Research in Community and Public Health Nursing

Soon Nyoung Yun

19 Articles

Effectiveness of Community-based Case Management for Patients with Hypertension: Soon Nyoung Yun, In Sook Lee, Jin Hyun Kim, Young Ko; J Korean Acad Community Health Nurs. 2014;25(3):159-169. Published online September 30, 2014; DOI: https://doi.org/10.12799/jkachn.2014.25.3.159

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Abstract PDF: PURPOSE
The purpose of this study was to evaluate the effectiveness of case management for patients with hypertension on their health status and medical service utilization.
METHODS
This study was a secondary analysis of data collected for a larger study of chronic disease management in 2008 using the National Health Insurance Corporation database. A total of 12,944 patients who received case management for hypertension were included in this analysis. The subjects of case management were classified into subgroups, namely, over-use, under-use, and non-use groups according to the amount of medical service utilization. To compare the medical service utilization, a control group was selected randomly. The data were analyzed through descriptive statistics, McNemar test, and ANOVA.
RESULTS
All the subgroups displayed significant differences in blood pressure, self-management, social support, and their characteristics of medical service utilization. The total medical expense of the under-use and non-use groups increased after case management. However, there was no decrease in the medical expense of the over-use group.
CONCLUSION
This finding suggests that there is a need to re-examine why patients overuse medical services and to supplement specific strategies for encouraging appropriate medical service utilization, and enhancing case management efforts for the over-use group.

Analysis of the Factors Affecting to Youth Smoking Based on the Stage of Change: Yun Jeong Yi, Soon Nyoung Yun, Young Ko, Mi Kyoung Chang, Bo Ra Nam; J Korean Acad Community Health Nurs. 2009;20(2):225-233. Published online June 30, 2009

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Abstract PDF: PURPOSE
This study was to analyse the factors affecting youth smoking, especially self-efficacy and perceived social norm, based on the stage of change.
METHODS
A self-reported survey was conducted during the period from the 21st of April to the 17th of May, 2008. Data were collected from 10,707 students of 12 middle schools in Seoul, Gyeonggi-do, and Incheon. The data were analysed with SPSS/WIN 15.0.
RESULT
The smoking possibility was 2.18 times higher in the male students than in female students, and 1.76 times higher in 8th-grade students and 2.48 times higher in 9th-grade students than in 7th-grade ones. Smoking possibility increased when students had more experience in alcohol, more friends who smoke, or worse relationship with their parents. Also this study showed that high-level self-efficacy and perceived social norm were acting as inhibiting factors of smoking.
CONCLUSION
To reduce the youth's smoking rate, smoking prevention programs should provide educational chances to learn knowledge and skills on how to reject smoking temptation. Also, someone significant like parents should make it clear to the youth that they do not want their children to smoke.

A Study on the Satisfaction of Web-Based Health Education Programs: Soon Nyoung Yun, Jeong Eun Kim, In Sook Lee, Bok Im Lee, Eun Jun Park, Soo Yeon Park; J Korean Acad Community Health Nurs. 2009;20(2):134-142. Published online June 30, 2009

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Abstract PDF: PURPOSE
This study was to present the process of web-based educational program (WEP) development and to identify factors affecting satisfaction with WEP for the certificate of healthcare managers working at the National Health Insurance Corporation (NHIC).
METHODS
Subjects were healthcare managers and voluntary participants of WEP. A total of 1,449 respondents were surveyed through an online questionnaire about their satisfaction with the educational contents and system.
RESULTS
The mean contents satisfaction was 3.75 (SD 0.54), and system satisfaction 4.68 (SD 0.54). According to statistical analysis, the type of certification, experience and professional career of health care management affected contents satisfaction. And factors affecting system satisfaction were the type of certification and gender.
CONCLUSION
WEP was utilized as a pre-requisite course for the certificate program of healthcare managers. However, the development of advanced WEP is suggested to meet the educational needs of healthcare managers who have certificate or license and their job related to healthcare management.

