Research in Community and Public Health Nursing

Volume 15 (4); December 2004

Original Articles

An Evaluative Study of Health Education Programs for Community-based Hypertension Control in Public Health Centers: In Sook Lee; J Korean Acad Community Health Nurs. 2004;15(4):517-527. Published online December 31, 2004

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Abstract PDF: PURPOSE
This research is to find a solution for educational work on high blood pressure control in public health centers by analyzing their current status.
METHOD
It analyzed data from 133 public health centers that had been doing educational work on high blood pressure, through a questionnaire. Also, it developed recommendations by converging opinions from an expert group made of 25 people with nominal group technique.
RESULT
The educational methods of public health centers did not make any approach to get to the goal of the work. The mass media education and campaign activities for the general public had just temporary and passive propensities. In education for patients, it did not use appropriate methods to present management techniques for diagnosis process of patients, medication management, self monitoring BP, and risk factors. Pocket book for monitoring high blood pressure was not focused on self- recording for self-management. The expert group recommended that educational materials for adults should be developed focusing on treatments and observance of risk factors through daily living, and those for children should be focused on basic understanding about diseases, and life style.
CONCLUSION
Presenting direction and strategy of fundamental education work is needed for public health centers by giving them standard educational guidelines of managing high blood pressure nationally, and it is desirable that fundamental frameworks of educational materials should be developed and distributed by professional groups nationally.

A Survey on Awareness of Health Education in the Manpower of Public Health Center: Yeon Hee Choi; J Korean Acad Community Health Nurs. 2004;15(4):528-538. Published online December 31, 2004

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Abstract PDF: PURPOSE
This study was conducted to investigate the level of awareness about health education in the manpower of public health center, in order to suggest a basis data for the development of a job-training program.
METHOD
The subjects were 96 manpowers of public health centers. Data were collected from August 2nd, 2002 to September 20th using a self reported questionnaire survey. The data were analyzed using frequency, percentile and chi2 test.
RESULTS
The most necessary of health education according to health promotion service is 'quitting smoking' during the adolescent period. The most necessary of health education media according to health promotion service is 'reducing alcohol intake'. The most efficient media of health education is 'beam projector'. The most necessary capacity of health educator is 'planning capacity of health education'. The most necessary support implementing health education is 'manpower supply'.
CONCLUSION
The level of awareness of health education in the manpower of the public health center are expected to provide basic data for developing job-training programs that might improve advanced knowledge and techniques of health education.

Evaluation Study of Home Health Care Program Operated in G Public Health Center: Young Sook Kim, Myung Soon Kim; J Korean Acad Community Health Nurs. 2004;15(4):539-550. Published online December 31, 2004

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Abstract PDF: No abstract available.

Development of a Model of a Day Care Center for Rural Elderly People: Kyung Sook Kang; J Korean Acad Community Health Nurs. 2004;15(4):551-565. Published online December 31, 2004

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Abstract PDF: PURPOSE
The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes.
METHOD
Research design for this study was a multi-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach.
RESULTS
1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center --> unified health sub-center --> public health hospital (public health center) --> public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self-reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulationbased positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of "rules of law of elderly welfare." CONCLUSION: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.

Factors Influencing Depression with Emotional Labor among Workers in the Service Industry: Bok Im Lee, Hye Sun Jung, Soon Lae Kim, Kyung Yong Rhee; J Korean Acad Community Health Nurs. 2004;15(4):566-576. Published online December 31, 2004

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Abstract PDF: No abstract available.

Effects of a Health Promoting Education Program on Self-Efficacy, Knowledge of Health Management and Health Promoting Behavior for Middle-Aged Women: Kun Ja Lee, Chun Ja Chang, Jae Hee Yoo; J Korean Acad Community Health Nurs. 2004;15(4):577-586. Published online December 31, 2004

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Abstract PDF: PURPOSE
This study is to examine the effect of a health promoting education program for middle-aged women.
METHODS
Health promoting education program: The subject group consisted of 116 women between 40 and 60 years of age. Three 12-week sessions consisted of a 90 minute class each week, from March 14th to November 14th, 2003. Pre- and post-education tests were collected after each session. The data was collected using structured questionnaires before and after the education sessions. Data were analyzed employing descriptive statistics, paired t-test with SPSS/PC (10.0 version) program.
RESULTS
There were significant changes in health promoting behavior, but no significant changes in the self-efficacy and the knowledge of health management.
CONCLUSION
This study showed that a health promoting education program has partially positive effects for middle-aged women. Based on this study, a continuous education program through a community health center is needed for middle-aged women's health.

