Research in Community and Public Health Nursing

Corrigendum

Corrigendum: Educational Status and Needs of Premature Birth Prevention and Its Association with Preconception Health Behavior among Women of Childbearing Age in Korea: Sun Hee Kim, Ji-Yeon Hong, Mi Kyung Park; Res Community Public Health Nurs. 2023;34(1):83-84. Published online March 31, 2023; DOI: https://doi.org/10.12799/jkachn.2022.33.4.372.e1

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Original Articles

Factors Affecting the Risk of Cardiovascular Disease in Postmenopausal Women: A Postmenopausal Period-Stratified Analysis: Jui Kim, Choi Hyoungshim; Res Community Public Health Nurs. 2023;34(1):72-82. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00297

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Abstract PDF: Purpose
This study aimed to investigate the factors affecting the risk of cardiovascular disease among postmenopausal Korean women. Methods: This postmenopausal period-stratified analysis used secondary data from the Korea National Health and Nutrition Examination Survey from 2016 to 2018. We selected 1,465 participants with all the relevant data for analysis. The Chi-square test and multiple logistic regression analysis were used to analyze the data. Results: Age, subjective health status, body mass index, and triglyceride level were the factors that influenced the risk of cardiovascular disease for women with a postmenopausal period ≤5 years, whereas age, subjective health status, household income, body mass index, and triglyceride level were the factors that influenced the risk of cardiovascular disease for women with a postmenopausal period >5 years and ≤10 years. Conclusion: Planning health promotion strategies to lower the risk of cardiovascular disease in women must consider the differences among women according to the menopausal status and postmenopausal period.

The Effects of Emotional Labor and Workplace Violence on the Somatic Symptoms of Customer Service Employees in Department Stores: Bongsoon Ryu, Bo Hyun Park; Res Community Public Health Nurs. 2023;34(1):61-71. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00339

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This study was aimed to explore the effects of emotional labor and workplace violence on the somatic symptoms of customer service employees in department stores. Methods: Data from a total of 218 subjects were collected from July 21, 2021 to August 10, 2021, using a self-report questionnaire. The data were analyzed using descriptive statistics, X2-test, and logistic regression. Results: Among 4 sub-scales of workplace violence, a factor affecting the possibility of the moderate or high severity of somatic symptoms was found to be a risk group in "Experience of psychological and sexual violence from customer” (OR: 2.94). On the other hand, emotional labor did not show a statistically significant effect. In addition, education level, monthly income, subjective health status, and working hours per week were also factors affecting somatic symptoms.
Conclusion
In order to reduce the somatic symptoms of customer service employees in department stores, it is necessary to raise the awareness of employers and customers first, and follow-up research is necessary on the development of strategy and systems for the establishment of active and diverse protective devices to protect workers at the organizational level.

Gestational diabetes and breastfeeding-related pain as major contributors to early breastfeeding cessation: Deulle Min, Eun Ju Kwak, Seung Mi Park; Res Community Public Health Nurs. 2023;34(1):52-60. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00332

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This study aimed to determine the effects of gestational diabetes mellitus, breastfeeding-related pain, and infant growth on the cessation of breastfeeding. Methods: This is secondary data analysis. This study included 60 pregnant women from 3 prenatal breastfeeding clinics. Pregnant women aged 20–49 years, with or without a diagnosis of gestational diabetes mellitus were enrolled. The participants were administered four self-reported questionnaires, one at 5 days, 14 days, 3 months, and 6 months postpartum. A linear mixed model and Cox regression analysis were used. Data were collected between May 25, 2020 and June 14, 2021. Results: The rate of breastfeeding cessation was 55.0% (n=33). The average maternal ages were 32.30 (±4.61) and 31.33 (±7.05) years in the cessation and maintenance groups, respectively. The average duration of breastfeeding in the cessation group was 56.27 (±37.48) days. After adjusting for all covariates, the risk of breastfeeding cessation was 2.5 times greater among participants diagnosed with gestational diabetes mellitus (p=.042). Additionally, the risk of breastfeeding cessation was 1.3 times greater among those with severe breastfeeding-related pain (p=.015). Conclusion: The first two months postpartum is the most essential time for healthcare workers to provide support and address difficulties associated with breastfeeding for mothers with gestational diabetes mellitus.

