Research in Community and Public Health Nursing

Nam Hee Park

12 Articles

A Structural Equation Modeling of Prostate Cancer Screening Intention: Ji Hye Jeong, Nam Hee Park; J Korean Acad Community Health Nurs. 2019;30(4):471-483. Published online December 31, 2019; DOI: https://doi.org/10.12799/jkachn.2019.30.4.471

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Abstract PDF: PURPOSE
The purpose of this study was to identify factors associated with the intention of the prostate cancer screening (PCS). To achieve this purpose, a structural equation model was established based on the health belief model and the theory of planned behavior.
METHODS
The subjects of this study were 260 male participants who were between 40 and 74 years old and had not taken the PCS. Data were collected using a structured self-report questionnaire (i.e., perceived benefits, perceived barriers, attitude, subjective norms, perceived behavior control, and intention of the PCS). Descriptive statistics, reliability analysis, correlation analysis, confirmatory factor analysis, and fitness test were used to test hypotheses.
RESULTS
The intention of the PCS was directly affected by the perceived behavior control and indirectly influenced by the perceived benefits. The structural equation model also showed that the perceived behavior control explained 78% of the intention.
CONCLUSION
To raise the intention to take the PCS, it is necessary to increase the confidence of a subject that may control its difficulties and inform the perceived benefits of the PCS to a subject.

Analysis of Spatial Distribution of Hypertension Prevalence and Its Related Factors based on the Model of Social Determinants of Health: Min Jung Kim, Nam Hee Park; J Korean Acad Community Health Nurs. 2018;29(4):414-428. Published online December 31, 2018; DOI: https://doi.org/10.12799/jkachn.2018.29.4.414

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Abstract PDF: PURPOSE
The purpose of this study is to identify the spatial distribution of hypertension prevalence and to investigate individual and regional-level factors contributing to the prevalence of hypertension in the region.
METHODS
This study is a cross-sectional research using the 2015 Community Health Survey. Total 64,473 people from 7 metropolitan cities were used for the final analysis. Geoda program was adopted to identify the regional distribution of hypertension prevalence and analyzed by descriptive statistics, one-way ANOVA and correlation analysis using SPSS statistics 23.0 program. Multi-level analysis was performed using SPSS (GLMM).
RESULTS
The prevalence of hypertension was related to individual level factors such as age, monthly household income, normal salt intake, walking practice days, and regional level factors including number of doctors per 10,000 population, number of parks, and fast food score. Besides, regional level factors were associated with hypertension prevalencies independently without the effects of individual level factors even though the influences of individual level factors ware larger than those of regional factors.
CONCLUSION
Respectively, both individual and regional level factors should be considered in hypertension intervention programs. Also, a national level research is further required by exploring various environmental factors and those influences relating to the hypertension prevalence.

Mediating Effects of Self-leadership in the Relationship between Public Health Nurses' Organizational Culture and Their Job Performance: Nam Hee Park, Kyung Jo Lee, Sang Ju Lee; J Korean Acad Community Health Nurs. 2017;28(1):23-33. Published online March 31, 2017; DOI: https://doi.org/10.12799/jkachn.2017.28.1.23

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Abstract PDF

PURPOSE
The purpose of this research is to enhance organizational competitiveness of health centers as well as private medical institutions serving as public health and medical institutions. It tries to help them to cope with the requirements from health consumers, to enhance public health nurses' job performance.
METHODS
After verifying the reliability of the tool, confirmatory factor analysis was used to detect a model, in which valid path coefficients exist among variables. The detected model was then selected as the subject and its validity was verified. Finally, a structural equation model was applied to verify whether the estimate was suitable for the purpose of this research.
RESULTS
As for the nursing organizational culture, the public health nurses considered relation-oriented culture the most desirable. As for the self-leadership, they considered self-compensation the most desirable. It was found that mediating effects of self-leadership was partially significant.
CONCLUSION
To enhance job performance, it is necessary to make a transition from the organizational culture to the relation-oriented culture and it is also necessary to develop a program capable of reinforcing self-leadership. In addition, it is necessary to conduct a research to verify whether such a developed self-leadership program is influential on job performance enhancement.

