Research in Community and Public Health Nursing

Volume 10 (1); June 1999

Original Articles

A Study on the Fee-Based Model Development of Day Care Centers for the Elderly: Shin Sook Chung, Yeon Kang Chung; J Korean Acad Community Health Nurs. 1999;10(1):5-18. Published online June 30, 1999

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Abstract PDF: The aim of this study is the development of a fee-based model day care center for the elderly by inquiring into the current condition of facilities in America and in Korea, and in surveying the opinion of domestic elderly about day care facilities. A field trip to U.S. day care services was held between July 5 and July 15 in 1997, and an on-the-spot study for domestic facilities took place during March in 1998. Our research reveals that the overall supply of day care facilities can not meet future demand in terms of quality and quantity. Therefore a model must be created for day care centers of a that consists of a director from a professional group. an adequate environment, and a standardized in order to offer a qualified public health service linked to the home and community in Korea. The director of a day care center is a critical variable in determining the quality of service. Professional skills related to the needs of the elderly and the person's quality of service should be considered in appointing director for the center. This study belleves that a professional nurse should be the director of a day care center. The operating environment of a day care facility should be made up of considerable space comparable to the number of residents, should be in a comfortable and safe location, and should have equipment that provides a qualified, safe service to the elderly. Our model is designed for 20 persons and allocates 4 Peng per person. This model is comprised of a reading room. a craft room, a health room, a room for physical therapy, a dining room, a staff office, and a multi-purpose room connected to other rooms. Day care service should be a comprehensive service program meeting the multidimensional needs of the elderly. A comprehensive service program needs a team of various professionals made up of the elderly family, participants, nurses, social workers, physical therapists, nutritionists, and medical doctors. The program will also include health care service, physical therapy, speech therapy. diet, occupational therapy, transportation service, health and an education program, etc. In conclusion, a model of a day care center is developed with the following components: a professional director and an environment and program, that considers the physical, mental, and social characteristics of the elderly. A model should also motivate self-reliance self-fulfillment in the elderly in order to fulfill their health needs and to prevent isolation from society and mental depression. Furthermore, This facility will be a beneficial factor in reducing a family's burden on caring for the elderly that includes unnecessary hospital expenses. The following is a suggestion based on results this study: A service program should be developed to fit the conditions of the elderly in Korea by specifically analyzing the needs of the elderly.

The Effect of Group Recreation Therapy on Depression, Self-Esteem and Life Satisfaction of the Elderly: Yeon Hwa Kim; J Korean Acad Community Health Nurs. 1999;10(1):19-31. Published online June 30, 1999

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Abstract PDF: This study was conducted to investigate the effect. of group recreation therapy as a community nursing intervention on depression, self-esteem and life satisfaction. The period of data collection was from september 7, 1998 to November 14, 1998 and a total of 46 elderly were studied at a nursing home in Taegu, Korea. Among them, 25 elderly received group recreation therapy(experimental group) and the other 21 didn't(control group). The study design was a non-equivalent control group pretest-posttest design considered to quasi-experimental research. The data analysis of this study was computerized by using an SPSS/PC and hypothesis testing was done with an ANCOVA and pearson correlation coefficient. The results are as follows. 1. The depression of the experimental group was significantly reduced compared with the control group(F=37.797, P=.000). 2. The self-esteem of the experimental group was increased compared with the control group, but significant differences were not found(F=1.604, P=.212). 3. The life satisfaction of the experimental group was increased compared with the control group (F=37.420, P=.000). 4. A significant negative correlation between depression and self-esteem and life satisfaction of the elderly(r=.-620, r=.-555, P<.001) was observed, a significant positive correlation between self-esteem and life satisfaction was observed(r=.477, P=<.001). In conclusial, it was found that group recreation therapy was an effective tool to redue depression and increase life satisfaction, thus helping the elderly cope with the problems of age.