School Nurses’ Perception of Job Performance Difficulties, Job Stress, Job Identity and Job Satisfaction: Eun Kyo Cho, Hyun Jung Moon; Res Community Public Health Nurs. 2023;34(1):43-51. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00010

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Abstract PDF: Purpose
To examine school nurses' perception of job performance difficulties, stress, identity, and satisfaction, and to identify the factors that affect job satisfaction. Methods: Data were collected through online survey questionnaires distributed to 189 regular school nurses working in Metropolitan I. The self-report questionnaire consisted of three instruments and demographic questions. The data were collected from June 29 to July 31, 2020, and analyzed using frequency, percentage, mean and standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression statistical techniques. Results: Perception of job performance difficulties showed a significant positive correlation with job stress (r=.20. p=.007), job identity (r=-.55, p<.001) and job satisfaction (r=-.39, p<.001), and each showed a negative correlation. Job stress showed a negative correlation with job satisfaction (r=-.65, p<.001), and job satisfaction and job identity showed a positive correlation (r=.53, p<.001). Job stress (β=-.58, p<.001), job identity (β=.43, p<.001), school-level elementary school (β=.19, p<.001), and middle school (β=.13, p=.011) were found to have a significant effect on job satisfaction. Conclusion: As job stress, job identity, and school level are important factors influencing job satisfaction, interventions are needed to lower the job stress of school nurses and strengthen their job identity. In addition, since the job satisfaction of school nurses can have a great impact on the health and happiness of students as well as the quality of life of future generations, it is necessary to improve policies and systems to increase the job satisfaction of school nurses.

Needs assessment of community health practitioners for community care competency of older adults: Na Bee Yoon, Hyeon Kyeong Lee, Haesun Lee, Sang Woo Park; Res Community Public Health Nurs. 2023;34(1):32-42. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00360

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Abstract PDF: Purpose
To identify needs and priorities of community care competency for older adults among community health practitioners. Methods: Data were collected from a convenient sample of 326 community health practitioners using an online questionnaire, which included items on community care competencies and personal characteristics. Items were developed through literature review, consultation meeting, content validity verification, and preliminary investigation. The data were analyzed using the t-test, one-way ANOVA, and Scheffe’s test with SPSS 25.0. The analysis of needs and priorities was conducted by using the Borich needs assessment and the Locus for focus model. Results: Three competencies have been identified as high-priority needs; ‘Linkages with resources’, ‘Education to others’, ‘Leadership and management’. Conclusion: The findings of this study indicate the need to develop an educational program for community health practitioners to strengthen community care competencies. The programs will need to be provided, especially for young community health practitioners, to ensure that they are well equipped to care for community-dwelling older adults living in rural areas.

Validation of Types of Body Pain Areas and Related Factors in the Korean Aged Using Latent Class Analysis: Sang Ye Shin, Eun Suk Lee; Res Community Public Health Nurs. 2023;34(1):22-31. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00290

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Abstract PDF: Purpose
The purpose of this study is to find a nursing intervention plan by classifying the body pain areas of the Korean aged and analyzing related factors. Methods: This study performed the latent class analysis, cross-analysis, and one-way ANOVA using the SPSS 25, M-plus 7.0 program on 4,388 older adults aged 65 or over using the data from the 2020 Aging Research Panel. Results: As a result of the Latent Class Analysis, participants divided into four groups. Group 1 was the 'shoulder and low back pain group' with high shoulder and back pain, group 2 was the 'upper body pain group' with severe pain in the arms, wrists and fingers and chest, group 3 was the 'lower pain focused group' with high pain in the legs and knees, and finally, group 4 was the 'general low pain group' with low pain overall. The result of the study shows that the group that did not exercise regularly, the female group, and the low socioeconomic status group have more pain in general. The upper body central pain group showed a low level of life satisfaction. Conclusion: This study discusses various nursing interventions for the prevention of chronic pain, especially for the aged female group who has diverse body pain areas, the aged with low socioeconomic status, and the aged who do not exercise.

Factors Associated with Fear of Falling by Fall Experience in the Community-dwelling Elderly: Yeong Mi Seo, Eun Sook Lee; Res Community Public Health Nurs. 2023;34(1):12-21. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00199

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This study aimed to identify factors associated with fear of falling(FOF) by fall experience in the community-dwelling elderly. Methods: Multivariate logistic regression with complex samples was used to analyze the data of 74,475 elders aged 65 and over from the Community Health Survey in 2019. Results: Factors associated with FOF included gender, age, education level, smoking, high-risk drinking, physical activity, stress, depression, cognitive impairment, subjective health status, hypertension, and diabetes mellitus in the non-fall group. In the single fall group, the associated factors were gender, age, physical activity, stress, depression, cognitive impairment, and subjective health status. Related factors in the recurrent fall group included gender, age, physical activity, cognitive impairment, and subjective health status. Conclusion: The study’s findings suggest that it is necessary to develop different strategies to prevent FOF by understanding the contributing factors of FOF in each group of fall experience.