The Processes of Habituating to Smoking among Teenagers: Soon Nyoung Yun, Yun Jeong Yi, Eun Young Suh, Chun Mi Kim, Young Ko, Mi Gyeong Jang, Jeong Hee Hyeon; J Korean Acad Community Health Nurs. 2008;19(4):636-648. Published online December 31, 2008

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Abstract PDF: PURPOSE
The smoking rates among teenagers in Korea grow gradually since 1980s despite of the numerous programs for youth smoking prevention and cessation have been developed and implemented. The purpose of this study was to explore and describe the processes of habituating to smoking among teenagers using the grounded theory methodology.
METHOD
Qualitative data was collected via six focus group interviews. A total of 38 people, twelve teachers and 24 middle school students participated in this study. All focus group interviews were tape-recorded, transcribed, and analyzed according to the grounded theory methodology.
RESULTS
The overriding theme of the elicited grounded theory was "stepping into a quagmire by a merest chance". The student participants began smoking by a simple chance. The contingent factors to starting smoking were "discord within the family", "family member's smoking", "schoolwork stresses", or "a rebellious spirit". The conditions of smoking included accessibility, going around in group, and the lack of discipline. "Stigmatizing", "involved in mob violence", and "making a poor academic record" coexisted as the covariance of the smoking habituation.
CONCLUSION
The findings of this study illustrated the comprehensive and insightful picture of the phenomena under investigation. Nursing implications and further directions for research were discussed.

A Comparative Study on Health Promotion Behaviors and Affecting Factors of Aged Women in Urban and Rural Area: Ji Yun Lee, Soon Nyoung Yun; J Korean Acad Community Health Nurs. 2005;16(1):13-22. Published online March 31, 2005

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Abstract PDF: No abstract available.

The Factors Affecting the Health Promoting Life Style in Hypertensive Male Workers: Eun Young Hong, Soon Nyoung Yun; J Korean Acad Community Health Nurs. 2004;15(3):397-407. Published online September 30, 2004

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Abstract PDF: PURPOSE
In Korea, as the number of hypertensive worker grows, identifying the level of health promoting life style practice and related factors in hypertensive workers is becoming more and more important.
METHOD
The subjects of this study were 195 hypertensive male workers in Korea. The data was collected during 3 months ranging from August 2003 to October 2003. The data was analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression by SAS 8.1 program.
RESULTS
It was found that there were significant differences between age, religion, medication, perceived health status, perceived benefits, internal health locus of control, powerful other health locus of control and health promoting life style practice. The most significant factor affecting the health promoting life style practice was internal health locus of control. The combination of internal health locus of control, specific self-efficacy, powerful other health locus of control, general self-efficacy accounted for 51.0% of the health promoting life style practice.
CONCLUSION
The level of health promoting life style practice was very low, so it is urgent to manage and care for hypertensive male workers continuously and systemically with occupational health nurses. Based on the above results, cognitive perceptual characteristics should be considered when developing health education programs for hypertensive workers.

A Study on Model Development for Urban Community Nursing Center: Soon Nyoung Yun; J Korean Acad Community Health Nurs. 2002;13(2):260-271. Published online June 30, 2002

