Research in Community and Public Health Nursing

Volume 5 (2); December 1994

Original Articles

The role and responsibility of community health practitioner based on the rural community development and the reform of health care system: Hwa Joong Kim; J Korean Acad Community Health Nurs. 1994;5(2):101-108. Published online December 31, 1994

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Abstract PDF: This study was conducted by community survey of 215 community health practitiner's posts and literature review of official documents. The result was as follows ; 1. The role and responsibility of community health practitioner's post must be studied by the community health practitioner and the community health leader, and on the basement of community health needs, community development plan, and reforom of health care system. 2. Comprehensive health care of community is very important role and responsibility of community health practitioners. However, it was supervised by the senior community health practitioner in provincial government. 3. The community health practitioner must be trained by formal inservice educational program focused on comprehensive health care. 4. The community health practitoner must be the health guider and health leader as the member of community.

An Effect of the Self-Regulation Program for Hypertensives: Synthesis & testing of Orem and Bandura's theory: Young Im Park, Yeo Shin Hong; J Korean Acad Community Health Nurs. 1994;5(2):109-129. Published online December 31, 1994

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Abstract PDF: Chronic health problems has become a major concern and challenge to the health care professionals today. Especially hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Self-care is an essential factor that keeps chronic patients in control of their health and wellness. Thus this study was conducted to identify the effect of the comprehensive self-regulation program as a nursing intervention on the promotion self-care performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi-experimental research with pre and post test design was used. The subjects of the study was consisted of thirty persons with mild or moderate essential hypertension from two companies in Cheong-ju city. The whole program was carried out from October, 1993 to February, 1994. The self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The instruments used for data collection in this study were as follows : 1) Instruments used for measuring the knowledge about hypertension, multiple health locus of control, and perceived benifits and barriers were adapted from previous studies and modified by author to be fit for the subjects. 2) Self-efficacy scale and self-care performance record were developed by the author. 3) Physiological parameters included systolic / diastolic blood pressure, body weight, level of blood cholesterol, and 24hour ambulatory blood pressure. The post-experimental Cronbach's Alpha as the reliability test of scales were 0.703-0.897, an appropriate level of confidence. The effect of the program was analyzed by experimental stages ; the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t-test and t-test, repeated measure ANOVA, and pearson's correlation to de termine the effect of program. The results were as follows : 1) After the self-regulation program, scores on knowledge(t=-2.41, p=.011), perceived self-efficacy (F=5.60, p=.001), self-care performance(F=22.31, p=.0001) were significantly higher than those before the program. 2) After the program, both systolic and diastolic blood pressure were significantly lower than those before the program(F=10.89 -13.11, p=.0001). However in 24hour ambulatory blood pressure, systolic mean pressure was nearly significantly lower, but not in diastolic mean pressure. 3) After the program, the body weight was significant decresed(t=5.53, p=.0001), but the blood cholesterol level was not decreased significantly except in those cases with higher cholesterol level. 4) There were significant relationships between changes in self-care performance and diastolic pressure at 1st week (r=.3389, p=.033) and changes in self-care performance and systolic pressure at 9th week(r=.3651, p=.024). 5) There were significant relationship between perceived self-efficacy and self-care performance at 5th week(r=.5313, p=.001) and 9th week (r=.3026, p=.052). 6) After the program, internal health locus of control and perceived benefits did not show significant change, but perceived barriers was significantly lower than those before the program (t=3.57, p=.0001). From the above results, it can be concluded that 1) The self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives and to lower the blood pressure. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings. 2) The synthesis of Orem's self-care theory and Bandura's self-regulation & self-efficacy theory in this study was proved to enhance explanation and prediction of the change of self-care behavior. Thus the result of the study would contribute in development of the self-care theory and an expansion of practice-theory.

A Study on the Establishment of Clinical Nurse Specialist: Young Soon Byun, Young Im Kim, Mi Sook Song; J Korean Acad Community Health Nurs. 1994;5(2):130-146. Published online December 31, 1994

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Abstract PDF: Our medical care system is trying to diversify in order to meet the client's needs, and to adjust to a medical environment which is changing very rapidly. Because current nursing theory and practice focus on holistic care, health care management, education, and research, contrary to the traditional emphasis on only assisting a physician, more autonomy and specialization for the implementation of nursing are required. Considering these trends and actual needs, the category of clinical nurse specialist should be established as soon as possible. In order to develop strategies for implementing this new professional specialty, the authors conducted a field survey and literature review of the current system in Korea. As a result, various obstacles and constraints were discovered as follows : 1) There are few accredited educational programs for the training of CNS's. 2) Several hospitals already have staff designated as clinical nurse specialist (CNS) even though the term CNS is not yet standardized or adopted in nationwide. 3) The role of the CNS is not clearly understood by the medical societies, or even nursing societies. A nurse who works in specific nursing areas such as central supply, kidney dialysis, intensive care, coronary care, etc. for a long time, considers herself/himself a CNS. Based upon the above findings, the following alternatives are recommended. 1) The role of the CNS should be defined according to specified functions and authority : professional autonomy ; counselling and educating patients and their familes, nurses, and even other medical personnel ; research on improvement of nursing ; and management of the nursing environment including medical resources, information, and cases. 2) the qualification of CNS should be attained only by a nurse who has an RN license and clinical experience of more than 3 years in a specific nursing field: passes a qualifying examination; and contributes to the professional development of peers, colleagues, and others. A master's degree should only be optional, because of the insufficient of graduate programs which are well designed for the CNS. 3) The CNS should initially be a head nurse rather than line staff in order to deal with as wide an experience base as possible. 4) The nursing specialty could be divided into two areas such as a clinical field and a community field. The clinical field could then be categorized by the Styles' classification such as diseases and pathogenics, systems, ages, acuity, skills/techniques, and function/role ; the community field could be classified according to work site.

