Earticle

Purpose: The objective of this study was to compare the outcome of out-of-hospital cardiac arrest (OHCA) between National Health Insurance(NHI) and Medical Aid(MA), before (2019) and during 2020 COVID-19 in Seoul. Methods: This is a retrospective cohort study that used nationwide OHCA registry collected in 2019 and 2020. The participants were patients with medical etiology who lived in Seoul and were transferred by 119 ambulance in Seoul. It was classified into NHI and MA according to health insurance status. Main outcomes included survival rate and good neurological recovery. Results: A total of 2,888 patients (2,543 NHI and 345 MA) in 2019 and 2,949 patients (2,638 NHI and 311 MA) in 2020 were included. In 2020, the bystander cardiopulmonary resuscitation (CPR), was significantly lower in MA (25.7%) than in NHI (38.1%). Survival rate in the MA decreased from 11.6% in 2019 to 10.6% in 2020, while increased from 10.1% to 13.3% in NHI. The odds ratio of good neurological recovery were 0.47 (95%CI, 0.25-0.86) for the MA group compared with NHI during 2020 COVID-19. Conclusion: There were disparities in bystander CPR and good neurological recovery by health insurance status during COVID-19 pandemic. Public health interventions should strive to reduce disparity of MA group in OHCA.

Purpose: We aimed to identify disaster preparedness, disaster response competency, and willingness to participate in disaster response among university students. Methods: Data were collected from the paramedic students after consent to this study through online. The period of data collection was from June 13 to August 3, 2023 and 207 questionnaires were analyzed using SPSS 27.0 program. Results: The subject's disaster preparedness was 7.67±3.10 out of 15, disaster response competency was 2.79±0.69 out of 5, and willingness to participate in disaster response was 6.06±4.59 out of 15. There was a significant difference in disaster preparedness depending on the disaster education experience (p<.001), in disaster response competency depending on the number of courses completed (p<.05), in willingness to participate in disaster response in cases of disaster experience (p<.05) and number of times disaster education was completed (F=3.146, p=.047). In particular, if the number of disaster training courses completed was three or more, disaster response competency and willingness to participate in disaster response were significantly high. There was a significant positive correlation between the subjects' disaster preparedness and disaster response competency (r=.655, p<.001). Conclusion: Three or more sessions of continuous disaster education is important, it will be necessary to develop educational content that matches the characteristics of the target subjects or college.

Purpose: This study aims to evaluate the risk of work-related musculoskeletal disorders (WMSDs) in 119 EMT during patient-carrying tasks using a long backboard (LBB) and a variable stretcher. Methods: Manikins were used as patients, and 45 new 119 EMT from K Fire Academy were filmed performing patient-carrying tasks on stairs. The tasks were analyzed using Ovako working posture analysis system (OWAS) and Rapid entire body assessment (REBA). Results: In using LBB, the OWAS score was Mode 3(Mean 2.37, Maximum 3), requiring as soon as possible corrective action, the REBA score was Mode 11(Mean 9.16, Maximum 11), requiring immediate improvement. In using variable stretcher, the OWAS score was Mode 1(Mean 2.33, Maximum 3), non-necessity for corrective action, the REBA score was Mode 9(Mean 8.0, Maximum 11), requiring as soon as possible. Conclusion: In conclusion, improvement was needed in one task (carrying a patient using a LBB) in the OWAS and in two tasks (carrying a patient using a LBB, carrying a patient using a variable stretcher) in the REBA. Thereby, required attention and management of WMSDs during training. In addition, it is essential to carry out objective and quantitative assessments through ergonomic analysis by occupational health professionals when designing future training programs to prevent WMSDs.

Purpose: The purpose of this study was to analyze the characteristics of patients who canceled their ED visits and to determine the factors that influence ED cancellation. Methods: Retrospective study that analyzed data from the electronic medical records(EMR) and Prehospital Care Reports(PCRs) of 305 patients who cancelled their appointments at a single emergency medical center over a six-month period from October 12, 2022, to April 12, 2023. Results: ED cancellations were 2.287 times higher if the patient presented to the ambulance after outpatient hours(09:00∼17:00) (p=.007), and ED cancellations were 3.712 times higher if the patient presented to the ambulance under the influence of alcohol(p=.011). For patients' symptoms, medical diseases were associated with a 1.965 times increase in cancelled ED visits compared to other modes of transport (p=.005), while mental and chronic diseases were associated with a 67.3% decrease in cancelled ED visits compared to other modes of transport (OR=0.327, CI=[0.130-0.822], p=.018). symptomatic improvement was associated with a 2.482 times increase in presentations to a 119 ambulance compared to delayed waiting time(p=.022). Conclusion: Emergency medical centers should consider improving the legal system, such as increasing emergency medical care fees, to reduce the number of patients who cancel their appointments.