Comparative Study on Social Support and Perceived Health between Obese Women and Normal Weight Women: Myoung Ja Wang, Jeong Ah Kim; J Korean Acad Community Health Nurs. 2004;15(4):587-599. Published online December 31, 2004

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Abstract PDF: PURPOSE
The purpose of this study is to compare abdomen-fat rate, life style and social- support between normal weight women and obese women.
METHOD
304 women objectives from their 30 to 59 years of age were selected living in Je-chon city, Chung-Buck province and their height and weight were measured from April 1st to June 30th, 2003. Data were classified into low-weight group (18.5kg/m2), normal-weight group (18.5~22.9kg/m2), over-weight group (23~24.9kg/m2), and obese group (25kg/m2) following the Korean Conference of Obesity, 2001, in which 119 people in the normal weight group and 91 people in the obese group, i.e. total 210 people were analyzed in sequence. Using SPSS Win 10.1 Program, frequency and percentile, and by ANOVA, chi2 -test and t-test were treated.
RESULTS
The average age of obese women was 46.68 distributing 40.7% of forties and 39.6% of fifties while normal-weight women were average 41.73 -year old distributing 53.8% of forties and 34.5% of thirties, which revealed aged in obese women. The body fat rate of obese women averaged 37.52+/-4.17%, in which 98.9% of obese women and 21.0% of normal weight women with a more than 30% of body-fat rate resulted in a higher body-fat rate in obese women. The waists of obese women averaged 88.37+/-8.22cm, in which more than 85cm showed in obese women of 68.2% and normal weight women of 7.6% indicating a higher waist-fat rate in obese women. The abdomen-fat rate of more than 0.85 of waist vs hip-fat showed 74.7% in obese women and 58.4% in normal weight women, indicating a higher abdomen-fat rate in obese women. Obese women and normal weight women showed significant differences in education level, number of children, religion, menstrual status, and mother's weight. Especially, obese women ate hotter or saltier food than normal weight women preferring meat. However, no significant differences appeared in marital status, social economic status, occupation, eating habits, smoking, drinking and physical exercise. Social support levels showed a lower rate in obese women than in normal weight women, indicating a statistically significant difference (p<.05). Observing areas of social support, obese women showed lower rates in attachment/intimacy, social integrity, opportunity of foster and confidence in value except help and instruction, which indicated a statistically significant difference (p<.05). Social support for obese women showed significant differences in age, education level, social hierarchy, religion and menstrual status. Obese women were more negative than normal weight women in health recognition, indicating a statistically significant difference (p<.01). Normal weight women showed higher health recognition when provided high social support and significantly low (p<.01) health recognition when provided low social support. However, there was no significant difference in health recognition in obese women whether high or low social support was given. The health recognition of obese women showed significant differences in age, education level, social hierarchy, number of children, menstrual status, physical exercise, eating habits, eating taste and preference of food.
CONCLUSION
Obese women showed elder than normal-weight women, higher body-fat rate and abdomen-fat rate, lower social support, and a tendency to more negative health recognition. Therefore, providing weight-control programs for the treatment of obesity and prevention of recurrence for obese women to prevent progressing to adult disease and promote a healthy life, we suggest that better eating habits and the encouragement of regular physical exercise should be included, as well as total approachment on change of health recognition and social support would be needed.

A Study on Health Promotion Behavior, Perceived Stress and Constipation of Female University Students: Suk Yong Kil, Won Oak Oh, Min Hyun Suk; J Korean Acad Community Health Nurs. 2004;15(4):600-607. Published online December 31, 2004

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Abstract PDF: PURPOSE
This study was conducted to examine the relationship among health promotion behavior, perceived stress and constipation.
METHOD
The subjects of this study consisted of 212 female university students. The data was collected using questionnaires from October to December, 2003 and analyzed t-test, ANOVA, Pearson Correlation Coefficients using SAS.
RESULT
The subjects with difficulties in bowel elimination were 57.6% and there was a significant negative correlation between health promotion behavior and constipation.
CONCLUSION
Data from this study suggest that constipation is an important health problem among female university students and needs further research to understand factors related to constipation.