A Path Analysis for Health-related Quality of Life in Long-term Care Insurance In-home Service Users: Je Hyun Kim, Seung Mi Park; Res Community Public Health Nurs. 2023;34(1):1-11. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00283

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Abstract PDF: Purpose
The purpose of this study is to construct and verify a path model for the factors affecting on quality of life in long-term care insurance in-home service users.
Methods
Total 246 participants using long-term care insurance in-home service were recruited from long-term care agencies. Data collection was conducted using a structured questionnaire from March 1st to March 31st 2021. The collected data were analyzed using SPSS 26 and AMOS 26 programs.
Results
The hypothetical path model was suitable for explaining the health-related quality of life in long-term care insurance in-home service users and has an explanatory power of 39.8%. Long-term care grade, depression, perceived health status, social support, age and living arrangement had a significant total effect on the quality of life in long-term care insurance in-home service users.
Conclusion
Long-term care insurance in-home service policies need to be expanded, such as screening and relieving depression, strengthening social support, and fostering a positive perception of health to improve the quality of life of the elderly.

Effects of Depression, Social Support of Tuberculosis Patients on Self-care: Go Un Lee, Hye Kyung Lee; J Korean Acad Community Health Nurs. 2022;33(4):456-464. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.456

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The purpose of this study was by understanding the correlation between the depression, social support and self-care of tuberculosis patients and by identifying the factors that influence the self-care. Methods: The study subjects were 119 outpatients who were diagnosed with pulmonary and respiratory tuberculosis at a university hospital in D city. The survey questions measured depression, social support, self-care. Using the SPSS/WIN 23.0 program, the collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlations and multiple regression analysis. Results: As a result of correlation analysis, there was a statistically significant negative correlation between self-care and depression (r=-.53, p<.001), and there was a significant positive correlation between self-care and social support (r=.68, p<.001). Factors affecting self-care of the subjects were social support (β=.51, p<.001), depression (β=-.32, p<.001), drug discontinuation experience (β=-.30, p<.001) and drug resistance (β=-.14, p<.001). These factors explained 62% of the variance. Conclusion: In order to improve the self-care ability of tuberculosis patients, it is necessary to develop education and nursing intervention programs that can lower patients' depression and strengthen social support.

The Mediating Effect of Acceptance Action in the Relationship between Diabetes Distress and Self-stigma among Old Adults with Diabetes in South Korea: Hye Sun Kim, Ka Woun Seo; J Korean Acad Community Health Nurs. 2022;33(4):446-455. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.446

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This study investigated the mediating effects of acceptance action on the relationship between diabetes distress and self-stigma in older adults with diabetes. Methods: A descriptive research approach was adopted using 187 patients diagnosed with diabetes mellitus by an endocrinology doctor. The data were collected from 26 to 31 March, 2020 and were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient analysis, and hierarchical multiple regression. Results: The mean scores for diabetes distress, self-stigma, and acceptance action were 2.98±0.64, 2.54±0.74, and 4.16±0.35, respectively. Acceptance action partially mediated the relationship between diabetes distress and self-stigma (z=1.98, p=.024), with an explanatory power of 51.0%. Conclusion: To reduce diabetes self-stigma among old adults in diabetes distress situations, it is necessary to improve their acceptance action and develop step-by-step differentiated acceptance action enhancement programs through multidisciplinary collaborations.

Perceived Discrimination and Workplace Violence among School Health Teachers: Relationship with School Organizational Climate: Joohee Kim, Young Ko; J Korean Acad Community Health Nurs. 2022;33(4):432-445. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.432

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The purpose of this study was to identify the relationship of the school organizational climate with perceived discrimination and the workplace violence among school health teachers. Methods: The research design was a cross-sectional study. The subjects of the study were 350 school health teachers with more than one year of teaching experience. Data were collected online using a questionnaire. Research variables are general characteristics, organizational climate, perceived discrimination, and workplace violence. The relationship between organizational climate and perceived discrimination and the relationship between organizational climate and workplace violence were analyzed using regression analysis. Results: The score for organizational climate of health teachers was 3.10 out of 5 points, the score for perceived discrimination was 2.85 out of 5 points, and the experience rate of workplace violence was 16.9%. School organizational climate was related to both workplace violence and perceived discrimination. The subcomponents of organizational climate affecting perceived discrimination of health teachers were interrelationship and the level of compensation. The subcomponents of organizational climate affecting workplace violence of health teachers were interrelationship and autonomy. Conclusion: The improvement of the school's organizational climate can reduce the level of workplace violence and discrimination against health teachers. It is important to establish an appropriate evaluation system for health teachers and to recognize the role and expertise of health teachers. In addition, it is necessary for school administraters to actively support health teahcers and to create an organizational climate where they can be friendly and communicative.