No English Title Available: No author name in English, No author name in English,; J Korean Acad Community Health Nurs. 1994;5(2):147-161. Published online December 31, 1994

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Abstract PDF: No abstract available.

The control of the hypertension in rural primary health care setting in Korea: Young Hae Chung, Hae Young Kang, Mi Young Chung; J Korean Acad Community Health Nurs. 1994;5(2):162-180. Published online December 31, 1994

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Abstract PDF: The control of the chronic degenerative diseases becomes a challenge in Korea as the aging of the population progresses. Accordingly, the importance of the control of the hypertension, one of the major chronic degenerative diseases, in the primary health care settings increases. However, such control activities are still minimal. This study gives brief description of how the rural residents who are currently registered for the control of the hypertension feel about the activities of the health centers, subcenters and the CHP posts, in relation to the control of the hypertension. We also describe the knowledge and practice of the registered hypertensive. In general, the knowledge, the acceptance and the satisfaction of the respondents about the hypertension control activities were not very high. Respondents being managed by the health center showed the highest knowledge, acceptance and satisfaction, and those being managed by the subcenters ranked lowest. The knowledge about the hypertension was not satisfactory. There were great variations among the items in terms of the proportion answered correctly. As many as 60% of the respondents take medication regularly but only 4.5% were practicing weight control regularly. Despite some limitations of the study, the results can be very useful for those planning hypertension control programs. The educational materials and the dietary protocols need to be developed in accordance with the regional social and food pattern, so that they can be utilized with minimal modification for each beneficiary. We also suggest to minimize the area a health personnel covers. In other word, running several small health posts at village level would be more effective than running a subcenter at the township level, in terms of the hypertension control.

A Study on the Knowledge and Attitude about Tuberculosis on Elementary School student in Seoul: Eun Hee Kim; J Korean Acad Community Health Nurs. 1994;5(2):181-202. Published online December 31, 1994

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Abstract PDF: This study was conducted in order to grasp the condition of the student's knowledge and attitude about tuberculosis. And to offer the basic materials for the prevent tuberculosis in elementary school. The objects were comprised 395 of volunteered 6th grade students who study in two elementary schools. The material of this study was the questionaire(chronbach alpha=.9016) suited to the purposed of this research which has been made through studying references. All the questionaire were collected immediately without explanation. The data was collected from 13rd to 25th of May on 1994. Analysis of the data was done utilizing SPSS for percentage, mean, ANOVA and pearson-Correlation Coefficient. The Result are as follows; 1. General features of the objects of study. Sex distribution was similar. Salary of 1000-1500 thousand won were highest (40.2%), nuclear family was highest (87.1%), fathers of graduated high school were the highest(44.0%), mothers of graduated high school were the highest(56.8%). And there was nobody about tuberculosis patient in one's close relatives were highest(95.4%). 2. The conditions of attitude about tuberculosis. Having experience of tuberculin test were highest(59.0%). Less than 9mm indulation among the tuberculin tested group were 85.1%, more than indulation were 14.9%. Have a B. C. G. injection among the less than 9mm indulation were 83.2%. Leave alone among the more than 10mm indulation were 56.0%. Think it too much trouble to do not tuberculine test were 63.0%. Do not take a chest X-ray in the past were 60.3%. And take a chest X-ray in the past were 39.7%. Health educated group was 74.3%. If tuberculosis sign was developed, notified to parent was 73.8%. 3. The condition of knowledge about tuberculosis. When 5 points was given to "very affiming" and 1 point was given to "very deny", the total average was 3.54. And symptom of tuberculosis secion was 3.67, vaccination of tuberculosis section was 3.66, tuberculine test section was 3.56, epidemiology of tuberculosis section was 3.54, infection of tuberculosis section was 3.38. And every section showed affirmative correlation(P<.001). 4. Correlation between the general features and attitude variables. High incomed group may have more attitude on tuberculin test than low incomed group(chi2=16. 190, P<.01). High educated group may have more attitude on tuberculin test than low educated group(Father : chi2=28.530, P<.001, Mother: chi2=26.060, P<.001). High educated group may have more attitude on health education than low educated group(Father: chi2=20. 767, P<.000, Mother: chi2=10.639$, P<.05). Nuclear family may have more attitude on notify to parent than others(chi2=51.45, P<.000). Tuberculosis patient in one's close associates have more attitude on notify to parent than others(chi2=51. 45, P<.000). 5. Difference between the general features and knowledge of tuberculosis. High incomed group were highest score in knowledge (F=3.99, P<.01). High educated group were highest score in knowledge(Father : F=8.81, P<.000, Mother: F=9.09, P<.000). 6. Difference between the attitude and knowledge of tuberculosis. Tuberculin tested group were highest score in knowledge(t=9.88, P<.000). Taken chest X-ray group were highest score in knowledge (t=2.07, P<.05). Received health education group were highest score in knowledge(t=6.83, P<.000). Notified symptoms to teachers and parent group were highest score in knowledge(F=3.89, P<.01).