Purpose: This study attempted to provide basic data to improve the maturation of career attitudes of emergency medical services students by identifying the effects of clinical practice satisfaction and career undecided level on the maturation of career attitudes of emergency medical services students who had experienced clinical practice. Methods: From May 1 to July 31, 2023, data were collected using a structured questionnaire from third and fourth year students who were enrolled in the department of paramedicine a university in City D and had experienced clinical practice. Results: The results showed that clinical practice satisfaction was significantly positively correlated with career attitude maturity (r=.382, p<.001) and negatively correlated with career indecision (r=.241, p=.002). The influencing factor of career attitude maturity was clinical practice satisfaction (β=.314, p<.001), with an explanatory power of 16%. Conclusion: It was confirmed that the influencing factor of career attitude maturity was clinical practice satisfaction, and the need to find ways to improve clinical practice satisfaction and develop customized education and practice programs for each institution to improve career attitude maturity of emergency rescue students was confirmed. Therefore, it is necessary to find specific ways to improve clinical practice satisfaction and develop customized educational practice programs for each institution.

Purpose: The purpose of this study is to investigate the impact of paramedic students' five-factor personality characteristics and stress coping behavior on the stress of emergency room practice. Methods: This study conducted a survey targeting 2 grade - 4 grade paramedic students who had experience practice at emergency room at N University and B University located in Cheonan, South Chungcheong Province. Results: ‘Agreeableness’ was the highest at 33.88±6.31 and ‘Neuroticism’ was the lowest at 27.82±7.43. Among stress coping methods, ‘active coping’ was higher at 3.39 than ‘passive coping’ at 3.21, and the subarea with the highest score was ‘wishful coping’. When looking at clinical practice stress by sub-domain, ‘practical training environment’ was the highest at 2.96, and ‘interpersonal conflict’ was the lowest at 2.14. There was a negative correlation between clinical practice stress and friendliness (r=-.220, p=.014) and a positive correlation with active coping (r=.210, p=.019). The influential factors were friendliness (β=-.267) and active coping (β=.258). Conclusion: The paramedic students who participated in this study showed a high level of agreeableness among the five personality traits and used a active coping style to cope with stress. Agreeableness has been shown to lower clinical practice stress, and active coping is classified as the most appropriate coping style, so research is needed to guide people to utilize friendliness and active coping well.

Purpose: We aimed to identify the awareness and reporting obligation attitude toward child abuse among paramedic students who will become paramedics in the future and play an important role as those with an obligation to report child abuse. Methods: Data were collected from the paramedic students after consent to this study through online. The period of data collection was from July 10 to August 2, 2023 and 142 questionnaires were analyzed using SPSS 27.0 program. Results: 79.6% of the subjects knew who was required to report child abuse, but only 46.5% knew the reporting agency, and 30.3% knew the reporting procedure. Additionally, 83.8% were willing to report child abuse when discovered. Awareness of child abuse was 4.58±0.29 points out of 5. The reporting obligation attitude toward child abuse was 3.53±0.74 out of 5. Awareness of child abuse was determined by whether one was required to report child abuse (p<.05), whether one was aware of the reporting procedure (p<.05), and whether one was willing to report child abuse (p<.05), there appeared to be a significant difference. Attitude toward reporting obligation regarding child abuse was determined by gender (p<.05), whether one was aware of the obligation to report child abuse (p<.05), and willingness to report upon discovery of child abuse (p<.01), it was found that there was a significant difference. Conclusion: It is necessary to develop realistic educational content that can be linked to suspected abuse sites in hospitals and out of hospitals so that students who will become paramedics in the future can play an active role as mandatory reporters of child abuse.

Purpose: This study attempted to identify how academic self-efficacy, grit, and learned helplessness influence Academic delay behavior in college students and provide a foundation for reducing Academic delay behavior in college students. Methods: Data was collected from October 12, 2023 to October 30, 2023 using a structured questionnaire from 170 college students at a university in City D. The data was collected using a structured questionnaire. Results: Academic delay behaviors were significantly negatively correlated with academic self-efficacy (r=-.371, p<.001) and grit (r=-.562, p=.012), and significantly positively correlated with learned helplessness (r=.341, p<.001). Conclusion: Finally, In order to reduce academic delay behaviors among college students, it is necessary to actively utilize educational environments that promote academic achievement and grit, academic-related counseling programs, and learning environments that do not suffer from academic helplessness.

Purpose: The purpose of this study was to determine the level of depression, anxiety, and stress among health college students and to identify factors affecting sleep quality to provide a basis for improving sleep quality among health college students. Methods: Data was collected using a structured questionnaire from 181 college students at a university in City D from October 1 to October 31, 2023. Results: Sleep quality was significantly and positively correlated with depression (r=.703, p<.001), anxiety (r=.680, p<.001), and stress (r=.708, p<.001), and its predictors were caffeine consumption (β =-.174, p=.044), Satisfaction with college life (β=-.137, p=.009), depression (β=.251, p=.013). Stress (β=.277, p=.007), with an explanatory power of 56%. Conclusion: To improve the sleep quality of college students, we should encourage them to reduce their caffeine intake, run various programs to improve their satisfaction with college life, and expand mental health counseling programs on campus to monitor their mental health status regularly so that they can actively manage depression and stress.