Study on Subjectivity and the Health of the Elderly: Hae Kyung Chung, Kyung Hee Kim, Hye Jin Kwon, Eun Ja Yeun, Yeoun Kang Chung; J Korean Acad Community Health Nurs. 1999;10(1):32-43. Published online June 30, 1999

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Abstract PDF: This study is to classify subjectification and the perceived health of the elderly according to Q-methodology and to provide basic materials for health promotion of the elderly. In this study, 28 elderly people residing in Seoul classified 33 selected statements in to 9 standards. The material taken from this process resulted in 4 types by the analysis using a PC QUANL program.
Case
1 thought that religion was important for their health. Case 2 were go-getters they thought they felt healthy at work. Case 3 took a serious view of their relationships with other people. Case 4 centered around the couple, and thought it important to live with their life's companion.

Investigation & Study Analysis of Health Affairs for the Old: In Sook Hyun; J Korean Acad Community Health Nurs. 1999;10(1):44-52. Published online June 30, 1999

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Abstract PDF: This investigation & study has been made in oder to revitalilize the health care for the elderly in public health centers. The date subject, including 88 persons in charge health services in public heal centers, were from Chejudo. These were largely female, the average age was 38.4 at the health center. Their responsibilities included home visitation, nutrition management for the early, health education, and physical therapy. The most important problem were personal management and a lack of facilities, especially in home visitation, health education, physical therapy. Systematic networks of various activities are needed to encourage not only the patient but also volunteer who will also take part in these services. The numbers of members in charge of the elderly are not only to be increased and educate with facilities and equipment but also better provided with proper facilities and equipment. This is the best way to conduct health services the elderly.

A Correlation Study on Spiritual Wellbeing, Hope and Perceived Health Status of the Elderly: Mi Soon Sung, Chung Nam Kim; J Korean Acad Community Health Nurs. 1999;10(1):53-69. Published online June 30, 1999

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Abstract PDF: A descriptive correlation study was done to provide a basic data for comprehensive nursing care by analyzing the relationship between spiritual wellbeing, hope and perceived health status of the elderly. 195 respondents who lived at their homes and 148 respondents who lived at the facilities for elders such as nursing homes and elder's rehabilitation centers were selected and their age was over 60 years old. Paloutzian and Ellison(1982)'s spiritual wellbeing scale, Nowotny(1989)'s hope scale and Northern Illinois University's health self rating scale was used. From August 10th to August 25th, 1998, ready made questionnaires were handed out by researcher to those who can fill it out and for those who cannot fill out the questionnaires alone, the researcher read it and finished by interview. This study used Pearson's correlation coefficient for the hypothetic test and the average point and standard deviation of spiritual wellbeing, hope, and perceived health status were checked. To find out the difference between spiritual wellbeing, hope, and perceived health status by general characteristics ANOVA and Tukey test were used. The results are as follows : 1. The mean score for spiritual wellbeing of the elders was 42.27(SD+/-9.67) in a possible range of 20-80. The average point of spiritual wellbeing was 2.11(SD+/-0.97) point to 4 point full marks. The mean score of religious wellbeing was 21.37(SD+/-7.02) and that of existential wellbeing was 20.90(SD+/-4.63) in a possible range of 10-40. The average point of religious wellbeing was 2.14(SD+/-0.70)points and existential wellbeing was 2.09(SD+/-0.46) points to 4 point full marks. 2. The mean score for hope was 67.16(SD+/-12.28) in a possible range of 29-116. The average point of hope was 2.31(SD+/-0.42) points to 4 point full marks. 3. The mean score for perceived health status was 8.72(SD+/-2.49) in a possible range of 4-14. 4. In testing the hypothesis concerning the relationship between spiritual wellbeing and hope, there was a statistically positive correlation(r=0.5209, p=0.0001). 5. In testing the hypothesis concerning the relationship between spiritual wellbeing and perceived health status, there was a statistically positive correlation(r=0.1427, p=0.0081). 6. In testing the hypothesis concerning the relationship between hope and perceived health status, there was a statistically positive correlation(r=0.2797, p=0.0001). 7. There were significant differences in spiritual wellbeing according to sex, religion, and present occupation. 8. There were significant differences in hope according to residential places, age, religion, educational level, family status, average monthly pocket money. 9. There were significant differences in perceived health status according to residential places, sex, age, educational level, present occupation and family status. From the above results it can be concluded that: There was a positive correlation between spiritual wellbeing and hope, spiritual wellbeing and perceived health status, hope and perceived health status. When the nurse implicate the nursing intervention which can be promote the spiritual wellbeing and hope, elder's perceived health status also can be improved.