An investigational study about the needs for exercise of adult inpatients: Myoun Gae Choe, Smi Choi, Young Mi Lim; J Korean Acad Community Health Nurs. 1994;5(2):203-215. Published online December 31, 1994

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Abstract PDF: The purpose of this study was to investigate the needs for exercise of adult inpatients and ultimately to provide basic data for planning nursing intervention of patients who need exercise. The tool used for this study was a structured questionnaire which consisted of 42 items. The test items were classified into seven factors. The seven factors of the needs for exercise were need for achievement, need for activity, need for affiliation, need for autonomy, need for catharsis, need for homeostasis, and need for exhibition. Subjects of this study were 127 patients in two general hospitals in Seoul, and one general hospital in Chun Ann City. The needs of exercise were identified and the data were analyzed by gender, age, occupation, education level, monthly income, size of patient room, patient group who requires exercise and the other patient group who requires bed rest, using one-way ANOVA and Scheffe test as post-hoc. The findings of this study were as follows ; 1) Among the needs for exercise of adult patients, the highest level of the needs was the need for homeostasis. The next highest was the need for achievement, then need for activity, need for catharsis, need for autonomy, need for affiliation, and the lowest was the need for exhibition. 2) Maintaining physical fitness stood first in the need for homeostasis, relieving psychological and physical powerlessness in the need for activity, mood diversion in the need for catharsis, happiness of the family in the need for affiliation, maintaining the balanced body figure in the need for exhibition, practicing planned life in the need for achievement, and improving the ability to overcome the crisis in the need for autonomy. 3) Male patients exhibited the higher level of the needs than female patients in all factors except the need for exhibition and homeostasis. 4) There was no statistical difference in the needs between age, occupation, monthly income, and the size of patient room. 5) The need for achievement was high as the level of education goes higher. 6) The patients who performed regular exercise before admission had higher needs for activity, achievement, and autonomy, compared with the patients who did not perform the regular exercise before admission. 7) There was no statistical difference in the needs between patient group who requires exercise and the other patient group who requires bed rest. The need for homeostasis was the highest in both groups. The results from this study suggest that the need for exercise of adult inpatients should be assessed before planning exercise intervention.

A Study on Occupational Care Diver Though Nurse's Experiences in General Hospitals: Hae Soon Kim, Sook Young Kim, Mi Sung Park; J Korean Acad Community Health Nurs. 1994;5(2):216-226. Published online December 31, 1994

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Abstract PDF: This study attempted to analize nurse's experiences about care giver including nurse's recognition of occupational care giver's existence, the helping part of occupational care giver's activities, problems between occupational care giver and nurse, and correlations between reasons of problems and each variable. The subjects of the study are 218 nurses who are working at general hospitals. The study informations gathered by using structured questionnaire which consisted of 38 items. The reliability of the instrument was cronhach's 0.8310. The collected data was analized by spss program for the statistics of percent, t-test, ANOVA, and Pearson's correlation. The study results were as follows : 1. For the nurse's recognition of occupational care giver's existence 70.2% of nurses(153 nurses) who felt occupaitional care giver's existence was helpful. The result showed 2.20 when transfered to score. 2. Occupational care giver's activities which were helpful to nurses were in order of following : simple serving, personal hygiene, companion of talking, room arrangement, and saftey management. 3. Among 10 items of the problems which nurses having experiences with occupational care givers, 4 items were related with nurses directly. 88.4% of the reasons of the problems were due to lack of occupational care giver's eduction. 4. For the relationships of general characteristics and nurse's reason of problems there was the significant difference in the nurse's status and education. There was the significant difference showed in the group of over status of charge nurse and over college education(T=-2.08, P<0.05, T=-2.13, P<0.01) 5. Correlation between nurse's recognition of occupational care giver's existence and the problems between care giver and the nurse revealed weak relationship (r=0.2002, P<0.01). However, correlation between nurse's recognition of occupational care giver's existence and degree of occupational care giver's helping and also relationship of degree of care giver's helping and problems between these two groups were not statistically significant.

Community diagnosis of health life style in the maternal community: A project for maternal & child health at Ban Nong Loob division in Thailand: Ae Young So; J Korean Acad Community Health Nurs. 1994;5(2):227-235. Published online December 31, 1994

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Abstract PDF: No abstract available.

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