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Abstract PDF: OBJECTIVES
The purpose of this study was to identify basic health needs of adult clients to develop a community nursing center model in Seoul.
METHODS
Data were collected using a questionnaire survey from 894 adults registered at a public health center who were health management members, and visiting 4 community nursing centers, University of Wisconsin, Milwaukee during the period from July 1999 to January 2000. The data were analyzed using frequency, percentile, t-test, and ANOVA.
RESULTS
1) The University of Wisconsin- Milwaukee School of Nursing has a long tradition of developing 4 community nursing centers with innovative health care programs. CNCs integrate the ability to implement and test effective intervention strategies with education, research, and practices of nursing students and faculty. They were designed to enhance the health status and quality of life for urban communities through the development of productive, outcome focused, collaborative partnerships among UWM-Nursing faculties and staff, other health and human service providers, consumers, and policy makers. It links the financial resources between UWM and 9 voluntary agencies and 12 public funding organizations including federal, state, and local governments. 2) Of the total health management members, 37.4% were reported to have at least one type of chronic disease such as hypertension, diabetes, and arthritis. Ten percent of them reported having obesity, and 44.2% reported lack of exercise. The health status of the subjects was within normal range in laboratory tests. However, female subjects showed more significant differences in obesity and cholesterol levels than male subjects. The subjects, who were in their 50s, showed more significant differences in obesity, SGOT, SGPT, and cholesterol levels than the subjects in other age groups.
CONCLUSION
A community nursing center needs to be developed, that has a link between the nursing college and the public health center, with partnerships and a multidisciplinary approach. Based on the study results, exercise programs for middle aged adults are considered necessary. In particular, specific exercise programs for pre-menopausal women needs to be implemented in the future to prevent them from developing osteoporosis.

Test of the New Health Promotion Model for the Prediction of Female Employees' Health Promotion Behavior at the Manufacturing Plants: Soon Nyoung Yun; J Korean Acad Community Health Nurs. 2001;12(3):557-569. Published online December 31, 2001

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Abstract PDF: The purpose of the study was to test the Pender's New Health Promotion Model in order to explain and predict female workers' health promotion behavior at manufacturing plants by using latent variable structural equation model. The data were collected from 280 female workers at 8 electronic factories located at Seoul, Kyunggi, and Incheon using a structured questionnaire through interview and self-report. LISREL was used to test the model. The results are as follows; 8 out of 15 paths of the modified one from the hypothetical model of Health Promotion were statistically significant and the total variance was 40%. The relationship between the previous health behavior and the cognitive emotional factor, and the interpersonal factor, and the situational factor each, and the relationship between perceived health status and interpersonal factor, and health promotion behavior each among gamma paths were unidirectional. On the beta paths, the relationship between the interpersonal factor and the cognitive emotional factor was bi-directional; the relationships amongst the interpersonal factor and the commitment to action, and the health promotion behavior were unidirectional. But the commitment to action was not a significant mediating factor to the health promotion behavior. Pender's New Model is considered good to explain and predict the female workers' health promotion behavior. The interpersonal factor should be considered in occupational nursing practice. But the concepts of situation and commitment to action should be further validated and measured.

Occupational Stress of the Workers in a Electronic Manufacturing Factory: Jeong Hee Kim, Soon Nyoung Yun; J Korean Acad Community Health Nurs. 2001;12(1):239-246. Published online March 31, 2001

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Abstract PDF: This paper attempts to identify the occupational stress-related factors among the workers at the manufacturing industry and to provide the basic data concerning development of stress management program focused on the manufacturing industry. The subjects exhibit significantly highest level of 'the characteristics of task and participation in decision making factor'. And the mean score of 'the avoid coping strategies' was higher than 'the control coping strategies'. The main factor that affected the occupational stress responses was 'the physio-environmental factor' and it was explained 15.6% out of the total variance of the stress responses. Also, it would be explained 29% out of the total variance of the stress responses with 'the characteristics of task/participation in decision making factor', sex, social support, and 'extra-organizational stressor'. In conclusion, For developing the stress management program in workplace, 'the physical environmental factor' and 'the characteristics of task and participation in decision making factor' should be considered. Also, It should be identified the direct and indirect paths among factors that significantly related factors to the occupational stress of workers further more.