Analyses on the Mean Length of Stay of and the Income Effects due to Early Discharge of Car Accident Patients at General Hospital: Ho Sihn Ryu; J Korean Acad Community Health Nurs. 1999;10(1):70-79. Published online June 30, 1999

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Abstract PDF: This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

Appropriateness Evaluation of Hospitalization for the Cerebral Ischemia Patients: Hyo Young Yeom, Soon Lae Kim; J Korean Acad Community Health Nurs. 1999;10(1):80-92. Published online June 30, 1999

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Abstract PDF: The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. It is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(kappa=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay 10.9+/-6.7 days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

Comparative Study on the Job Satisfaction of Part-time Nurses and Internship Nurses: Sook Ja Choi; J Korean Acad Community Health Nurs. 1999;10(1):93-105. Published online June 30, 1999

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Abstract PDF: Recently, Korean health care industry managers are paying more attention to customer oriented service, the rationalization of business administration, and quality control of service to adjust their business to outer environment since IMF bailout program. They are focusing on the cost reduction through remodeling the size and structure of man power, viz. labor flexibility. Nurses are not free from this juncture and contingent nurses are increasing fast. This article intends to verify the actual condition of two types of contingent nurses-part-time nurses and internship nurses-and to compare their job satisfaction to provide basic resource for efficient management of nurse man power. The concrete goals of this article are; Firstly, to verify the actual condition of their employment. Secondly, to compare their job satisfaction. And Thirdly, to the relation between employment condition and job satisfaction. To accomplish these research goals, a statistical survey was executed, in which 384 questionnaires-66 for manager nurses, 318 for contingent nurses-were given to nurses working at 66 general hospitals-which have at least 100 beds-in Seoul. Among them, 121 questionnaires-of 28 general hospitals-were returned. Then, the data coded and submitted to mean, standard deviation, T-test, variance analysis (ANOVA), correlation analysis, multiple regression analysis with SAS program. The research results of the contingent nurses are followings: 1. Two types of contingent nurses shows similar age spans: they are mostly 21-30 years old and unmarried. But internship nurses have high level of educational career. Part-time nurses spread at general beds, out-patient part, intensive care part, operation part, etc, but internship nurses work mostly at general beds. 2. Two groups shows difference in actual employment condition: average employment career of part-time nurses is 7.0 months but internship nurses' is 2.0 months: average duty-on days per month of part-time nurses are 23.7 days but internship nurses' are 24.8 days. But there are little difference in average working time per day: 7.7 hours for part-time nurses and 0 hours for internship nurses. 3. The average wage per month for part-time nurses is 836,026 won but for internship nurses is 557,428 won-66.7% of part-time nurses'. Both groups are enjoying little additional pay. 4. Both groups are getting job not so much through advertisement of newspaper or hospitals as through acquainted person or college. 5. Both groups show very high level of job satisfaction: 3.2195 for part-time nurses and 3.2881 for internship nurses. But they show very low satisfaction on payment level compared with other categories and two groups show meaningful difference(P<.0001). 6. The multiple regression test reveals the factors related with job satisfaction: wage level, working part(OR or ICU), age, job career, and motive of contingent job-taking('because I can take care of family duties at the same time') influence positively: motive of contingent job-taking('because I can work regularly without alternation') influences negatively.

A Study on Home Care and Home Visiting Nursing in Japan: Jeung Im Kim; J Korean Acad Community Health Nurs. 1999;10(1):106-120. Published online June 30, 1999