A Study on the Correlation among Family Functioning, Self-concept and Health Promotion Behavior of Elementary School Students: Su Ja Kwon, Eun Hee Kim, Tae Kyung Kim; J Korean Acad Community Health Nurs. 2004;15(4):608-617. Published online December 31, 2004

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Abstract PDF: PURPOSE
This study was to investigate family functioning, self-concept and health promotion behavior of elementary school students and to find out the correlation among these variables.
METHOD
The subjects were 277 students who participated voluntarily in the questionnaire. The instrument used in this study was family APGAR, self-concept and health promotion behavior tool. The data were collected from May 18th to 21st, 2004 with a self-administered questionnaire, using frequency, percentage, t-test, ANOVA, Pearson correlation coefficient and stepwise multiple regression with SPSS 10.0 win.
RESULTS
1) The mean score of health promotion behavior by general characteristics was significant in educational status of mother (F=5.352, p=0.005), living standard (F=9.646, p=0.000) and perceived health status (F=8.349, p=0.000). 2) The mean score of family functioning was 3.57 (5 point scale), self-concept was 3.47 (5 point scale) and health promotion behavior was 3.67 (5 point scale). 3) In the relationship between family functioning and self-concept was correlated (r=.547), family functioning and health promotion behavior was correlated (r=.518) and self-concept and health promotion behavior was correlated (r=.670). 4) The most influencing variable was self-concept, accounting for 43% in stepwise multiple regression. A combination of self-concept, family functioning and perceived health status explained 47% of the variance for health promoting behavior.
CONCLUSION
Considering the results above, we can recognize that there are close relations among the family functioning, self-concept and health promotion behavior. Therefore, it is necessary to elevate the level of self-concept and family functioning in order to get health promotion behavior of the elementary school students.

Oral Health Behavior and Dental Health Status of Preschool Children: Jung Soon Moon, Byung Sun Song, Sun Nam Park; J Korean Acad Community Health Nurs. 2004;15(4):618-627. Published online December 31, 2004

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Abstract PDF: PURPOSE
To investigate the dental health status of kindergarten children according to their oral health behavior.
METHOD
The subjects were 172 kindergarten children aged 5. A structured questionnaire was used for dental health behavior (and oral health status were examined by dentist and bacteria in salivary.
RESULT
1. Mean score of oral health behavior of children was 4.69 points (SD1.65) with the highest score being 13. No significant differences were observed according to sex, except using tooth paste. A total 71.5% of subjects brushed their tooth twice a day, 9.9% of them once a day, 18.6% of them three times a day. 19.2% of children brushed their teeth after breakfast and lunch, 89.5% of then after dinner, 5.8% of them before going to bed. 18.6% of children brushed correctly, 79.7% of them used tooth paste with fluorine, 3.5% of them regularly examined oral cavity, 84.4% of them took cariogenic food without any restrain. (67.1% of them were observed with oral cavity by their mother. 2. Streptococcus mutans and lactobacilli in the saliva was 3.66 (x106 CFU/ml) and 1.05 (x103 CFU/ml), respectively. No significant differences were observed according to sex, while lactobacilli were significantly lower in those children who had regular dental examinations. 3. The index of plaque was 1.56 and the boys were significantly higher than the girls. The mean dft was 4.99. No significant differences were observed according to sex, while the children whose oral cavity was observed regular were significantly lower than those who were not observed.
CONCLUSION
As a whole the practice of oral health behavior of the kindergarten children was poor, and regular dental examinations and oral cavity observations affect their dental health status. These results suggest that intensive dental health education was needed not only for the pre-school children but also their parents and teachers.

The Effects of Follow-Up Care on Social Support, Self-esteem and Maternal Confidence in Low Birth-weight Infant's Mothers: Kwang Ok Lee, Ja Hyung Lee, Yun Mi Paek; J Korean Acad Community Health Nurs. 2004;15(4):628-638. Published online December 31, 2004

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Abstract PDF: PURPOSE
The purpose of this study was to examine the effect of follow-up care on the social support, self-esteem and maternal confidence in mothers of low birth weight infants.
METHODS
This study applied a quasiexperiment study method to examine the pre-post intervention effects. Eighty-eight mothers whose infants were below 2.5kg of Low birth weight were studied. The period for the data collection was from July to December in 2003. Self Reported Survey and Face to Face Interview by the highly trained home Visiting Nurses were used for this study.
RESULTS
Most of the participants reported statistically significant improvements in the score of social support, self-esteem and maternal confidence after they received the intervention.
CONCLUSION
Longitudinal study for the mothers of low birth weight infants might reveal more comprehensive findings. Moreover, follow-up care, which is linked with community health care services, is needed to continue the post hospital care services. Additionally, qualified and professional intervention programs should be provided to consider the characteristics of mothers of low birth weight infants.