The Study on the Model Development and Analysis of 'Child Growth and Developmental Clinic': Focusing on the public health center: Kyung Ja Han, Kyung Sook Bang, Soon Nyoung Yun; J Korean Acad Community Health Nurs. 2001;12(1):49-59. Published online March 31, 2001

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Abstract PDF: PURPOSE
This study was intended to develop the framework of public health center based 'Child growth and developmental clinic' and analyze the efficiency of services. This was the part of Mother-Child Health Guidance Project by the Public Health Center in Seoul. The purposes of this project were to improve children's health and development with early detection of developmental delay by screening test, and to assist and guide the parent for child care and rearing, so that children can reach their maximum potential.
METHODS
Framework and standards for operation of 'Child growth and development clinic' were developed. We selected screening tool, developed parent education materials, and educated the personnel of public health center.
RESULTS
243 children were enrolled for developmental screening, and we detect the children with developmental delay and referred them for further evaluation. The proportion of developmental delayed children was approximately 2% of the enrolled children. Also, we analyzed the characteristics of enrolled children, and their parental needs and attitude on child rearing. Some problems in operation of developmental clinic were discussed.
CONCLUSION
Though we can found some limitations, we are confident that pubic health center can be charge of important role for improving child development for the majority. This study will be the basis of children's developmental clinic running by public health center.

The Middle-aged's Health Problems and Health Behavior in an Urban Area: Soon Nyoung Yun, Jeong Hee Kim; J Korean Acad Community Health Nurs. 2000;11(2):486-498. Published online December 31, 2000

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Abstract PDF: The purpose of this study is to identify health problems and health behaviors of the middle-aged residing in urban areas and to plan and implement health promotion programs based on their health needs. The subjects' age ranged from 30-64 years in 1.040 middle-aged residing in an area of Kangbook-ku in Seoul. The data were collected from September 1998 to February 1999 with structured questionnaire using face-to-face or telephone interviews. The data were analyzed by SPSS-PC+ and identified by chi2 test and ANOVA. The results were as follows: 1. 35.4% of the males and 27.8% of the female responded that they were healthy regarding their perceived health status. In the order of chronic illness prevalence in the case of males was hypertension, diabetes, and digestive disorders and. in the case of females, was digestive disorders, hypertension, arthritis, anemia, and diabetes. 2. Male and female's smoking rates were 7.3% and 3.6% each and marked the highest rate of 30 to 40 years: drinking behavior was 66.9% in males and 32.2% in females. 3. The younger males had the worse dietary habits and had the lowest frequency of regular exercise. The older the females were, the more their weight increased. According to the results, health promotion programs by sex are recommended, especially in the target population of 30 to 40 years. and focused on the strategies for promoting self-care and actual health practice: it is strongly suggested that health promotion programs for adolescent and school-aged children before middle aged health behavior begins.

The Relationships between Job Stressor, Coping Strategies, and Stress Responses of Manufacturing Workers: Jeong Hee Kim, Soon Nyoung Yun; J Korean Acad Community Health Nurs. 1999;10(2):387-399. Published online December 31, 1999

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Abstract PDF: The purpose of this study is to identify the relationships of job stressor. coping strategies. and stress responses of manufactoring workers. Data were collected through self-reported questionnaires from 262 of the manufacturing workers in a local electronic company from July to August. 1999. For data analysis. Cronbach's alpha. Factor Analysis. Descriptive statistics. ANOVA, and Pearson's correlation coefficient with SPSS/PC+ 7.5 version program were used. The results were as follows: 1. Regard to the stress responses and coping strategies by sociodemographic variables. 'the overall stress responses' showed significant differences by sex. age. marrital state. The use of 'control coping strategy' showed significant differences by sex and the type of work. The use of 'avoid coping strategy' showed significant differences by sex. age. married state. year of career. and income. 2. The average scores of 'the job characteristics and participation in decision making factor'. 'the physical environmental factor'. and 'the role and leadership factor' were 2.66. 2.59. 2.59 in order. The average scores for 'the avoid coping strategy' and 'the control coping strategy' were 3.03. 2.97. The average scores for 'the overall. psychosoical. and physical stress responses' were 2.18. 2.18. 2.23. 3. The 'control coping strategy' was negatively related to 'the job characteristics and participation in decision making factor'. 'the role and leadership factor'. 'the psychosocial stress responses'. and 'the overall responses'. 'The control coping strategy' was positively related to all of 'the job stressors'. 'the physical stress responses', and' the overall stress responses'. 'The physical environment factor' was positively related to all of 'the stress reponses'. 'the role and leadership factor'. and 'the job characteristics and participation in decision making factor'. According to the results of this study, the suggestions were as follows: 1. The coping strategies of manufacturing workers in the specific job stress situation should be considered to future studies. 2. In order to applying the stress management program in the workplace. The organizational intervention focused on 'the job characteristics and participation in decision making' will be needed. 3. To support and use of 'control coping strategy' of the workers. the organizational efforts should be required.