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Abstract PDF: Japan has been prepared for aging society from 1970. In 1970, the percentage of distribution of population of 65 years old and over was 7.1%. It is similar to present percentile of the elderly in Korea. Therefore, it will be needed to study about home care and home visiting nursing in Japan at present. This study was aimed to prepare the fundamental documents for home care nursing in Korea and to know the background of new health care system of Long-term Care Insurance in Japan, by studying home care and home visiting nursing in Japan. With the continuing aging of the population, especially the increase in the number of latter stage elderly, it is predicted that there will be an increase in the number of the elderly who are bedridden and suffering senile dementia. To ensure that these people will be able to continue living in the communities and homes they are accustomed to, surrounded by their families and neighbors, Japan substantially improve and expand in-home services. There were also long-term effort to reach the level of services outlined in the Gold Plan and the New Gold Plan within the decade between FY 1991 and FY 1999 in the field of health care and welfare. Under this plan, the most noticeable change was occurred in home care, home was permitted as the field of care and visiting nursing was established in law. Through this 10-Year Strategy for Promotion of Health and Welfare Services for the Aged, many problems have been improved and solved, but some problems remained such as inadequate service supply and consumption of medical insurance for the elderly. Japan will be a society composed 25% of elderly people of total population in 2020, and it will be soon faced with a shortage of welfare and medical facilities and manpower. As for equalizing the benefits and cost burdens, and other future arrangements for health care and welfare, Long-term Care insurance system was established in 1994. This system will be enforced from April 2000 and use present facilities and services. To know home care and home visiting nursing in Japan, we need to consider present conditions well and to take notice of changes and measures to cope with an aging society continuously.

A Study on the Factors in Relation to Job Performance of Community-Based Rehabilitation Program in Health Centers: Ji Yun Kim; J Korean Acad Community Health Nurs. 1999;10(1):121-139. Published online June 30, 1999

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Abstract PDF: Persons with disabilities have increased and among others, number of them in the community is at the high proportion. But they have a difficulty in physical, psychological adjusting and they don't be offered appropriate, sufficient rehabilitation services. Therefore, Community-Based Rehabilitation Services in Health Center be needed. With these backgrounds, this study was conducted to examine factors in relation to job performance of community-based rehabilitation program in Health Centers, and the factors are characteristics of district nurses, internal factors, external-environmental factors. This study provides guidelines for effective management for rehabilitation program. Subject in this study were 122 Health Centers randomly chosen. Data were collected from September, 16, 1998 to October, 9, 1998, and the data for analyses were ones of 105 respondents. The instrument of this study was job performance of community-based rehabilitation program is modified WHO guidelines. Credibility of instruments was 0.73-0.95 in main study. The summary of results was as follows. First, the mean of job performance of com munity-based rehabilitation program was 2.33 of full score 4.00. Significant differences were not obtained on the job performance among areas. Second, stepwise multiple regression analysis revealed that the most powerful predictor to job performance was community-based health program. The number of volunteer workers, the score of cooperation with other institution, the number of visiting nurse, the number of facilities for person with disabilities are accountable factor to the job performance of community-based rehabilitation program. In conclusions, for all the people with disabilities, Health Centers are necessary to promote community-based rehabilitation program and to increase participation of community residents and to cooperate with other institution.

A Study on the Relations between Health - Promoting Behaviors and Self-Efficacy/Perceived Health Status: Mi Young Lee, Mi Hye Choi, Yeon Kang Chung, Eune Hee Her; J Korean Acad Community Health Nurs. 1999;10(1):140-153. Published online June 30, 1999

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Abstract PDF: This study is designed to furnish basic data for development of health-care program to promote health of the middle-aged adult by making the middle-aged adult an object who have radically increasing death rate because of chronic degenerative diaease, finding out the executive degree of health-promoting behaviors, and verifying the relation between self-efficacy/perceived health status and health-promoting behaviors. The results are as follows. 1) The hypothesis that 'the higher the self-efficacy, the better the health-promoting behaviors' was supported on a meaningful level(r=.30l, p=.000) 2) The hypothesis that 'The health-promoting behaviors will have differences according to the perceived health status' was supported on a meaningful level in the sections of the control of stress(p=.000), the self-achievement (p=.000), the exercise(p=.002), the control of interpersonal relation(p=.014) and the eating habit(p=.061) and was rejected in the sections of drinking' smoking(p=.787), heath-responsibility (p=.061). The fact that executive degree of health-promoting life-style have correlation with self-efficacy was found out and we need to develop health-education program to promote self-efficacy.

