Research in Community and Public Health Nursing

Volume 13 (3); September 2002

Original Articles

Validity Field Testing of Family Nursing Phenomen in Korea by the Retrospective Method of ICNP: Soon Nyung Yun, Hyun Sook Kim, Yong Suk Kwon, Kyung Min Park, Ji Hyun Lee, Young Ae Ko, Ae Young So, Soon Ok Yang, Young Im Kim, Hee Girl Kim, Jin Joo Oh, Myoung Ja Wang, Soon Lae Kim, Kyung Sook Kang, Ji Yun Lee; J Korean Acad Community Health Nurs. 2002;13(3):423-432. Published online September 30, 2002

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Abstract PDF: This study was conducted to test the validity of characteristics of family nursing phenomena in Korea identified in a previous study by Yoon, S. Y, et al.(1999). Data for this study were collected from 355 (first measurement 186, second measurement 169) nurses whose family nursing careers were more than one year using a cross sectional survey method. The distribution per one characteristic ranged between 0 to 5. The phenomena that had two or more characteristics and had a score of 3.0 points or more included 'disturbance in marital role', 'disturbance in family communication', 'inappropriate family coping', 'lack of family intimacy', 'unhealthy life style', 'deficit of financial management skill and support', 'inadequate care management sick member', and 'inadequate home-making'. The essential characteristics of the 8 phenomena presented above included 27 items. Further studies on family nursing phenomena in Korea are needed to support the evidence through surveys of families in the field. A reconfirmation study, as well as qualitative research on the low validity of the characteristics, needs to be more performed in the future.

Development of a Home Care Need Assessment Tool: Focused on Home Care Nursing Diagnoses based on Self Care: Ae Young So, Byong Hee Cho; J Korean Acad Community Health Nurs. 2002;13(3):433-443. Published online September 30, 2002

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Abstract PDF: OBJECTIVES
The purpose of this study was to develop a framework for home care and a Home Care Need Assessment Tool.
METHOD
1. Identifying common domains in the provision of home care. 2. Charts of 253 home care clients were reviewed to obtain a classification of the nursing diagnoses. 3. A focus group methodology was used to develop the domains. 4. The tool was applied to 439 home care clients.(Kappa value=0.460-1.000, sensitivity, 0.444-1.000; specificity, 0.743-1.000). 5. Some refinements and extractions of the defining characteristics and related factors were made based on the results of the focus group.
RESULTS
Home Care Need Assessment Tool consists of three parts; -Part : factors related to basic conditions -Part : a screening component that enables home care nurses to assess 30 multiple domains of 53 nursing diagnoses. -Part : summative nursing diagnoses and nursing need intensity for the clients.
CONCLUSION
This tool provides a comprehensive assessment that helps the recognition of many strengths as well as problems of the clients. It will be usefully utilized in scheduling home care nursing plans and evaluating client outcomes.

Nursing Case Management Program Development for the Elderly at Hospital: Eun Young Shin; J Korean Acad Community Health Nurs. 2002;13(3):444-455. Published online September 30, 2002

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Abstract PDF: PURPOSE
This study was performed to develop the case management program that can provide the qualitative health care service to satisfy the increasing needs for health care elderly and prevent the increase in medical cost cased by prolonged and repetitive hospitalization.
METHOD
The survey was completed as follows. First, 290 elderly patients who would be soon discharged in 4 hospitals are participated in the survey on needs of nursing care and case management programs. Second, 70 professionals working at 5 hospitals including doctors, nurses, social workers and so on are participated in the survey on the case management team operation.
RESULT
Level of needs to Nursing care and case management programs showed so high. Professionals suggested on the case management team operation. Finally, based on the survey and literature review, the case management program was developed.
CONCLUSION
In this study, the specific models for the five case management services were suggested. It is thought that the service provision by the case management team based on the multi-disciplinary case management program model suggested in this study would be suggested as a constituent of the effective health care delivery system for the hospitalized elderly patients.