Developing the Joint Employment System of Occupational Health Nurse Practitioners for the Minor Enterprises in Korea (Part 2): Comparison of Opinions between Employers and Occupational Health Nurses: Young Im Kim, Kyung Ja June, Sung Eun Lee, Soon Nyoung Yun; J Korean Acad Community Health Nurs. 1998;9(2):313-323. Published online December 31, 1998

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Abstract PDF: This study is to develop the model on the joint employment system of occupational health nurse practitioners for medium or small sized enterprises in Korea based on the comparison opinions between employers and occupational health nurses (OHN). The data were collected by questionnaires from Oct. to Nov. in 1997. The number of subjects was 210 OHNs and 176 employers, response rate was 47.1% for OHNs and 23.2% for employers. The SAS PC program was used for the descriptive statistics. The results were as follow: 1. More than three years career was preferred for qualification of OHN by employers and OHNs. OHNs preferred that all instruments and materials should be equipped in each industry, but employers preferred that they should be equipped by OHN. 2. For the limit number of industries and employees per one OHN, employers preferred average 2.25 industries and 307 employees, OHNs preferred average 3.0 industries and 448 employees. Both of them preferred two times visit per week for all day long. 3. OHNs wanted that the local office of Ministry of Labor could act as mediator, but employers preferred direct contact individually. For the average wage, employers preferred 887,000 won per month, but OHNs preferred 1,960,000 won per month. 4. OHNs preferred the Korean Association of Occupational Health Nurse as the recruit agency. Finally, employers and OHNs have the opinions that they can choose this system depending on the condition. There is in need of development of effective strategy for this new system such as manpower development, cost-benefit analysis, establishment of occupational health service standard, advertisement for employers, and government supported project.

Health Behavior of the Obese Adult - Based on the Johnson's Behavioral System Model: Jeong Hee Kim, Soon Nyoung Yun; J Korean Acad Community Health Nurs. 1997;8(2):277-288. Published online December 31, 1997

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Abstract PDF: The purpose of this study is to identify the behavioral subsystems of the obese adult and contribute to the utility of Johnson's Behavioral System Model. The subjects were 167 obese adults in out-patients clinics of 2 hospitals and health clinics for 4 companies. These data were collected by a structured questionnaire with 52 items from July 1 to Sep. 30, 1995. The instrument used for this study was modified from the DBSM-self reporting instrument (1983) and Grubbs(1980)'s. The reliability of this method was cronbach's alpha=.8476 and the construct validity of it was accepted by using a factor analysis. These data were analyzed by frequency, percentage, mean, standard deviation, factor analysis, pearson's correlation coefficient, Kruskal-Wallis with an SPSS PC+ Program. The results of this study were as follows: 1. The 9 behavioral subsystems of the obese were indentified : sex-related, attachment-affiliative I(social), dependency, ingestive, eliminative, restorative, aggressive-protective, attachment-affiliative and II (familial), an achievement behavioral subsystem. 2. Out of 9 subsystems, the highest significant positive correlation between dependency and acheivement subsystem was found(r=.5357, p<.01), The next, attachment-affiliative I and attachment-affiliative II subsystem was correlated significantly (r=.4526, p<.01). Significant positive correlations among sex-related, achivement, attachment-affiliative I, II, dependency, restorative, and aggressive-protective subsystems were found. But, ingestive and eliminative subsystems were not correlated with the above seven subsystems significantly, only the positive correlation between the ingestive and eliminative subsystems was found. 3. The explained variance of the 9 subsystems was explained as 56.1% out of a total of one. The sex-related subsystem was the first factor explaining 16.3% of the total variance and then the next 8 factors which resulted in 39.8%. According to the results of this study, the suggestions were as follows: 1. In the nursing practice, nursing assessmentand intervention of the obese should be in cluded not only in ingestive and eliminative subsystems but also in sex-related, attachment-affiliative I, dependency, restorative, aggressive-protective, attachment -affiliative II, and achievement behavioral subsystem. 2. Concerning instruments, some items to measure the eliminative, dependency, and aggressive-protective behavioral subsystems with relatively reliability are needed. 3. Johnson's concept of a dependency subsystem should be clarified. 4. Correlation among the 7 subsystems, and the ingestive and eliminative subsystems should be clarified.