A Study on the Prevalence Rate of Hypertension and the Actual Conditions of Control: Hyeon Ok Kim; J Korean Acad Community Health Nurs. 1999;10(1):154-172. Published online June 30, 1999

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Abstract PDF: In order to analyse the prevalence rate of hypertension and the actual conditions of control, we selected five districts out of eleven eups and myuns in Chinan Country. We administered structured questionaries to 309 adults above the age of 40, computerized the data using SPSS - PC+. More than 40.1% of adults over 40 in Chinan County have health disorders ranging from high blood pressure to hypertension including alert high blood pressure at 36.2%, relatively high. Among general characteristics, differences in the rate of hypertension were influenced by age, occupation and places of residence. Over 71 who are engaged in agriculture, who don't have jobs, who reside in Sungsu, Jungchun, Chinan-eup all have higher hypertension rates than other groups. Accordingly, the control of hypertension should be focused on these people. As a result of the control of blood pressure, the survey showed 93.0% of the subjects were checked mainly at hospitals clinics, health centers subhealth centers and community health posts more than once a year, relatively high level of blood pressure management. However, the difference between their blood pressure measurements at ordinary times and the level of blood pressure at the time of research was quite considerable. Only 47.3% of the subjects diagnosed with high blood pressure and 70.3% of the subjects with normal blood pressure recognized their blood pressure accurately 52.7% of the subjects diagnosed with high blood pressure showed errors in understanding their blood pressure at normal times. Because these errors can cause problems in the control of blood pressure, proper management should be executed through a systematic examination. As a result of the high blood pressure control condition, the average period of hypertension was 74.5(+/-92.8) months, 92.3% of the subjects were diagnosed with high blood pressure at hospitals.clinics, health centers.subhealth centers.community health posts, but only 29.5% were examined after a general check up on high blood pressure was completed. 70.5% were diagnosed with high blood pressure only after measuring their blood pressure. 14.1% of the subjects were hospitalized because of falls influenced by high blood pressure. 33.3% attended hospitals and health centers regularily for medical treatment and this shows how low the rate of the control of blood pressure. Most people did not undergo medical treatment, because they had no painful symptoms (46.7%), they didn't need to take the medicine(28.9%), or they forget to take the medicine(20.0%). These problems in the control of hypertension were discovered in the process of diagnosing high blood pressure at health medical institutions. Many people did not recognize the need for consistent control of blood pressure. That is, although the diagnosis for high blood pressures performed at hospitals.clinics, health centers.subhealth centers and community health posts, was 92.3%, more than 70.5% of the subjects were not examined completely with regard to blood pressure. Accordingly, heath medical institutions must diagnose high blood pressure not only by only measuring blood pressure but also by using systematic process of examination. As for the people diagnosed with high blood pressure, one should perform consistent medical approaches and help them to recognize the importance of the continuous control of blood pressure through subject-oriented education. Problems the subjects experienced were the following numbness in the limbs easily paralyzed stitches in their shoulders which felt painful, stiff necks, occiputs felt heavy, headaches when they got up in the morning, felt dizzy when standing and moving their heads and poor eyesight. The rate of knowledge related to high blood pressure was 78.7 points, comparatively low. Whether they had normal blood pressure or hypertension made no difference. These results are not desirable. Adult-oriented education forgot the prevention and management of high blood pressure should be implemented. Hypertensive-oriented education should be especially reinforced. Because there was a difference in the level of knowledge according to age, academic career, occupation or place of residence, education related to hypertension should be intensified and focused on those over the age of 71 those who did not attend school, those who do not have jobs and are engaged in agriculture and residents living in Bugui, Jungchun regions. The degree of healthy life practice in hypertensives is poor, particularly weight control, as opposed to people who have normal blood pressure. It makes no difference in smoking, the amount of daily smoking, drinking, the control of salt because each result means that they are not practicing healthy life or modifying their life-style. The development and programs to improve a healthy life should be executed.

A Study of the Index Measurement for School Health Promoting Behaviors: Young Im Kim, Young Im Park, Jee Young Ahn; J Korean Acad Community Health Nurs. 1999;10(1):173-182. Published online June 30, 1999

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Abstract PDF: The objectives of this study were to measure the index of school health promoting behaviors and to identify the influencing factors in performing these behaviors. School health promotion indexes were composed of 6 areas developed by the WHO. The data were collected by questionnaires from June to September, 1998. The subjects were 199 elementary school nurses and data were analyzed by a SAS - PC program. The results of this study were as follows: 1) The total mean of the elementary school health promotion indexes was 3.45 with school health service being the highest score at 3.68. Other scores were 3.58-personal health skills and 3.03-community relationship. 2) There were significant relationships between school health promoting behaviors and independent variables. The important variables influencing to the school physical environment were school health budgets and the career of school nurses. Also the educational background and the career of school nurses were significant variables in school health service. From these results, it is recommended that a comprehensive school health promoting program including the 6 areas of health promotion be developed. A training program for school nurses in health promotion is necessary.