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Mediating Factors in Nursing Competency: A Structural Model Analysis for Nurses’ Communication, Self-Leadership, Self-Efficacy, and Nursing Performance
Ae Young Kim, In Ok Sim
International Journal of Environmental Research and Public Health.2020; 17(18): 6850. CrossRef

The Effects of the Designated Doctor System on Health Care Utilization of Medical Aid Beneficiaries with Chronic Diseases: Min Jung Kim, Young Ha Cho, Nam Hee Park; J Korean Acad Community Health Nurs. 2015;26(3):278-291. Published online September 30, 2015; DOI: https://doi.org/10.12799/jkachn.2015.26.3.278

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PURPOSE
This study was conducted to examine differences in health care utilization and related costs between before and after the introduction of the designated doctor system, and to find out factors making the differences.
METHODS
Data were collected from 200 medical aid beneficiaries having one or more chronic diseases, registered in the designated doctor system during the year of 2012, and the relationship between the use of health services and claimed medical expenses was analyzed through paired t-test and multiple regression analysis using the SPSS 18.0 program.
RESULTS
There was a decrease in the number of total benefit days and the number of outpatient and medication days, but some cases showed an increase after the designation of medical institution. In general, hospital stay increased after the introduction of the system. However, the number of medical institutions utilized was reduced in most cases after designation. Conversely, medical expenses increased in most cases after the designation of medical institution.
CONCLUSION
These results suggest that a detailed scheme to designate medical institutions should be made in consideration of the seriousness of illness and classification of medical institutions not only for the beneficiaries' enhanced health but for the effective management of medical aid fund.

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A Two-step Clustering Approach for Measuring Socioeconomic Factors Associated with Cardiovascular Health among Older Adults in South Korea
Chi-Young Lee
Korean Journal of Adult Nursing.2020; 32(6): 551. CrossRef

The Influence of Health Literacy and Diabetes Knowledge on Diabetes Self-care Activities in Korean Low-income Elders with Diabetes: Ji Hye Jeong, Nam Hee Park, So Young Shin; J Korean Acad Community Health Nurs. 2014;25(3):217-224. Published online September 30, 2014; DOI: https://doi.org/10.12799/jkachn.2014.25.3.217

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PURPOSE
This study aimed to assess the levels of and relationships among health literacy, knowledge about diabetes, and self-care activities in the Korean low-income elderly with diabetes and to identify factors influencing the self-care activities of this vulnerable population.
METHODS
This study surveyed a total of 151 low-income elderly patients with diabetes registered at 16 Visiting Health Care Services in B City, Korea. Health literacy was measured with the Newest Vital Sign. Diabetes knowledge was measured with the Diabetes Knowledge Test. The Summary of Diabetes Self-care Activities Questionnaire was used to assess diabetes self-care activities. A stepwise multiple regression analysis was conducted to identify significant factors influencing diabetes self-care activities in these patients.
RESULTS
In the regression model, diabetes knowledge (beta=.322, p<.001), exercise (beta=.337, p<.001), and experiences of diabetes education (beta=.241, p=.001) were significantly associated with increased diabetes self-care activities in low-income elderly patients with diabetes when gender, education, health literacy, and subjective health state were controlled.
CONCLUSION
To improve diabetes self-care activities in the low-income elderly with diabetes, it is important to develop a customized program considering their knowledge, exercise, and diabetes education experience.

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The Relationship between Health Literacy of Elderly Diabetics and Adherence to Treatment, Babol, Iran, 2021
Abdollah Goli Roshan, Seyedeh Navabeh Hosseinkhani, Reza Norouzadeh
Qom Univ Med Sci J.2021; 14(12): 70. CrossRef
The Role of Health Literacy in Diabetes Knowledge, Self-Care, and Glycemic Control: a Meta-analysis
Laura Marciano, Anne-Linda Camerini, Peter J. Schulz
Journal of General Internal Medicine.2019; 34(6): 1007. CrossRef
Evidence-based health literacy improvements: trends on health literacy studies in Korea
Soo Jin Kang, Mi Sook Lee
Korean Journal of Health Education and Promotion.2015; 32(4): 93. CrossRef

The Effects of a Mobile Computerized System for Individual Tailored Home Care Services in a City: Nam Hee Park, Rang Jang, Jung Young Kim, Myoung Soo Kim; J Korean Acad Community Health Nurs. 2012;23(1):71-81. Published online March 31, 2012; DOI: https://doi.org/10.0000/jkachn.2012.23.1.71

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Abstract PDF: PURPOSE
The aim of this study was to evaluate the process and outcome of a mobile computerized system for individual home visiting healthcare.
METHODS
A nonequivalent control group non-synchronized design was employed for this study. The newly constructed system was administered to 80 healthcare providers in the experimental group for 8 weeks. Data were analyzed using descriptive analysis, t-test, and ANCOVA with the SPSS 18.0 program.
RESULTS
In the process stage, the difference in the frequency of computerized information usage between the experimental and control groups was significant as 8.88+/-3.20 and 7.08+/-2.92, respectively (t=3.90, p<.001). In the outcome evaluation stage, all kinds of healthy lifestyle such as alcohol use, nutrition, weight management and mental health were not improved.
CONCLUSION
The findings of this study showed that the revised mobile computerized system was an effective device for individual visiting healthcare providers. Further advanced strategies for using this system should be developed and applied in a broad range of community healthcare.