Factors Associated with Depression in Older Adults Living Alone during the COVID-19 Pandemic: Eun Hye Hong, Kyung Hee Lee; J Korean Acad Community Health Nurs. 2022;33(4):418-431. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.418

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The aims of this study were to examine the rate of depression among older adults living alone and to identify factors associated with depression in older adults living alone during the COVID-19 pandemic. Methods: A secondary data analysis was performed using data from the 2020 Korea Community Health Survey. The study participants were 18,824 older adults aged 65 years and over living alone. The data of the complex sample design was analyzed with consideration for weights, stratification, and clustering. Complex sample multiple logistic regression was conducted to identify factors associated with depression in older adults living alone during the COVID-19 pandemic. Results: The results showed that the rate of depression in older adults living alone was 6.3%. Older adults living alone with decreased physical activity, decreased hours of sleep, and an increased or similar frequency of meeting with friends or neighbors were found to be more likely to have depression. In terms of factors related to the practice of COVID-19 infection prevention and control rules, not disinfecting regularly and not wearing a mask indoors were related to depression. For health-related factors, fair or poor self-rated health status, not having breakfast every day, and feeling stressed were related to depression. Conclusion: It is recommended to develop tailored interventions to prevent depression among older adults living alone by considering the factors related to their depression during the COVID-19 pandemic.

Prevalence and Risk Factors of Diabetic Retinopathy in Diabetes People using Korean National Health and Nutrition Examination Survey VII: Ihn Sook Jeong, Chan Mi Kang; J Korean Acad Community Health Nurs. 2022;33(4):408-417. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.408

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This study aimed to investigate the prevalence and risk factors of diabetic retinopathy (DR) in people with diabetes mellitus (DM) using Korean National Health and Nutrition Examination Survey VII (2017~2018). Methods: DM was defined as in two ways; 1) doctor's diagnosis (Group 1, n=549), 2) one of doctor's diagnosis, medication, or hyperglycemia (Group 2, n=849). The DR prevalence was measured as the prevalence proportion (%). Risk factors for developing DR were analyzed using multiple logistic regression, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: The prevalence of DR was 25.87% in Group 1 and 20.14% in Group 2. Risk factors for DR were identified as insulin therapy (Group 1: OR=5.31, Group 2: OR=5.27), DM duration ≥10 years (Group 1: OR=2.20, Group 2: OR=3.10), and systolic blood pressure ≥140 mmHg (Group 1: OR=2.26, Group 2: OR=2.23) for both groups. Conclusion: Considering the DR prevalence, eye examinations education is highly recommended as part of a diabetes management programs in the community. It is also proposed to shorten the eye examination cycle for people with risk factors and establish a referral system to link between screening to treatment.

Influencing Factors for Sleep Quality among Firefighters: Based on Objective and Subjective Evaluation: Ye Seul Jeon, Hee Seung Choi; J Korean Acad Community Health Nurs. 2022;33(4):396-407. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.396

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The purpose of this study was to assess insomnia and the quality of sleep, investigate the concordance between objective and self-report sleep patterns, and identify physiological, psychological, and situational factors influencing insomnia and sleep quality among firefighters. Methods: A descriptive, cross-sectional study was conducted with 103 firefighters in Korea. The collected data were analyzed using SPSS 23.0. Descriptive statistics, the independent t-test, and hierarchical logistic regression analysis were performed. Results: Insomnia was found in 66 (64.1 %) of the total subjects, and the average quality of sleep (PSQI) was 5.65 (SD=2.57). Total sleep time (401.00 minutes) and sleep latency (21.60 minutes) measured using self-reported scales were longer than the ones measured using objective measurements by approximately 48.70 and 17.10 minutes, respectively. Factors related to insomnia included the role as a paramedic (OR=4.28, 95% CI: 1.02~17.92), anxiety (OR=1.12, 95% CI: 1.01~1.24), and sedentary lifestyle (OR=0.85, 95% CI: 0.78~0.94), and factors related to sleep quality were physical illness status (OR=5.17, 95% CI: 1.53~17.51) and social support (OR=0.86, 95% CI: 0.78~0.95). Conclusion: The results show a high prevalence of insomnia, poor quality of sleep and the discrepancy between objective and subjective sleep patterns among firefighters. To promote sleep quality and health, early screening and treatment of anxiety and physical illness are required. It is necessary to conduct further studies examining the relationship between physical activity level and sleep.

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