Patient safety education effectively shifted students' attitudes towards systems-based thinking and increased their sense of collective responsibility. Strategies for improving superior-subordinate communication within a hierarchical culture should be added to the patient safety curriculum.

BackgroundOccupational physicians (OPs) have complex relationships with employees, employers, and the general public. OPs may have simultaneous obligations towards third parties, which can lead to variable conflicts of interests. Among the various studies of ethical issues related to OPs, few have focused on the Korean OPs. The aim of the present survey was to investigate the ethical contexts, the practical resolutions, and the ethical principles for the Korean OPs.MethodsAn email with a self-administered questionnaire was sent to members of the Korean Society of Occupational and Environmental Medicine, comprising 150 specialists and 130 residents. The questionnaire was also distributed to 52 specialists and 46 residents who attended the annual meeting of the Korean Association of Occupational and Environmental Clinics in October 2015, and to 240 specialists by uploading the questionnaire to the online community ‘oem-doctors’ in February 2016. The responses to each question (perception of general ethical conflicts, recognition of various ethical codes for OPs, core professional values in ethics of occupational medicine, and a mock case study) were compared between specialists and residents by the chi-squared test and Fisher’s exact test.ResultsResponses were received from 80 specialists and 71 residents. Most participants had experienced ethical conflicts at work and felt the need for systematic education and training. OPs suffered the most ethical conflicts in decisions regarding occupational health examination and evaluation for work relatedness. Over 60% of total participants were unaware of the ethical codes of other countries. Participants thought ‘consideration of worker’s health and safety’ (26.0%) and ‘neutrality’ (24.7%) as the prominent ethical values in professionality ofoccupational medicine. In mock cases, participants chose beneficence and justice for fitness for work and confidential information acquired while on duty, and beneficence and respect for autonomy in pre-placement examinations.ConclusionsThis study evaluated the current perception of and attitude toward ethical issues among the Korean OPs. These findings will facilitate the development of a code of ethics and the ethical decision-making program forthe Korean OPs.Electronic supplementary materialThe online version of this article (doi:10.1186/s40557-017-0182-z) contains supplementary material, which is available to authorized users.

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Background: This study aims to investigate the relationship between metabolic syndrome and depression in Korean adults using data from the 2016 and 2018 Korean National Health and Nutrition Examination Surveys (KNHANES). Methods: The total number of participants in the 7th period 1st year (2016) and 3rd year (2018) surveys of KNHANES was 16142. This study was conducted with 10,722 subjects who met the diagnostic criteria for metabolic syndrome and responded to the Patient Health Questionnaire-9 (PHQ-9). Analysis of covariance was used to adjust the differences due to demographic factors, laboratory findings, and underlying diseases to understand the relationship between metabolic syndrome and PHQ-9 scores, if any. Results: The prevalence of metabolic syndrome was determined to be 25.6% in this study. The PHQ-9 scores with and without metabolic syndrome were 2.56 and 2.48, respectively, and there was no significant difference when the confounding variable was corrected (p=0.406). According to the analysis of each PHQ-9 item and metabolic syndrome, the results were not significant. Conclusion: In this cross-sectional study conducted in Korean adults, no significant correlation was found between metabolic syndrome and depression.

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Background: This study explores the correlation among obesity, suicide plans, and suicide attempts in adults over 19 years of age in South Korea. Methods: The study used data from adults who had participated in the 2018 Korea National Health and Nutrition Examination Survey. Obesity was defined as having a body mass index of ≥25 kg/m 2. To identify differences between the characteristics of those who had reported suicide plans and attempts, a complex sample chi-square test was conducted. To analyze the effect of obesity on suicide plans and attempts, a logistic regression analysis was performed. Results: There was no significant difference in the rate of suicide plans in one year between obese and non-obese groups; however, the rate of actual suicide attempts was significantly high in the obese group (p<0.050). After correcting for variables that were significantly different between the groups, obesity was found to have no significant effect on suicide plans but was linked to a significant increase in suicide attempts (odds ratio=3.355, p=0.008). Conclusion: Obesity was found to have no effect on the suicide planning rate; however, the probability of a suicide attempt was high in obese adults.

Background: The goal of this study was to confirm the relationship between subjective body shape perception and the depression screening tool Patient Health Questionnaire-9 (PHQ-9) in the geriatric population. Methods: A total of 1,251 subjects were analyzed among adults aged 65 or older who performed the 2020 Korean National Health and Nutrition Examination Survey. The subjective body shape perception was divided into three groups (thin, normal, and obese). Depression screening tool PHQ-9 10 points were employed as a cut-off value. The association between subjective body shape perception and the risk of depression based on the PHQ-9 was first verified by a chi-square test, and then logistic regression analysis was performed along with items expected to influence the relationship.Results: There was a considerable difference between the depression risk and the normal groups in subjective body shape perception, which was classified as thin, normal, and obese. In the final model, the group who thought they were thin had an increased risk of depression compared with the normal group. Dyslipidemia, being female, and not owning a home have all been demonstrated to greatly raise the risk of depression. Conclusion:We verified that subjective body shape was related to the risk of depression through the PHQ-9.