open.2022; 12(3): e054302.     CrossRef
  • Timing of Breastfeeding Initiation Mediates the Association between Delivery Mode, Source of Breastfeeding Education, and Postpartum Depression Symptoms
    Xinran Shen, Shunna Lin, Hui Li, Nubiya Amaerjiang, Wen Shu, Menglong Li, Huidi Xiao, Sofia Segura-Pérez, Rafael Pérez-Escamilla, Xin Fan, Yifei Hu
    Nutrients.2022; 14(14): 2959.     CrossRef
  • Determinants of early initiation of breast feeding among mothers of children aged less than 24 months in Ethiopia: A community-based cross-sectional study
    Sewunet Sako, Girma Gilano, Be'emnet Tekabe, Sintayehu Abebe
    BMJ Open.2022; 12(10): e062905.     CrossRef
  • Socioeconomic determinants and inequalities in exclusive breastfeeding among children in Peru
    Akram Hernández-Vásquez, Rodrigo Vargas-Fernández
    Frontiers in Nutrition.2022;[Epub]     CrossRef
Data Profile
The current status of health data on Korean children and adolescents
Eunyoung Lee, Dahye Baik, Yoon Park, Moran Ki
Epidemiol Health. 2017;39:e2017059.   Published online December 26, 2017
DOI: https://doi.org/10.4178/epih.e2017059
  • 14,906 View
  • 267 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Childhood and adolescence are critical periods that affect adults’ health status. Therefore, the factors influencing the health of children and adolescents should be analyzed. In Korea, a wide range of youth-related health data has been obtained, both on the regional level and on the national level. This report summarizes the current status of studies related to the health of Korean children and adolescents. Data for which open access is offered include the Korea Youth Risk Behavior Web-based Study, the Panel Study on Korean Children, the Korean Youth Panel Survey, the Korean Children and Youth Panel Survey, and the Student Health Examination. In addition, the Health Examination of Korean Youth Outside of School, the Korean Children and Adolescents Obesity Cohort Study, the Korean Children’s Environmental Health Study, the Korea Youth Media Use and Harmful Environment Survey, the Comprehensive Survey of Korean Youth, and the Multicultural Adolescents Panel Study are summarized.
Summary
Korean summary
청소년시기는 성인의 건강상태에 영향을 미치는 중요한 시기이다. 따라서 청소년의 건강에 영향을 미치는 여러 가지 요소들에 대한 분석이 필요하다. 한국에서 청소년건강과 관련한 데이터는 지역 단위에서뿐 아니라 국가 단위에서도 수집되고 있다. 해당 데이터가 공개되고 있는 것으로는 청소년건강행태온라인조사, 한국아동패널, 한국청소년패널조사, 한국아동ㆍ청소년패널조사, 학교건강검사가 있다. 이외에도 학교 밖 청소년 건강검진조사, 소아비만 및 대사질환 코호트, 어린이 환경 보건 출생코호트, 청소년 매체이용 및 유해환경 실태조사, 청소년 종합실태조사, 다문화청소년패널조사를 요약하였다.

Citations

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  • Dietary intake and nutritional status of Korean children and adolescents: a review of national survey data
    Minji Kang, So Yoon Choi, Minyoung Jung
    Clinical and Experimental Pediatrics.2021; 64(9): 443.     CrossRef
  • Benefits of cooperation among large-scale cohort studies and human biomonitoring projects in environmental health research: An exercise in blood lead analysis of the Environment and Child Health International Birth Cohort Group
    Shoji F. Nakayama, Carolina Espina, Michihiro Kamijima, Per Magnus, Marie-Aline Charles, Jun Zhang, Birgit Wolz, André Conrad, Aline Murawski, Miyuki Iwai-Shimada, Cécile Zaros, Ida Henriette Caspersen, Marike Kolossa-Gehring, Helle Margrete Meltzer, Sjur
    International Journal of Hygiene and Environmental Health.2019; 222(8): 1059.     CrossRef
Original Article
Test-retest reliability of health behavior items in the Community Health Survey in South Korea
Soo Jeong Kim, Jin A Han, Young Hwa Kim, Bo Youl Choi, Su Young Kim, Hun Je Lee, In Hwan Oh, Sung-il Cho, Jakyoung Lee, Soon Young Lee
Epidemiol Health. 2015;37:e2015045.   Published online October 20, 2015
DOI: https://doi.org/10.4178/epih/e2015045
  • 19,760 View
  • 143 Download
  • 7 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Responses to health-related items on the Community Health Survey (CHS) provide evidence that is used to develop community-based health policy. This study aimed to assess the test-retest reliability of selected health behavioral items on the CHS according to item category, response period, and response scale.
METHODS
A sample of 159 men and women 20 to 69 years of age participated in a test-retest with an interval of 14 to 21 days. A total of 28 items relating to smoking, alcohol consumption, diet and weight control, and mental health were selected. We evaluated the test-retest reliability of the items using kappa statistics.
RESULTS
Kappa values ranged from 0.44 to 0.93. Items concerning habits had higher kappa values (mean, 0.7; standard error, 0.05) than items concerning awareness or attitudes (p=0.012). The kappa value of items with two- to four-point scales was 0.63, which was higher than the value of 0.59 for items with scales involving five or more points, although this difference was not statistically significant. Different kappa values were observed for each reference period, but no statistically significant differences were noted.
CONCLUSIONS
The test-retest reliability of the CHS items that we studied was associated with item category. Further study of the relationship between item category and reliability in domains other than health behaviors is required.
Summary
Korean summary
이 연구는 지역사회건강조사의 건강행태 문항 중 28개 문항에 대하여 문항의 특성, 준거기간, 보기의 척도에 따라 조사-재조사 신뢰도의 차이를 분석하였다. 전체 문항의 카파값의 범위는 0.44-0.93이었다. 문항의 특성별로는 인지 또는 태도에 비해 습관에 관한 문항의 신뢰도가 높았으며, 보기의 척도가 5점 척도 이상에 비해 2-4점 척도의 신뢰도가 높음을 확인하였다.

Citations

Citations to this article as recorded by  
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