Testing of the Theory of Planned Behavior in the Prediction of Smoking Cessation Intention and Smoking Cessation Behavior among Adolescent Smokers: Mi Ra Song, Soon Lae Kim; J Korean Acad Community Health Nurs. 2002;13(3):456-470. Published online September 30, 2002

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Abstract PDF: OBJECTIVES
The purpose of this study was to test the Theory of Planned Behavior (TPB) in the prediction of smoking cessation intention and smoking cessation behavior among adolescent smokers, in order to provide basic data to develop a future smoking cessation program as a nursing intervention.
METHOD
The study subjects were 80 adolescent smokers who had smoked one cigarette and attended a five-day school smoking cessation program. The data were collected from October 24 to December 21, 1999. The instruments used in this study were the tools developed by Jee (1994) to measure TPB variables such as attitude toward smoking cessation behavior, subjective norm, perceived behavioral control, smoking cessation intention, and smoking cessation behavior. The data were analyzed with the SAS/PC program using descriptive statistics, hierarchical multiple regression, and logistic multiple regression.
RESULTS
1. Attitude toward smoking cessation behavior, subjective norm, and perceived behavioral control were partially significant in predicting smoking cessation intention. 2. Smoking cessation intention and perceived behavioral control toward smoking cessation behavior did not significantly predict smoking cessation behavior. 3. There were partial interaction effects among the attitude toward smoking cessation behavior, subjective norm, and perceived behavioral control in the prediction of smoking cessation intention. 4. There were partial interaction effects between smoking cessation intention and perceiver behavioral control toward smoking cessation behavior in the prediction of smoking cessation behavior.
CONCLUSION
This study partially demonstrated support for the TPB model that was partially useful in predicting smoking cessation intention and smoking cessation behavior among adolescent smokers. Therefore, it is recommended that attitude toward smoking cessation behavior and perceived behavioral control should be considered in developing smoking cessation programs and implementing nursing interventions to change the smoking behavior of adolescent smokers.

A Study on the Knowledge and Attitudes toward Smoking among Middle School Students: Kyung Ok Baek, In Soon Kang; J Korean Acad Community Health Nurs. 2002;13(3):471-480. Published online September 30, 2002

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Abstract PDF: OBJECTIVES
This study was designed to provide basic information for smoking prevention education for middle school students by examining their knowledge and attitudes toward smoking.
METHOD
A survey was conducted in this study on 1,250 students from 12 middle schools in the six educational bureaus in the Busan region. Results from the preliminary survey showed that the reliability of the instruments for knowledge and attitudes toward smoking were 0.84 and 0.86, respectively. The data for this study were collected for 20 days from Dec. 1 to 20, 2000, and then statistically analyzed with the SAS program using frequency, percentage, mean and standard deviation, and two-way ANOVA.
RESULTS
(1) The highest frequency of responses found that both male and female students did not smoke at all. Among 170 students who had experiences of smoking, 66.5% reported they tried smoking because of curiosity, and 38.2% reported they first smoked during the 2nd grade of middle school and 1.2% during 4th grade of primary school. (2) In scores on smoking knowledge, the item with the highest score in both male and female students was one that they had no smoking experiences et al, followed by smoking experiences in the past and experiences of regular smoking. (3) In scores on attitude toward smoking, both male and female students were scored as the highest at the item that they had no smoking experiences et all, followed by the item that they smoked in the past and that they experienced regular smoking. (4) There was no significant correlation between knowledge and attitude toward smoking among the whole subjects (r=0.09, P=0.00). With regard to regular smoking experiences among the male and female students at the 3rd grade of middle school, there was a relatively high correlation between knowledge and attitude toward smoking among them (r=0.57, P=0.00; r=0.56, P=0.01).
CONCLUSION
Students who had never smoked or smoked only in the past need smoking prevention education consistently. Particularly, for those who were regular smokers, not only individualized but also organized in small size groups, they need an intensive educational program on the basis of counseling to reduce smoking and to put in practice smoking cessation.