Literature Review on the Stress Management Programs throughout Life-span: By foreign research for 1993-1996: Soon Nyoung Yun, Jeang Sook Choi, Kyung Sook Lee; J Korean Acad Community Health Nurs. 1997;8(2):178-196. Published online December 31, 1997

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Abstract PDF: The purpose of this study is to identify the kind, the frequency, and the type of Stress Management Program(SMPs) throughout life-span used foreign, recent research. The period of this study was from July 1 to Dec. 10, 1997. The data were collected through Medline using two concepts: stress management programs and life-span. The number of these research were 106 and thirty-one experimental researches that were tested the effectiveness of SMPs throughout life span were selected. The data were analysed by the kind, frequency, and life-span. The results were as follows: 1. The kind and frequency of SMP : The total number of the kind of SMP were twenty-two. The most used SMP was relaxation therapy, 22 out of 31. The second biofeedback was 10, the third, cognitive behavior program was 9, the fourth, nutrition and diet, and education were 7. The others were coping skill(4), cognitive therapy(4), breathing(4), imagery(3), autogenic training(3), sleep and rest(2), meditation(2), information(2), desensitization(2), hypnosis(2), behavior therapy(1), time management (1), visualization(I), yoga(I), diversion(1), and problem solving skill. 2. Throughout life-span: Most SMPs were applied to adolescents, young adults, and middle-adults. Other subjects could not be found under the schooler. 3. The type of SMPs : 28(90.3%) out of 31 research used combined-SMP : two-combined SMP, 5: three-combined SMP, twelve: four-combined SMP, seven: five-combined SMP. 4. Afterward, further study such as meta-analysis are needed in order to identify effective ness of the SMPs.

A Comparison of Outcomes of Visiting Nursing Service by the Organizational Structure of Health Centers: Soon Nyoung Yun, Sung Ae Park; J Korean Acad Community Health Nurs. 1996;7(1):5-17. Published online June 30, 1996

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Abstract PDF: The purpose of this study was to identify the differences of the outcomes of visiting nursing service (VNS) between the two types by the organizational structure of health centers. Type I referred to 3 health centers with departmentalization for VNS and type II of 3 health centers providing VNS under the subunit of a department. Data were collected from 38 visiting nurses at the six health centers for their perceived formalization, decision-making authority and job satisfaction, 293 clients for the satisfaction level with VNS served and their records analysis for level of quality care and frequency by the contents of VNS through the questionares during the period from June, 1 to August 30, 1993. Data were analyzed using chi2, F. t or/and Scheffe test. The result were as follows: 1) There were no significant differences in perceived formalization and decision -making authority of visiting nurses between the two types of health centers. 2) There were significant differences in the level of quality care and frequency of the VNS contents between the two types of health centers. 3) There were no significant differences in perceived clients' satisfaction and job satisfaction of the visting nurses between the two types of health centers. From this study, Not only organizational differentiation with the development of job standards and supportive system but also personnel development are suggested when new health care service in health centers begins.