A Study on High School Health Education Teachers' Activities and Other Influential Variables: Jae Soon Yoo; J Korean Acad Community Health Nurs. 1999;10(1):183-203. Published online June 30, 1999

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Abstract PDF: High school is regarded as the period when many important physical, mental and social developments occur, and when many health-related behaviors are formed. School health education is one of the major learning resources influencing health potential in the home and community as well as for the individual student. High school health education in Korea has a fundamental systemic flaw however, in that health-related subjects are divided and taught under various subjects at school. In order to achieve quality health education, it is essential to assess the learners' and teachers' educational needs. So far, most of the research projects that had been carried out for improving high school health education were limited to only the learners' educational need. They failed to include an educational assessment of the teachers. Therefore, in this study the high school health education teachers' needs relating to health education were investigated through a focus on the teachers' health education activity level, health education activity self-efficacy level, and perceived level of importance in health education content. In this study, research instruments these factors were constructed by Yoo(1997) on the basis of the PRECEDE model. The data for this study were collected from a sample consisting of twenty general and vocational high schools in Seoul and Chongju for a two month period beginning in July, 1996. In analyzing the data, an ANOVA test and stepwise multiple regression were accomplished using an SPSS - PC+ program. The results were as follows: The average level of health education activity and self-efficacy among high school health edu cation teachers were found to be low. But, teachers' perceived importance of health education contents was high. Teachers' activity and perceived importance concerning sex education were lower than in other health education areas. Health education activity of Military drill teachers was higher than that of physical education teachers as well as school nurses. But it was not significant. Health education activity self-efficacy of school nurses was higher than that of other teachers(p<.05). Perceived level of importance of health education contents was the most influential variable in teachers' health education activity. Health education activity self-efficacy level was not an influential variable in teachers' health education activity. The significance of this study is that it has diagnosed the needs of high school health education through the teachers' assessment of a variety of health factors related. These findings suggest that the management of an integrated health education, program requiring large changes in the curriculum of health education is necessary.

A Study on the Changing in Social Interest, Motivation and Attitude of Nursing College Students to Voluntary Activity after a Voluntary Program: Young Ran Han, Hong Ja Lee, Hye Joo Joo, Kyung Mee Cho, Yeun Ju Kim, Seoug Sook Hwang; J Korean Acad Community Health Nurs. 1999;10(1):204-226. Published online June 30, 1999

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Abstract PDF: This study attempted to compare the social interest, motivation, and attitude of nursing college students who participated in a voluntary program and the students who didn't participate in a voluntary program. The purpose of this study can be summarized as to find the effect of a voluntary program and to offer fundamental data for institutionalizing a voluntary program in college. The subjects were composed of two groups, one group attend the voluntary program and the other group doesn't. The subjects were 390 nursing students: 179 in the experimental group and 211 in the control group. The results of this study are as follows : 1. Before voluntary activities, the mean value of the control group was higher than that of the experimental group in social interest and altruistic motivation. The difference is statistically meaningful(t=-2.2.53, p=.25, t=-2.509, p=.013). 2. After voluntary activities, selfish motivation and altruistic motivation in the experimental group was higher than before. The difference is statistically meaningful(t=2.404, p=.0l7, t=-2.751, p=.007). 3. The social interest, selfish motivation, altruistic motivation toward voluntary activities and selfish attitude, altruistic attitude toward voluntary activities will not have changed in the control group before or after voluntary program. However, the altruistic attitude lowered after voluntary activity. It is statistically meaningful(t=2.694, p=.008). 4. After the voluntary activities, there was a significant difference between the experimental and control groups in altruistic attitude. In the experimental group, the mean value of altruistic attitude increased significantly, but in the control group the mean value of altruistic attitude decreased (t=2.15, p=.032). The results of this study showed that voluntary activities not only increase social interest and altruistic attitude, but also the subject's understanding toward the community.

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