Research in Community and Public Health Nursing

Volume 33 (3); September 2022

Original Articles

The Retention Factors among Nurses in Rural and Remote Areas: Lessons from the Community Health Practitioners in South Korea: Hye Jin Park, Kyung Ja June; J Korean Acad Community Health Nurs. 2022;33(3):269-278. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.269

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Abstract PDF: Purpose
This study analyzed the retention factors of Korean community health practitioners who sustained over 20 years based on a multi-dimensional framework. This study suggests global implications for nurses working in rural or remote areas, even during a worldwide pandemic. Methods: The participants were 16 Korean community health practitioners who worked in rural or remote locations for over 20 years. This study identified nurses' key retention factors contributing to long service in rural and remote areas. This is a qualitative study based on the narrative method and analysis was conducted using grounded theory. A semi-structured questionnaire was conducted based on the following: the life flow of the participants' first experience, episodes during the work experience, and reflections on the past 20 years. Results: First, personal 'financial needs' and 'callings' were motivation-related causal conditions. The adaptation of environment-work-community was the contextual condition leading to intervening conditions, building coping strategies by encountering a lifetime crisis. The consequences of 'transition' and 'maturation' naturally occurred with chronological changes. The unique factors were related to the 'external changes' in the Korean primary health system, which improved the participants' social status and welfare. Conclusion: Considering multi-dimensional retention factors was critical, including chronological (i.e., historical changes) and external factors (i.e., healthcare systems), to be supportive synchronously for rural nurses. Without this, the individuals working in the rural areas could be victimized by insecurity and self-commitment. Furthermore, considering the global pandemic, the retention of nurses is crucial to prevent the severity of isolation in rural and remote areas.

The Effect of Stress and Anxiety Caused by COVID-19 on the Quality of Life of Small Business Owners in an Area: Hae Ok Kim, Hyoen Jeong Kim, Hye Ji Jo; J Korean Acad Community Health Nurs. 2022;33(3):279-289. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.279

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Purpose
This is a descriptive correlation study to confirm the effect of stress and anxiety caused by COVID-19 on the quality of life of small business owners in an area under environment of COVID-19. Methods: The participants were 150 small business owners in an area. The collected data were analyzed by descriptive statistics, an independent t-test, a one-way ANOVA, Pearson's correlation coefficients, and multiple regression with the SPSS 25.0 Program. Results: The stress of small business owners averaged 3.67±0.65 out of 4 points, anxiety of COVID-19 was 2.65±0.52, and quality of life was 75.61±20.26 out of 130 points. The quality of life showed a significant negative correlation with ‘fear of infection’ (r=-.42, p<.001), ‘difficulties caused by social distancing’ (r=-.49, p<.001) in the stress subdomain, and anxiety (r=-.61, p<.001). On the other hand, stress, ‘fear of infection’ (r=.50, p<.001), ‘difficulties caused by social distancing’ (r=.60 p<.001), ‘anger against others’ (r=.35, p<.001) and anxiety showed positive correlation. Factors affecting the quality of life of the subjects were ‘fear of infection’ in the stress subdomain (β=-.23, p=.003), anxiety (β=-.45, p<.001), and residential area (J zone) (β=-.16, p=.030). These factors explained 47.0% of the variance. Conclusion: In order to enhance the quality of life of small business owners in an area, it is required to reduce stress and anxiety. In addition, it is necessary to prepare an intervention program that can reduce stress and anxiety of small business owners.

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Mediating effect of social support between COVID-19 stress on the mental health of older adults using customized care services: A cross-sectional study
Yujin Suh, YoungSun Park, Eun-Kyoung Han
Journal of Korean Gerontological Nursing.2023; 25(4): 410. CrossRef

Factors Influencing Self-esteem Changes in Multicultural Adolescents: Using a Linear Mixed Model: Ji Yeong Seo, Min Ah Park, Myeung Hee Han; J Korean Acad Community Health Nurs. 2022;33(3):290-298. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.290

