ObjectiveThis study evaluated the symptoms of post-traumatic stress disorder (PTSD) among North Korean defectors and their level of suicidal ideation and the correlation between these and heart-rate variability (HRV) to explore the possibility of using HRV as an objective neurobiological index of signs of autonomic nervous system disorder.MethodsA total of 32 North Korean defectors (nine men, 23 women) were selected as subjects, and their HRV was measured after they completed the Minnesota Multiphasic Personality Inventory-PTSD (MMPI-PTSD) scale and the Beck Depression Inventory (BDI).Results1) Low-frequency (LF)/high-frequency (HF) ratios in the HRV index and MMPI-PTSD scores were correlated (r=0.419, p<0.05), as were BDI item 9 (suicidal ideation) and MMPI-PTSD scores (r=0.600, p<0.01). 2) A regression analysis of LF/HF ratios and MMPI-PTSD scores revealed an R-value of 13.8% (Adj. R2=0.138, F=4.695, p=0.041), and a regression analysis of BDI item 9 and MMPI-PTSD scores showed an R-value of 32.8% (Adj. R2=0.328, F=11.234, p=0.003). In other words, the LF/HF ratio (β=0.419) and BDI item 9 (β=0.600) appear to be risk factors in predicting MMPI-PTSD scores.ConclusionThe LF/HF ratio, a standard index of autonomic nervous system activity, can be used as an objective neurobiological index to analyze PTSD among North Korean defectors presenting with various mental and physical symptoms, and the approximate level of suicide -ideation can act as a predicting factor for PTSD.

Public hospital executives and nurse managers should be actively involved in creating a strong safety climate. Furthermore, training programmes and managerial support focussed on improving patient safety and directed at less experienced nurses, especially those working at Red Cross hospitals in rural areas, need to be emphasised to prevent errors.

The study aimed to understand the experiences of adolescent smokers who participated in a self-reflection program for smoking cessation and to develop the theoretical basis for constructing similar programs. The program is unique from other smoking cessation programs in that it seeks to be creative and allow participants to establish an individualized vision for themselves. The participants, ten students from middle and high schools located in cities A and S, were interviewed right after the program ended. Data were collected from August to December 2019 and analyzed using a phenomenological approach to understand participant experiences in depth. The analysis revealed five major themes: ‘Uniqueness of the Program,’ ‘Perception of Smoking Cessation,’ ‘Positive Reflection on Life,’ ‘Understanding Others,’ and ‘A Search for Hope and Vision in Life.’ The findings revealed that their smoking behaviors were changed through self-reflection and enhancement of self-efficacy and that the program facilitated the formation of identity and vision for the future, which may indirectly strengthen the motivation for adolescent smokers to quit smoking. These findings suggest the need for a smoking cessation program that enhances self-concept and self-esteem. Moreover, it highlights the importance of follow-up research to ensure effectiveness and the need to develop programs with creative content.

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