Prevalence and Risk Factors of Dementia in the Community Elderly: Nam Hee Park, Youn Mee Lee, Lu Rie E; J Korean Acad Community Health Nurs. 2008;19(1):36-45. Published online March 31, 2008

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Abstract PDF: PURPOSE
This study was to estimate the prevalence of dementia in order to estimate the associations of dementia with its risk factors in the community elderly.
METHODS
The multistage random cluster sampling method was used to select the subjects. The response rate was 94.3%. For the 1st stage screening survey, the Korean-version Mini-Mental State Examination (K-MMSE) and the Bathel Index of activities of daily living (ADL) and instrumental activities of daily living (IADL) were used as primary screening tools. At the 2nd stage, diagnoses were confirmed according to the Clinical Dementia Rating Scale (CDR) and Computer Tomogram (CT).
RESULTS
Age-sex adjusted prevalence (%) [95% CI] of dementia was 6.25% [4.47-7.83] (male 4.21% [2.40-6.02]; female 8.28% [5.71-10.85]). Four statistically significant risk factors of the dementia were identified: age 70-74 (OR=1.367), age 75-79 (OR=1.712), age 80-84 (OR=2.465), age 85 over (OR=7.363); illiteracy (OR=3.827); unconsciousness after head injury (OR=3.383), and no exercise (OR=2.188). Hosmer and Lemeshow goodness-of-fit index of dementia risk model was E (logit of dementia)= -4.337+0.312*Age(70~74)+0.538*Age(75~79)+0.902*Age(80~84)+1.996*Age(85over)+1.342*Illiteracy+1.219*Unconsciousness after head trauma+0.783*No exercise. We confirmed that the overall prevalence of dementia in adults aged 65 and older was 94.3%. The risk factors of dementia were explained by age, illiteracy, unconsciousness after head trauma and no exercise.
CONCLUSION
These data have been used to estimate the incidence of dementia in elderly community population and to manage the possible role of risk factors as predictors of dementia.

The Effects of a Combined Exercise Program and Telephone Counseling on Physiological Functions, Self-efficacy and Depression in Obese Middle-aged Women: Nam Hee Park, Chae In Han, Eun Oak Choi; J Korean Acad Community Health Nurs. 2007;18(1):69-78. Published online March 31, 2007

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Abstract PDF: PURPOSE
This study was to determine the effects of a combined exercise program and telephone counseling in obese middle-aged women. The study also attempted to measure the effects of the program on physiological functions, self-efficacy and depression.
METHOD
This research employed a nonequivalent control group pretest-posttest design. The experimental group consisted of 29 obese middle-aged women, and the control group of 30 women. The subjects in the experimental group participated in a combined exercises program and telephone counseling for 12 weeks.
RESULTS
After performing the program for 12 weeks, BMI (p=.000), percent body fat (p<.007), TC (p=.026), TG (p=.035) and depression (p=.012) in the experimental group decreased significantly compared with the control group. Self-efficacy (p=.000) in the experimental group increased significantly compared with the control group after the program.
CONCLUSION
From these findings, it was confirmed that a combined exercises program and telephone counseling for obese middle-aged women can increase self-efficacy and decrease BMI, percent body fat, total cholesterol, triglyceride and depression. Therefore, this program can be utilized for various population groups including women, and further researches are required on programs for men.

A Study on the Development of Self-help Program with Care Burden for Families with Demented Elderly Persons: Jung Soon Kim, Su Ill Lee, Ki Tae Kim, Nam Hee Park; J Korean Acad Community Health Nurs. 2005;16(3):260-269. Published online September 30, 2005

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Abstract PDF: PURPOSE
This study were to understand the caregiving situation of families with the demented elderly and to develop a self-help program for them.
METHODS
A self-help program was designed to increase caregivers' confidence and skills in problem solving. In addition, it was designed to provide information about the demented elderly. The self-help program of this study was composed of nine sessions.
RESULTS
Family caregivers of elderly patients with dementia obviously experience high level of stress. which often leads the caregivers to negative outcomes such as depression, interference with social activities and health difficulties. That is, caring is stressful for caregivers because the demands of the caregiving situation tend to overwhelm the caregivers' coping resources. Therefore, families with demented elderly persons need assistances in order to be relieved from their care burden.
CONCLUSION
The self-help program includes the understanding of dementia, the family caregiving experiences of the demented elderly persons, the time for self-care, the search for helping, the improving of interpersonal relations and communications.