A study for quality assurance of visiting nurses service of a public health center: Soon Nyoung Yun, In Sook Lee, Hye Jin Hyun, In Ja You, Jai Nam Kim, Jung Hee Bae; J Korean Acad Community Health Nurs. 1995;6(2):275-285. Published online December 31, 1995

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Abstract PDF: The purpose of the study is to evaluate the visiting nurses service of a public health center. Data were collectd from the 36 clients who received services from a public health center. In terms of the process evaluation, the tool is composed 4 parts, 27 items such as assessment planning, implementation, and evaluation. It was measured through the health records by 2 peer review. In terms of the outcome evaluation, the level of client satisfaction was measured by self report or interview by 2 supervisor. The result were as follows: 1. 30% of 36 health records showed narsing process was not and out of them, nursing care plann including spectific activities were rarely established or unclear. 2. The lack of systematic data collection showed and nursing diagnosis was not adressed in health records review. 3. Client satisfaction score was 32, 97, out of maximum score 36. 4. The lack of sufficent objective data, care plan, record of client's health status change, and evaluation was founded therefore quality assurance for visiting nurses service and in-service education are required and the development of standardized record system need.

Community Health Practitioner's Commitment into Community : on the Aspect of Primary Health Care: Soon Nyoung Yun, Young Im Kim, Jeong Myung Choi; J Korean Acad Community Health Nurs. 1995;6(2):173-182. Published online December 31, 1995

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Abstract PDF: Primary health care(PHC) has been established since A Health Law for rural residents has been legislated in 1980 following the WHO declaration, "Health for All 2000". in 1978. PHC services are presently assumed to be provided by 2038 Community Health Practitioners(CHP) to about 28% out of rural population in Korea. Most CHPs have confronted the adaptation process to the community being practiced although a CHP's role is to evoke community participation for the improvement of their health by themselves. So the purpose of this study is to describe and explain of the commitment of CHPs into the community. Data were collected by direct interview and tape-recording under subjects' permission till theoretical saturation were occured from 6 CHPs. The subjects were 41 years old and have served in the community for 9 years in average. Main questions and concepts were explored from data according to the procedure of the grounded theory methodology. The results are as follows. 1) The number of the main concepts were twenty four that identified Motive, Desire, Personal characteristics, Unfamiliarity, Denial, Feeling of isolation, Self-sacrifice, Kindness, Patience, Assimilation, Respect for the residents, Support by the family, Support by the residents, Achievement, Acceptance of realities, Use of resources, Inducement of cooperation from the residents, Changes of the difference from time orientation between CHP and residents, Attitude as a official, Technical support, Cost management, Satisfaction level, Acknowledgement by the residents and discrepancy. 2) The twenty four concepts were categorized to seven groups such as Motivation, Feeling of Heterogeneity, Self-discipline, Social support, Induced changes in the attitudes of residents, Familarity and Persistent discrepancy. 3) The categorized groups were analyzed on the base of the Causal Conditions, Central Phenomena, Contexts, Intervening Conditions, Action / Interaction Strategies, and Consequences. Central phenomenon in this study was identified to be the feeling of heterogeneity. Community health practitioners experienced unfamiliarity and denial from the community and felt themselves isolated in the first. In time, they won the trust of residents by their efforts including self-sacrifice, kindness, patience, and assimilation. Afterward, practitioners got self-confidence and familiarity with lesser feeling of heterogeneity. Community health practitioners experienced unfamiliarity and denial from the community and felt themselves isolated in the first. In time, they won the trust of residents by their efforts including self-sacrifice, kindness, patience, and assimilation. Afterward, practitioners got self-confidence and familiarity with lesser feeling of heterogeneity. Nevertheless, practitioners could not commit themselves completely because of the persistent discrepancy between CHP and residents. 4) On the commitment process, the CHPs' feeling of heterogeneity were decresed and social support increesed and newly evolved induced change of residents through the continuous interaction between CHP and them. The contribution of this study would be concluded as follows. The contribution of this study would be concluded as follows. 1) It is expected that effective strategies for more rapid committment into the community can be developed based on this study. 2) More easy committment would be possible for the newly appointed CHP through understanding of the committment process identified on this study.