Attitude Type about Smoking of Smoking Middle School Students: Kyoung Soon Han, Sun Young Moon, Yong Hee Choi, Bok Chang Oh, Shin Jeong Kim; J Korean Acad Community Health Nurs. 2002;13(3):481-492. Published online September 30, 2002

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Abstract PDF: The purpose of this study was to understand and analyze the subjective structure of attitude The method was based on a Q-Methodological approach. The results of this study, there were four categories of smoking middle school students' attitude about smoking. The first type named Self Belief type that this type didn't sensible of their surrounding persons when they were smoking and they also were responsible for strong opinion at their behavior. The second type named Other's Awareness type that they were seen the behaviors they always have to see other person when they were smoked, but if they didn't smoke or have tobaccos they feel heavy and are restless. The third type named Solving of Anxiety type. They first used to smoke when they wanted to solve their anxiety, stress, awkwardness and angry. The fourth type named A Sense of Belonging Group type. This type followed if their friends were smoking they also did it with them. As to grasping of their motivation to smoking of middle school of students with smoking, they felt some intimacy and same quality each other. In consideration of various types of attitude about smoking, it was very necessary important to grasp the meaning because we were known about attitude, belief etc. And then Through getting hold of the meaning, we could understand with their thought and value of Students in middle school. Besides, as a substitute for the students were depending on smoking purposelessly will fix right self-confidence.

Determinants of Health Status in Adolescents: Min Hyun Suk, Won Oak Oh; J Korean Acad Community Health Nurs. 2002;13(3):493-502. Published online September 30, 2002

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Abstract PDF: PURPOSE
This study was conducted to measure the levels of Health status, perceived stress, self-esteem, and achievement motivation and assertive behavior of adolescents. The relationships among these variables as well as predictors of health status were examined.
METHOD
The sample was composed of 496 students (male: 195, female: 301) from 3 high schools in Seoul and Kyunggi-Do regions. The instruments used in this study were as follows: health status scale developed by Noh (1991), perceived stress scale developed by Park(1996), self-esteem scale developed by Rosenberg (1965), achievement motivation scale developed by Park(1986) and assertive behavior scale developed by Kim(1982). The reliability of the five instruments were examined using Chronbachs' alpha that ranged from .63 to .90 in this study. The data were analyzed with the SAS program using descriptive statistics, t-test, ANOVA, Duncan multiple comparison, Pearson correlation coefficients, and stepwise multiple regression.
RESULTS
The results were as follows: 1. The mean score of health status was 3.1, which was higher than the median of the instrument. 2. There were significant correlations of health status with self-esteem (r=.381, p=.0001), assertive behavior (r=.503, p=.0001), and perceived stress (r=-.352, p=.0001). 3. Stepwise multiple regression analysis showed that 34% of health status was affected by the level of assertive behavior (25%), self-esteem (7%), and perceived stress (2%).
CONCLUSION
Based on these findings, assertive behavior and self-esteem appear to be specific important areas of future research as to better understand the health status of adolescents, and to develop health status-related interventions for them.

Development of Educational Materials for Management and Prevention of Chronic Hepatitis: Mae Ja Kim, Gye Young Shin, Sun Ock Lee; J Korean Acad Community Health Nurs. 2002;13(3):503-512. Published online September 30, 2002

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Abstract PDF: PURPOSE
This study was conducted to develop educational materials for preventing type B viral hepatitis infection. Prior to this study, a survey had been conducted to define the educational needs of persons with hepatitis B antigen.
METHOD
Based on the results of the former study and a review of the literature, the content of the educational materials was confined to the transmission cycle and its prevention in type B hepatitis. A professional team that consisted of writers and producers videotaped the lectures provided by professors and instructors in a nursing school. A professional graphic designer produced the leaflet to enhance the visual effects.
RESULTS
The contents of the educational materials for type B hepatitis were composed of six parts: (1) the prevalence rate (or morbidity) of type B hepatitis antigen positive and its recent trend, (2) transformation of hepatitis, (3) transmission cycle of hepatitis infection, (4) persons who are susceptible to hepatitis and need a vaccination, (5) preventive approach - hepatitis vaccination and the guideline for patients' daily lives for preventing infection and (6) questions and answers. The materials were delivered in the form of lectures, visual charts, graphics, and multi-media.
CONCLUSION
The educational materials developed in this study may provide practical information and knowledge on strategies to prevent type B hepatitis. The educational materials may be utilized in primary health care centers or school health services.