Development of a Korean Senile Dementia Management Model: Jung Soon Kim, Myoung Soo Kim, Nam Hee Park; J Korean Acad Community Health Nurs. 2004;15(3):450-459. Published online September 30, 2004

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Abstract PDF: PURPOSE
The purpose of this study is to grasp the welfare service for the demented people staying at home and the service that caregivers want to use. Therefore, we are going to develop a Korean senile dementia-care management model.
METHOD
It analyzed the data of 185 demented people and caregivers, who registered in 16 public dementia-care centers in B city since June 2002.
RESULTS
1) The types of services used by the aged people with dementia staying at home were, in the order of frequency of use, the day-care center (26.5%), and home-help service (21.6%). 2). The types of services according to the degree of dementia were as follows; mild cases: home-care service (5.4%), moderate cases: day-care service (40.0%) and severe cases: day-care service (26.0%). 3). The caregivers who want to use senile welfare institutions accounted for 23.3%, and the major reason they could not use the institutions was due to their economic situation. 4) The Korean senile dementia care management system must be executed, considering caregivers' economic state and severity of dementia. Since the system was actively operated, many small sized welfare service institutions showed development.
CONCLUSION
The welfare services appropriate to the severity of dementia should be provided. With the model developed in this study, the dementia management requires sufficient care and should be achieved to reduce the caregivers' burden.

An Investigation on the Status of Care-giving for the Demented Elderly and Desire for In-house Care Services: Jung Soon Kim, Sui Il Lee, Ki Tae Kim, Ihn Sook Jeong, Nam Hee Park, Kyung Nam Lee, Mung Soo Kim; J Korean Acad Community Health Nurs. 2003;14(3):385-396. Published online September 30, 2003

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Abstract PDF: PURPOSE
The purpose of this study is to examine the status of care-giving for the demented elderly and to find out the need of community in-house care services- day care services, short-term care services, home help services, and home care services.
METHOD
It analyzed the data of 186 old people having dementia, and caregivers. Data were collected for five days, in September 2002.
RESULTS
The caregivers were mostly women and the burden for the care giving was high (87.5%). They used community care services, that is, day care services (26.5%), home care services (21.6%), home help services (10.8%), short-term care services (6.2%). Caregivers' age and education level were significant factors in the demand for day care services. Caregivers' education level was a statistically significant factor in the demand for short-term care services and home help services. Caregivers' age and education level were significant factors in the demand for home care services.
CONCLUSIONS
It is necessary to expand the financial aid for the active implementation of daytime protection for dementia-patients under medical treatment at home and to promote patients' recovery. It is necessary to enhance home help services and home care services, and to establish many day care centers and short term care centers. Through this, it will prevent caregivers from becoming burnt out due to the burden of care giving.

A Critical Review of Health Behavior Studies of Adolescents Conducted in Korea: Nam Hee Park, Hae Jung Lee; J Korean Acad Community Health Nurs. 2002;13(1):98-114. Published online March 31, 2002

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Abstract PDF: PURPOSE
This review examined literature relevant to adolescent's health behavior in order to identify key behaviors and factors related to health behaviors for targeting health promotion interventions.
METHOD
A critical review of 29 research articles was carried out using the guidelines suggested by Cooper.
RESULT
The majority of the studies were descriptive and cross-sectional. Generally, the study includes sub-dimensions such as general hygiene and daily life habit, safety and accident prevention, nutrition and eating (tobacco, drinking), exercise, mental health and stress management, health duty (drug, health examination, disease prevention). Factors highly related to health behaviors were age, living areas, economic status, parent health behaviors, parent health concern, social support, friends influence, self-efficacy, self-esteem, locus of control, and the perceived health status. Sex, parent education and health knowledge were not related to health behaviors of adolescents.
CONCLUSION
Several conceptual and methodological problems were identified in the studies review, such as restricted conceptualization of health behaviors and sampling issues which limit the generalizability of the study outcomes. Further research is needed to enhance the concept clarification and generalizablity of the study results.

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