Objectives Although family members of persons with disabilities face elevated suicide risk, predictive models remain underdeveloped in Korean contexts. This study aimed to develop machine learning–based predictive models for suicidal ideation among family members of persons with disabilities and examine differential risk patterns by disability onset type.
Methods This cross-sectional study analyzed 124,783 adult family members (59.9% spouses, 20.3% parents/ascendants, 14.6% adult children, 5.2% extended family) from the 2018 Korean Disability and Life Dynamics Panel using survey weights. Four predictive models, including machine learning approaches, were compared using 31 variables. The dataset was divided into training (70%) and test (30%) sets, with stratified analyses comparing congenital and acquired disability groups.
Results Among the 124,783 family members analyzed, least absolute shrinkage and selection operator (LASSO) with cross-validation achieved optimal performance (area under the receiver operating characteristic curve, 0.875 training; 0.853 test). LASSO selected 16 of 31 variables for the total sample, with family members’ depression as the strongest predictor (β=0.554), followed by disabled persons’ suicidal ideation (β=0.425). Stratified LASSO analyses revealed that national basic livelihood beneficiary status was the strongest predictor for families with congenital disability (β=0.541), while family members’ depression was the strongest predictor for families with acquired disability (β=0.562), demonstrating distinct predictive patterns by disability onset.
Conclusion These findings show that predictive factors differ substantially by disability onset type, indicating the need for tailored intervention approaches and offering an evidence-based foundation for targeted suicide prevention strategies.
Objectives The household secondary attack rate (SAR) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important indicator for community transmission. This study aimed to characterize transmission by comparing household SARs and identifying risk factors during the periods of Delta and Omicron variant predominance in Republic of Korea.
Methods We defined the period of Delta variant predominance (Delta period) as July 25, 2021 to January 15, 2022, and the period of Omicron variant predominance (Omicron period) as February 7 to September 3, 2022. The number of index cases included was 214,229 for the Delta period and 5,521,393 for the Omicron period. To identify the household SARs and risk factors for each period, logistic regression was performed to determine the adjusted odds ratio (aOR).
Results The SAR was 35.2% for the Delta period and 43.1% for the Omicron period. The aOR of infection was higher in 2 groups, those aged 0 to 18 years and ≥75 years, compared to those aged 19 to 49 years. Unvaccinated individuals (vs. vaccinated individuals) and individuals experiencing initial infection (vs. individuals experiencing a second or third infection) had an increased risk of infection with SARS-CoV-2.
Conclusion This study analyzed the household SARs and risk factors. We hope that the results can help develop age-specific immunization plans and responses to reduce the SAR in preparation for emerging infectious diseases or potential new variants of SARS-CoV-2.
Citations
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Lower Levels of Household Transmission of SARS-CoV-2 Omicron Variant of Concern vs Wild Type: An Interplay Between Transmissibility and Immune Status Angelique M A M Winkel, Eva Kozanli, Mildred E Haverkort, Sjoerd M Euser, Judith G C Sluiter-Post, Rob Mariman, Afke Vogelzang, Jordy de Bakker, Coen R Lap, Marianne A van Houten, Dirk Eggink, Steven F L van Lelyveld The Journal of Infectious Diseases.2025; 231(3): 653. CrossRef
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Objectives
The purpose of this study is to compare the agreement in opinion between the elderly in care facilities and their family members regarding the life-sustaining treatment at the deathbed and to find out if the intentions of the elderly are being properly reflected in their deathbed treatment. Methods
Data were collected from 85 elderly individuals at five care facilities in Chunkcheongnam-do and 85 family members. The data were collected with a self-administered questionnaire from July 22, 2013 to August 15, 2014. A total of 170 cases were analyzed using SPSS version 21. Results
First, the family members' preference for life-sustaining treatment was higher than the patients' preference. The preference between the elderly and their family members regarding life-sustaining treatment was statistically significant with regards to oral nutrition, pain control through oral and anal administration, pain control through intravenous administration, transfusion, and admission to an intensive care unit. Second, looking at the agreement between elderly and guardians regarding life-sustaining treatment, there was significant concordance about general testing, oral nutrition, intravenous hydration, intravenous nutrition, antibiotic treatment for severe infection with low resiliency, admission to an intensive care unit, blood pressure increase medication use, cardiopulmonary resuscitation, and tracheotomy. Conclusion
It is essential for the medical staff to confirm agreement between the elderly and their family members regarding life-sustaining treatment, and if such a prior agreement is not feasible, the patient's intention should be considered more actionable than their family members.
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Analysis of high-intensity care in intensive care units and its cost at the end of life among older people in South Korea between 2016 and 2019: a cross-sectional study of the health insurance review and assessment service national patient sample database Yunji Lee, Minjeong Jo, Taehwa Kim, Kyoungsun Yun BMJ Open.2021; 11(8): e049711. CrossRef
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Preferences of older inpatients and their family caregivers for life-sustaining treatments in South Korea Hyeyoung Hwang, Sook Ja Yang, Sarah Yeun-Sim Jeong Geriatric Nursing.2018; 39(4): 428. CrossRef
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