A Study on Relationships Between Environment, Organizational Structure, and Organizational Effectiveness of Public Health Centers in Korea: Soon Nyoung Yun; J Korean Acad Community Health Nurs. 1995;6(1):5-33. Published online June 30, 1995

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Abstract PDF: The objective of the study are two-fold: one is to explore the relationship between environment, organizational structure, and organizational effectiveness of public health centers in Korea, and the other is to examine the validity of contingency theory for improving the organizational structure of public health care agencies, with special emphasis on public health nursing administration. Accordingly, the conceptual model of the study consisted of three different concepts: environment, organizational structure, and organizational effectiveness, which were built up from the contingency theory. Data were collected during the period from 1st of May through 30th of June, 1990. From the total of 249 health centers in the country, one hundred and five centers were sampled non proportionally, according to the geopolitical distribution. Out of 105, 73 health centers responded to mailed questionnaire. The health centers were the unit of the study, and a various statistical analysis techniques were used: Reliability analysis(Cronbach's Alpha) for 4 measurement tools; Shapiro-Wilk statistic for normality test of measured scores of 6 variables: ANOVA, Pearson Correlaion analysis, regressional analysis, and canonical correlation analysis for the test of the relationships and differences between the variables. The results were. as follows : 1. No significant differences between forma lization, decision-making authority and environmental complexity were found(F=1.383, P=.24 ; F=.801, P=.37). 2. Negative relationships between formalization and decision-making authority for both urban and rural health centers were found(r=-.470, P=.002 ; r=-.348, P=.46). 3. No significant relationship between formalization and job satisfaction for both urban and rural health centers were found (r=-.242, P=.132, r=-.060, P=.739). 4. Significant positive relationship between decision - making authority and job satisfaction were found in urban health centers (r=.504, P=.0009), but no such relationship was observed in rural health centers. Regression coefficient between them was statistically significant(beta=1.535, P=.0002), and accuracy of regression line was accepted (W=.975, P= .420). 5. No significant relationships among formalization and family planning services, maternal health services, and tuberculosis control services for both urban and rural health centers were found. 6. Among decision-making authority and family planning services, maternal health services, and tuberculosis control services, significant positive relationship was found between de cision-making authority and family planning services(r=.286, P=.73). 7. A significant difference was found in maternal health services by the type of health centers (F=5.13, P=.026) but no difference was found in tuberculosis control services by the type of health centers, formalization, and decision-making authority. 8. A significant positive relationships were found between family planning services and maternal health services and tuberculosis control services, and between maternal health services and tuberculosis control services (r=-.499, P=.001 ; r=.457, P=.004 ; r=.495, P=.002) in case of urban health centers. In case of rural health centers, relationships between family planning services and tuberculosis control services, and between maternal health services and tuberculosis control services were statistically significant (r=.534, P=.002 ; r=.389, P=.027). No significant relationship was found between family planning and maternal health services. 9. A significant positive canonical correlation was found between the group of independent variables consisted of formalization and de cision-making authority and the group of dependent variables consisted of family planning services, maternal health services and tuberculosis control services(Rc=.455, P=.02). In case of urban health centers, no significant canonical correlation was found between them, but significant canoncial correlation was found in rural health centers(Rc=.578, P=.069). 10. Relationships between job satisfaction and health care productivity was not found significant. Through these results, the assumed relationship between environment and organizational structure was not supported in health centers. Therefore, the relationship between the organizational effectiveness and the congruence between environment and organizational structure that contingency theory proposes to exist was not able to be tested. However decision-making authority was found as an important variable of organizational structure affecting family planning services and job satisfaction in urban health centers. Thus it was suggested that decentralized decision making among health professionals would be a valuable strategy for improvement of organizational effectiveness in public health centers. It is also recommended that further studies to test contingency theory would use variability and uncertainty to define environment of public health centers instead of complexity.

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