A Study on the Relationship between Stress and Climacteric Symptoms of Midlife Men: Kyung Lim Han, Yeon Kang Chung, Jae On Lee; J Korean Acad Community Health Nurs. 2002;13(3):513-522. Published online September 30, 2002

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Abstract PDF: This study investigated stress and the extent of climacteric symptoms in mid-life men, and examined their relationship in order to better understand the stress and climacteric symptom experiences of mid-life men, and thereby attempted to offer basic materials for the development of a health improvement program that may help increase the quality of life of mid-life men. Three hundred mid-life men whose ages were between 40 and 59 and resided in the Seoul area were subjects of this study. The data were analyzed with the SAS PC program using descriptive statistics to analyze subjects' general characteristics and variables of stress and the extent of climacteric symptoms of the subjects. The relationship between stress and climacteric symptoms were examined by the Pearson Correlation Coefficient, and stress and the extent of climacteric symptoms in relation to the general characteristics were analyzed by T-test and ANOVA. The study conclusions are as follows: 1. Subjects general characteristics The average age of the subjects was 46 and 47.0% of them reported ages between 40 and 45. Of the subjects, 98% were married. In marriage satisfaction, those who were generally satisfied with their married life comprised 62.0% of the subjects. In terms of level of education, 95.7% were educated above the high school level. In occupational background, 59.7% had occupations related to technologies. As for religion, 42.7% had no religion. In number of children, 67.3% had 2 children. In residential status, 79.3% were living in their own homes. In terms of living arrangements, 87.7% of the subjects were living in the form of nuclear families. 2. Stress and the extent of climacteric symptoms The level of stress was scored as 2.94+/-0.74, and considering that the overall examination score is 27.16+/-1.32, the subjects' stress level was not viewed as particularly high. The average score of the extent of climacteric symptoms was 35.37+/-0.27. The extent of sub-domains of climacteric symptoms included skeleton symptoms (39.37+/-2.81), joint pain (39.16+/-3.66), vasomotor symptoms (35.39+/-3.01), other symptoms (36.99+/-3.02), psychological symptoms (34.68+/-3.01), urogenic symptoms (35.03+/-3.27), and cardiovascular symptoms (33.70+/-2.78). 3. General characteristics in relation to the stress level The subjects' general characteristics that were significantly related to the level of stress were marriage status (F=4.38, p=.001), marriage satisfaction (F=4.56, p=.001), educational background (F=2.68, p=.012), and age (F=2.48, p=.033). 4. General characteristics in relation to the level of climacteric symptoms The subjects' general characteristics that were significantly related to the level of climacteric symptoms were educational background (F=3.26, p=.007), age (F=2.58, p=.027), marriage status (F=2.62, p=.025), and marriage satisfaction (F=2.78. p=.032). 5. The correlation between stress and climacteric symptoms The subjects' level of stress and climacteric symptoms were significantly related to each other (r=0.578, p=0.000). The subjects' level of stress was correlated with sub-domains of the climacteric symptoms including psychological symptoms (r=0.579, p=0.000), joint pain (r=0.479, p=0.000), skeleton symptoms (r=0.477, p=0.000), other symptoms (r=0.467, p=0.000), vasomotor symptoms (r=0.4615, p=0.000), cardiovascular symptoms (r=0.458, p=0.000), urogenic symptoms (r=0.401, p=0.000). In summary, the climacteric symptoms suffered by mid-life men are positively correlated with their level of stress. In addition, the climacteric symptoms were affected by the level of stress.