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Abstract PDF: Purpose
This study was conducted to determine factors influencing changes in the self-esteem of multicultural adolescents over time. Methods: A longitudinal design was adopted to analyze secondary data. This study used the 2nd, 4th, and 6th year data of Multicultural Adolescents Panel Study (MAPS) collected by the Korea Youth Policy Institute. The linear mixed model was utilized to analyze self-esteem changes over time. Results: The factors of sex and age of the students, the mother’s Korean writing ability, and the Filipino or Japanese mothers had a significant effect on the self-esteem change of multi-cultural adolescents over time. Specifically, it was found that female students’ self-esteem was decreased by 0.04 (t=-2.39, p=.017) more than male students over time. As the subject’s age and mother’s Korean writing ability increased, self-esteem was decreased by 0.01 (t=-2.53, p=.011) and 0.03 (t=-2.52, p=.012) over time. In addition, compared to that of those who had mothers from Korea, self-esteem of those who had Filipino or Japanese mothers was decreased by 0.04 significantly. Conclusion: Therefore, when developing a self-esteem promotion program, it is necessary to develop content by reflecting the characteristics of mothers as well as the gender and age of students. Furthermore, the significance of this study is in that it established a foundation for a positive self-identity of multicultural adolescents whose number is increasing recently by identifying factors affecting their self-esteem.

Latent Classes of Depressive Symptom Trajectories of Adolescents and Determinants of Classes: Eun Joo Kim; J Korean Acad Community Health Nurs. 2022;33(3):299-311. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.299

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Purpose
Untreated depression in adolescents affects their entire life. It is important to detect and intervene early depression in adolescence considering the characteristics of adolescent’s depressive symptoms accompanied by internalization and externalization. The aim of this study was to identify latent classes of depressive symptom trajectories of adolescents and determinants of classes in Korea. Methods: The three time-point (2018~2020) data derived from the Korean Children and Youth Panel Survey 2018 were used (N=2,325). Latent Growth Curve Modeling (LGCM) was conducted to explore the depressive symptom trajectories in all adolescents, and Latent Class Growth Modeling (LCGM) was conducted to identify each latent class. Multinomial logistic regression analysis was performed to confirm the determinants of each latent class. Results: The LGCM results showed that there was no statistically significant change in all adolescents' depressive symptoms for 3 years. However, the LCGM results showed that four latent classes showing different trajectories were distinguished: 1) Low-stable (intercept=14.39, non-significant slope), 2) moderate-increasing (intercept=19.62, significantly increasing slope), 3) high-stable (intercept=26.30, non-significant slope), and 4) high-rapidly decreasing (intercept=26.34, significantly rapidly decreasing slope). The multinomial logistic regression analysis showed that the significant determinants (i.e., gender, self-esteem, aggression, somatization, peer relationship) of each latent class were different. Conclusion: When screening adolescent’s depression, it is necessary to monitor not only direct depression symptoms but also self-esteem, aggression, somatization symptoms, and peer relationships. The findings of this study may be valuable for nurses and policy makers to develop mental health programs for adolescents.

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What differentiates suicidal ideation from depressive symptoms amongst Korean young adults aged 20–39 years?
Jiwon Kang, Soong-nang Jang, Hyun-soo Kim
International Review of Psychiatry.2024; : 1. CrossRef
Factors Influencing Depression in Adolescents Focusing on the Degree of Appearance Stress
Mihye Lim, Myoungjin Kwon
Nursing Reports.2023; 13(1): 518. CrossRef
How final year high school students’ depression develop during COVID-19 in China? A latent class growth modeling analysis
Xinyu Zhang, Guangdong Zhou
Current Psychology.2023;[Epub] CrossRef

The Effect of the Delivery Format on Teaching Presence, Learning Presence, and Learning Outcomes in Distance Learning of Nursing Students: Synchronous versus Asynchronous Learning: Min A Kim, So Eun Choi; J Korean Acad Community Health Nurs. 2022;33(3):312-320. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.312

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Abstract PDF: Purpose
This study was performed to explore the effect of the delivery format on teaching presence, learning presence, and learning outcomes in distance learning of nursing students. Methods: A descriptive survey was conducted to understand teaching presence, learning presence, and learning outcomes depending on the delivery format of distance learning. Quota sampling methodology was used to recruit 295 nursing students from all over the country, and data collection was done from July 27 to September 10, 2020. The first delivery format for distance learning was synchronous learning in which communication between the instructor and students occurred simultaneously. The second delivery format was asynchronous learning in which prerecorded videos were provided and communication did not occur simultaneously. Results: In synchronous learning, teaching presence (especially direct facilitation) and learning presence (especially emotional expression) had a statistical significance that was higher than in asynchronous learning. However, in learning outcomes, there was no statistically significant difference. There were significant positive correlations between teaching presence, learning presence, and learning outcomes, and there were significant positive correlations. Conclusion: It can be suggested that learning outcomes can be improved if presence is improved in the distance learning environment based on the results of this study. It is necessary to add contact with nursing students and instructors to improve teaching presence in the asynchronous learning, and it is necessary to help students express their emotions to improve learning presence.