The Need for Hospice Care in Families of Patients with Cancer: Kyung Ah Kang, Shin Jeong Kim, Young Soon Kim; J Korean Acad Community Health Nurs. 2004;15(4):639-647. Published online December 31, 2004

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Abstract PDF: PURPOSE
The purpose of this study was to analyze the need for hospice care programs in families of patients with cancer.
METHOD
The study surveyed 98 families who were taking care of patients with cancer. This survey was conducted from August 2004 to October 2004 at two general hospitals in Seoul. The data were collected through a self-reporting questionnaire of 22 items. The items were classified into five areas by factor analysis to identify the construct validity. The reliability of the tool was established by Cronbach's alpha as .93 and the data collected were analyzed by descriptive statistics, t-test and ANOVA.
RESULTS
1) The degree of need for hospice care of the subjects showed a high average of 3.26 (+/-3.7). The need for 'emotional care of patients showed the highest mean (M=3.47), 'management of terminal physical symptoms' (M=3.34), 'control of secondary physical problems' (M=3.26), 'acceptance of the family's difficulty' (M=3.12), 'spiritual care for preparing for death' (M=2.96), respectively. 2) With respect to the demographic characteristics of the subjects, there were statistically significant differences in hospice care needs, according to the onset of diagnosis (F==3.110, p=.030).
CONCLUSION
Hospice care must be provided considering the needs of families of patients with cancer. In this sense, this country's needs as well as hospice nurses' higher concern and support for hospice care of patients require further education and program development to meet the current demands.

Diabetic Patients of the Community: Hee Seung Kim, Hyun Jung Kim, Kyung Mi Kim; J Korean Acad Community Health Nurs. 2004;15(4):648-654. Published online December 31, 2004

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Abstract PDF: PURPOSE
The purpose of this study was to investigate the depression trends by gender in type2 diabetic patients.
METHOD
One hundred Participants were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. Depression was measured using the Beck Depression Inventory. Glycosylated hemoglobin was determined by a high-performance liquid chromatography technique. Fasting plasma glucose and 2-hour post-prandial blood glucose were analyzed by the glucose oxidase method.
RESULTS
The Depression score was significantly higher in diabetic women (10.4) than in male diabetic patients (7.8). In male diabetic patients, depression was positively correlated with glycosylated hemoglobin (r=0.35, p= 0.006). However, there was no correlation between depression and glycosylated hemoglobin in female diabetic patients.
CONCLUSION
These findings indicate that depression score was significantly higher in female diabetic patients and the depression was positively correlated with glycosylated hemoglobin in male diabetic patients.

A Study on the Health Status among the Homeless in Shelters: Hyoung Sook Park, Soon Ja Lyu; J Korean Acad Community Health Nurs. 2004;15(4):655-665. Published online December 31, 2004

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Abstract PDF: PURPOSE
This study was aimed to investigate the physical and psychological health status of the homeless in shelters, and to suggest the basic data for caring them.
METHODS
Study subjects were 153 homeless people who were registered in the shelters of Dong-gu, Busan, between September 1st, 2003 and March 15th, 2004. Data on their physical health status were collected by measuring weight and height (BMI), taking X-rays (tuberculosis), testing blood (syphilis, glucose, HBsAb and HBsAb). Psychological health status was measured with Rosenberg's self-esteem scale and Beck's depression scale. Data were analyzed with descriptive statistics, chi2-test, t-test or F-test using SPSS (Win10.0). at alpha=0.05, two tailed test.
RESULTS
Mean age was 42.8 years old, high school graduated was 43.8%, and 60.8% didn't have medical benefits. Singles were 47.7%, 34.7% had bad family relationships and 39.2% hoped to live with family. 96.1% had a normal in chest X-ray test, and 96.1% had negative syphilis test 92.2% were negative for hepatitis antigen, 51.0% were antibody, 25.5% had hypertension, and 60.8% had a normal BMI test, and 84.3% had a normal blood sugar test. 39.2% were severely depressed, and 75.8% had a normal self-esteem level.
CONCLUSION
Physical health status of the homeless was relatively good. However, depression levels were high and self-esteem was low. Therefore, it is necessary to take an action to improve the psychological health status for the homeless.

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