Validation of the Nursing Outcomes Classification (NOC) to Nursing in Korea: Eun Joo Lee; J Korean Acad Community Health Nurs. 2002;13(3):523-531. Published online September 30, 2002

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Abstract PDF: PURPOSE
The purpose of this study was to assess the importance and sensitivity to nursing interventions of six sensitive nursing outcomes selected from the Nursing Outcomes Classification. The outcomes in this study were Self-Care: Activities of Daily Living, Self-Care: Instrumental Activities of Daily Living, Treatment Behavior: Illness or Injury, Knowledge: Health Promotion, Caregiver Performance: Direct Care, and Caregiver Physical Health.
METHOD
Data were collected from 97 visiting nurses working in public health centers located in a province and a capital city. The Fehring method was used to estimate outcomes and indicators for content validity. Simultaneous multiple regression and stepwise regression were used to evaluate relationships between each outcome and its indicators.
RESULTS
Results confirmed the importance and nursing sensitivity of the outcomes and their indicators. Multiple regression revealed key indicators of each outcome. Self-Care: Instrumental Activity of Daily Living needed to be revised. Neither all of the indicators nor the indicators showing the highest importance and contribution ratio were selected as independent variables for the stepwise regression model. The R2 of the regression models ranged from 29 to 56% in importance by selected indicators and from 56 to 83% in contribution.
CONCLUSION
Further research is needed for the revision of outcomes and their indicators.

The Effect of the Solution-Focused Group Counseling on Self-esteem, Depression, and Hope of Unemployed Homeless Persons: Hyun Mi Kim; J Korean Acad Community Health Nurs. 2002;13(3):532-540. Published online September 30, 2002

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Abstract PDF: PURPOSE
To examine the effect of the solution-focused group counseling on self-esteem, depression, and hope of unemployed homeless persons, and to develop a nursing intervention program designed to help rehabilitation of the unemployed homeless persons.
METHOD
This study was conducted from July 14 to September 29, 2000, and May 4 to August 17, 2001. The subjects were 30 unemployed homeless persons residing in 1 shelter in Seoul, Korea. This study used a quasi-experimental, one-group pretest-posttest design. The data were analyzed by frequency, percentage, and paired t-test using SPSS WIN program.
RESULTS
1) Self-esteem of the subjects increased significantly after the solution- focused group counseling (t=3.31, p=0.002). 2) Depression of the subjects decreased significantly after the solution- focused group counseling (t=2.05, p=0.046). 3) Hope of the subjects increased significantly after the solution- focused group counseling (t=2.65, p=0.011).
CONCLUSION
The solution- focused group counseling may be considered as an effective nursing intervention program for the unemployed homeless persons by improving their self-esteem and hope as well as reducing their depression. However, the effects of the program should be further addressed through a review study.

Analysis of Researches about Nutrition, Pain and Fatigue of Cancer Patients: Jung Sook Park, Hye Ok Kim, Mi Young Moom, Yun Jung Oh, Kui Im Jung, Mae Ok Yoon, Su Ja HwangBo; J Korean Acad Community Health Nurs. 2002;13(3):541-555. Published online September 30, 2002

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Abstract PDF: OBJECTIVES
This study is aimed to analyze the trend of research on nutrition, pain and fatigue of cancer patients in Korea, suggest direction for future research of nutrition, pain and fatigue of cancer patients.
METHODS
74 studies published from 1991 to 2001 were examined according to the year of publication, types of journal, research design, types of disease, care methods, major concepts, tool and research findings.
RESULTS
1) The number of studies related nutrition, pain and fatigue of cancer patients had increased rapidly since the 1996's(78.4%). 2) 42 nutrition, pain and fatigue of cancer patients studies(56.1%) were done for a thesis for a degree and 32 were nondegree research studies(43.9%). 3) 70 studies(94.7%) were quantitative study, which included in 40 descriptive studies(54.1%), 22 experimental studies (29.75), 5 correlative studies(6.8%), 2 comparative studies(2.7%) and 1 case study(1.4%), and 4 studies(5.3%) were qualitative study, which included in 3 content analysis studies(3.9%) and 1 phenomenological study(1.4%). 4) Researches about cancer more than 2 were the most by 48 studies(66.1%), following leukemia researches were 8 studies(10.8%), breast cancer researches were 7 studies(9.5%), gastric cancer researches were 4 studies(5.4%), pediatric cancer researches were 3 studies(4.1%), uterine cancer researches were 2 studies(2.7%). 5) Researches about chemotherapy were the most by 39 studies (52.6%), following analgesic researches were 14 studies(18.9%), researches that do not present treatment method were 9 studies(12.2%), radiation researches were 7 studies(9.5%). 6) In 22 experimental studies, the effects of 13 types of nursing interventions were tested. Research findings were effective almost but muscle relaxation therapy to decrease nausea and vomiting was no effect.
CONCLUSION
We need more researches about research of nutrition, pain and fatigue of cancer patients, especially need to prove the effect of intervention or program for nutrition, pain and fatigue of cancer patients by experimental research designs and need more qualitative researches to identify indepth the meaning of nutrition, pain and fatigue of cancer patients.