A Structural Equation Model on Standard Precautions Compliance of Nursing Students: Hey Jin Ha, Eun A Kim; J Korean Acad Community Health Nurs. 2022;33(3):321-331. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.321

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Abstract PDF: Purpose
This study is to establish a structural model for standard precautions compliance of nursing students. This conceptual model was based on the IMB (Information-Motivation-Behavioral skills) model of Fisher and Fisher. Methods: Data were collected from October 12 to December 1, 2020, and the subjects were nursing students from G metropolitan city and J province, and the data of a total of 334 subjects were analyzed. For data analysis, this study used the SPSS 24.0 and AMOS 24.0 programs. Results: The hypothetical model showed a good fit to the data: x ² =106.46 (p<.001), x ² /df=2.54, RMSEA=.07, SRMR=.04, CFI=.96, TLI=.94. It was confirmed that the variables that have a statistically significant influence on the standard precautions compliance in nursing students were in the order of self-efficacy, social support, personal attitude, and standard precautions knowledge. The model explained 48.3% of the variance in standard precautions compliance of nursing students. Conclusion: It is necessary to develop and apply various specialized extracurricular programs that can induce an individual attitude toward observing standard precautions compliance in a positive direction in relationships with teachers and peers and gain their support.

The Effectiveness of a mHealth Program Using Wearable Devices and Health Coaching among Bus Drivers for Promoting Physical Activity: Yeong Mi Ha, Sang Ho Lee, Su Yeon Lee, Yeo Joo Chae; J Korean Acad Community Health Nurs. 2022;33(3):332-339. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.332

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Abstract PDF: Purpose
Bus drivers are at high risk of chronic diseases due to risk factors associated with poor diet, physical inactivity, high levels of sedentary behaviors, and unfavorable working environments. This study developed a mHealth program for bus drivers, and examined the effectiveness of a mHealth program for promoting physical activity among bus drivers using wearable devices and health coaching. Methods: Forty-seven workers from two bus companies were allocated to the experimental group and the control group. Participants were asked to wear a wearable device (Fitbit Charge HR) during waking hours for a day. Participants in the experimental group were provided with a Fitbit, weekly face-to-face health coaching, a mHealth workbook, and text and photo messaging for 12 weeks. The control group only received a Fitbit. Results: By week 12, there were significant differences between the experimental and control groups in exercise self-efficacy (p<.015) and daily walking steps (p<.001). Conclusion: The findings have demonstrated that the mHealth program using wearable devices and health coaching is effective for bus drivers for promoting physical activity. Based on our findings, it is recommended to encourage the mHealth program using wearable devices and health coaching for bus drivers' wellness.

The Effects of Non-pharmacological Interventions on Sleep among Older Adults in Korean Long-term Care Facilities: A Systematic Review and Meta-analysis: Sun Ok Jung, Hye Young Kim, Eun Ju Choi; J Korean Acad Community Health Nurs. 2022;33(3):340-355. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.340

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Abstract PDF: Purpose
This study aimed to examine the effects of non-pharmacological sleep intervention programs in improving sleep quality among older adults in long-term care facilities. Methods: A literature search and selection was performed on nine different databases using the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Overall, 14 studies met the inclusion criteria and were systematically reviewed. For the metaanalysis, the effect size was estimated using the random-effects model in Review Manager (RevMan) desktop version 5.4 of the Cochrane Library. Results: The meta-analysis of overall non-pharmacological interventions obtained a total effect size of 1.0 (standardized mean difference [SMD]=1.0, 95% confidence interval [CI]: 0.64~1.35), which was statistically significant (Z=5.55, p<.001). The most frequently studied non-pharmacological intervention was aroma therapy, with an effect size of 0.61 (SMD=0.61, 95% CI: 0.14~1.08), which was statistically significant (Z=2.55, p=.010). In the subgroup analysis, group-based interventions, interventions for >4 weeks, and untreated control studies were more effective. Conclusion: This study confirms that non-pharmacological interventions are effective in improving sleep quality among older adults in long-term care facilities. However, the sample size was small and the risk of bias in assessing the interventions of individual studies was unclear or high, thereby limiting the generalizability of the results. Further reviews that evaluate randomized control trials, evidence-based interventions that consider older adult participants' physical activity levels, different intervention methods and durations, and different control group intervention types are needed to obtain more conclusive evidence.

Corrigendum

Corrigendum: Influencing Factors on COVID-19 Preventive Behaviors among College Students: Hye Seung Kim, Yun Hee Kim; J Korean Acad Community Health Nurs. 2022;33(3):356-356. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.356

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