The Relationships of Myers-Briggs Type Indicator and Assertiveness Training to Assertiveness Behavior and Conflict Management Mode: Jeong Hee Park; J Korean Acad Community Health Nurs. 2002;13(3):556-565. Published online September 30, 2002

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Abstract PDF: Due to the fact that nurses may deal with diverse populations in the work place, it is very important for then to maintain appropriate interpersonal relationships with clients. Nurses should maintain diverse types of relationships appropriately with patients with special needs and their families during crisis, other nursing colleagues and staff on the same team, clients in the school or work place as well as the community. In particular, a hospital is a society with a system and hierarchy, and the importance of interpersonal relationships is much more emphasized. In interpersonal relationships, it is very important for a person to communicate with others in an accurate manner, and when the communication is not achieved appropriately, the person may have troubles and experience distress and conflicts because of the inaccurate communication of thoughts. According to the findings of previous studies, nurses actually experience much distress in the work place because of the miscommunication that they have with others. The purpose of this study was to observe a correlation between Myers-Briggs Type Indicator and assertiveness behavior, and to exam the effects of assertiveness training on the assertiveness behavior and conflict management mode. The subjects of this study included 20 persons in the experimental group and 20 persons the in control group. Myers-Briggs Type Indicator was applied before the study. The assertiveness training group received six, 120 minutes sessions over a 3 week period. Pre-test on assertiveness behavior, Communication Conflict Inventory-General, Role Conflict Inventory- General, Conflict Management Mode was achieved for all the subjects prior to the training. Post-test was administered to all the subjects one week following the last session. The data were analyzed using SPSS PC program to obtain findings on mean, standard distribution, t-test, and Pearson correlation. The results are as follows: 1 Myers-Briggs Type Indicator Introvert/Extrovert was correlated to assertive behavior and avoid- response type conflict management mode. 2 The assertiveness training was correlated to assertiveness behavior, communication conflict degree, and avoid- response type conflict management mode. 3 The post-test scores between the training group and the control group were significantly different in assertiveness behavior and avoid-response type conflict management mode. It is suggested that more studies need to be done to differentiate the effects of Myers-Briggs Type Indicator and assertiveness training on assertiveness behavior and avoid-response type conflict management mode.

Concept Analysis of Support: Kyung Sook Kang, Mi Young Jeong, Mee Young Kim, Su Hyun Jang; J Korean Acad Community Health Nurs. 2002;13(3):566-573. Published online September 30, 2002

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Abstract PDF: A concept is a building block of a theory. The purpose of a concept analysis is to clarify the critical attributes of a concept and identify its real meaning, particularly if the concept is not understood in a clear and accurate manner. This study was conducted to analyze the concept of support, which has been adopted from another discipline and unclearly used in nursing science. For concept analysis of this study, Walker and Avant's method was used. Support is defined as a domain with emotional, informational, material and evaluative aspects. Critical attributes of the concept of support included (1) an experience of support between a support provider and a client, (2) communication, (3) a relationship of mutual interchange of emotional, informational, material, evaluative support, and (4) intention. Cases related to the concept of support included model cases and appendix cases (against, boundary, and related). Antecedents of support were anxiety, depression, and loss of self-esteem, and consequences of support were comfort, increase of self-esteem, and trust. Based on these results, a nursing intervention that can provide a better quality of life for the prevention of diseases, health management, and health promotion may be developed in the future.

The Evaluation of Occupational Health Program at a Granite Company in U.S.A.: Sung Eun Yi; J Korean Acad Community Health Nurs. 2002;13(3):574-583. Published online September 30, 2002

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Abstract PDF: No abstract available.

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