Research in Community and Public Health Nursing

Volume 15 (2); June 2004

Original Articles

Analysis of Time Taken for Visiting Nursing Activities by Visiting Nurses: Sook Ja Yang, Kyung Rim Shin, Ok Soo Kim, Hye Young Kim, Kyung Hee Kim, Eun Ha Kim; J Korean Acad Community Health Nurs. 2004;15(2):177-186. Published online June 30, 2004

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Abstract PDF: PURPOSE
The purpose of this study is to analyse time taken for visiting nursing activities by visiting nurses in health centers.
METHOD
A questionnaire was developed by a research team for the technological support of visiting nursing activities and visiting nurses. A total of 481 questionnaires were recovered by five visiting nurses from May to October 2003.
RESULT
A visiting nurse's total length of time for visiting activities was 532.2 minutes per day and the number of households a visiting nurse visits a day was 4.5. A visiting nurse spent 133.3 minutes for actual nursing services and 119.1 minutes for travelling. Time for actual nursing activities was more than half of the total working hours. Time for travelling was 42.9 minutes on the average when using public transportation means and 25.6 minutes when using a car.
CONCLUSION
The results of this study is expected to be used as basic data in establishing plans for the adequate supply of visiting nurses based on demands for visiting nursing services.

Development of Organization System for Health Management Program of Maternal-child in Public Health Centers: Na Mi Hwang, Hyun Tae Park; J Korean Acad Community Health Nurs. 2004;15(2):187-196. Published online June 30, 2004

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Abstract PDF: PURPOSE
The purposes of this study are: to evaluate the effectiveness of organizations engaged in MCH programs; and to suggest the executive organizational system of maternal and child health (MCH) services linked to HP services at public health centers.
METHOD
This study analyzes data on the present conditions and evaluates the organizational effectiveness of MCH workers at public health centers nationwide. The organizational effectiveness of MCH organization is assessed by MCH workers. Finally, this study seeks to obtain consensus among experts in the field of MCH.
RESULT
The results are as follows. Of public health centers, 61.9% have a MCH organization for their MCH programs. For the other 38.2%, MCH services are undertaken by HP organization. Executive organizational systems for MCH services at leading MCH health centers are classified into three types: Type I (provides MCH and HP services through MCH organizations); Type II (provides MCH and HP Services through HP organizations); and Type III (provides MCH services through MCH organizations and HP services through HP organizations). The evaluation of the organizational effectiveness of MCH organizations shows that Type II is the most effective in terms of teamwork, autonomy, service quality and resource utilization.
CONCLUSION
This study suggests that executive organizations for MCH and HP services for women and children should be established in accordance with lifetime health programs in order for public health centers to utilize the limited MCH and HP resources efficiently.

Development an Evaluation Tool for Evaluation of Hypertension Prevention and Management Program in Community Health Posts: Myung Soon Kwon, Won Jung Cho; J Korean Acad Community Health Nurs. 2004;15(2):197-208. Published online June 30, 2004

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Abstract PDF: PURPOSE
This study was to develop an effective evaluation tool for evaluation of hypertension prevention and management program(HPMP) in community health posts (CHPs).
METHOD
Evaluation tool composed from the literature review, the field visiting, and the in-depth interviews with the community health practitioners.
RESULT
The evaluation tool had four domains, each with different maximum points:, hypertension prevention (35), hypertension management (40), environment of the CHPs(10), and evaluation system of the HPMP(15). The first domain was hypertension prevention with sub-domains of health education, and early detection of patients with hypertension. The second domain was hypertension management with sub-domains of management of health records of patients, education and counseling , and treatment and follow-up of patients. The third domain was the environment of the CHPs with subdomains of accessibility of CHPs to residents, accessibility of general health data to the public, and availability of health information to the public by multimedia. The fourth domain was the evaluation system of the HPMP with the subdomains of planning of program, formative evaluation, process evaluation, and summative evaluation.
CONCLUSION
The newly developed evaluation tool will contribute not only to plan and set goals for evaluation of HPMP in CHPs.

Development & Evaluation of Community-Based Home Care Nursing Service Program: Won Jung Cho, Cho Ja Kim, Won Hee Lee, Kyu Sook Kang, Eui Geum Oh, Hee Ok Park; J Korean Acad Community Health Nurs. 2004;15(2):209-217. Published online June 30, 2004

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Abstract PDF: PURPOSE
The purpose of this study was to construct the structure, process and outcome of community-based home care nursing service and to examine their validity.
METHOD
There were two steps. The first step was developing the structure and process of community-based home care and the second was evaluating the outcome of community-based home care. Home care services were provided to 25 clients who had health problems. Data on these clients were analyzed.
RESULT
According to Albrecht Model, in the developed structure and process of community-based home care, structure contained facility's philosophy, organization, delivery system, steering committee, office, equipments, medical instruments, the home care nurse and client of home care nursing. Process contained classification of client, nursing diagnosis and nursing intervention. The majority of clients were men (56%). The service was used mostly by people aged over 50 (82%). The most frequent nursing diagnoses were altered urinary elimination (23.2%), impaired skin integrity (21.8%) and risk for infection (17.6%). Nursing interventions included wound care (16.7%), tube care (15.1%) and catheter care (14.5%).
CONCLUSION
Several strategies are suggested from this study: first, activate a referral system within the national health care system; second, increase public information on home care nursing; third, develop home care nursing services for elderly people; and fourth, construct a cooperation system between home care services and social welfare services.

The Effects of Self-help Management Program for Post Stroke Patients at Home: Young Hee Mun; J Korean Acad Community Health Nurs. 2004;15(2):218-227. Published online June 30, 2004

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Abstract PDF: PURPOSE
The purpose of this study was to determine the effects of 5 weeks self-help management program developed by Kim et al. (2000-b) and reinforced with music therapy for post stroke patients.
METHOD
This was pre-experimental study and the subjects were 14 post stroke hemiplegic patients at home who were registered at the Gunsan Health Center. The program was applied for five weeks and two hours for each session composed of the preparation step, the main step and the finishing step. The contents of the program were ROM exercise, daily activity training, risk factors and aftereffects, nutrition management and stress management. To collect data, all subjects were questioned before and after the application of the program. Collected data were analyzed through frequencies, percentages, Wilcoxen signed rank test and Cronbach's alpha using SPSS-WIN program.
RESULT
After the application of the self-help management program, a statistically significant increase was observed in the subjects' ability to perform activities of daily living (p=.039), ability to perform instrumental activities of daily living (p=.005), self-efficacy (p=.001), self-care behavior (p=.001) and quality of life (p=.001), and a statistically significant decrease was observed in depression (p=.012).
CONCLUSION
The present self-help management program was found to be helpful in improving the subjects' physical and psychological functions after they were attacked by stroke, so to be an effective nursing intervention strategy for post stoke patients. Future researches need to reinforce and materialize music therapy and to develop and apply a self-help management program that includes not only post stroke patients but also their families. In addition, it is necessary to expand the scope of subjects and apply follow-up management in order to continue self-help meetings.

Analysis of Trend in Gerontological Nursing Researches in Korea: Focused on community nursing journals: Myoung Ja Wang, Young Mi Park, Myung Hee Lee, Kyung Wha Chang, Kyung Jae Lee, Sang Hee Chun, Jong Yul Lee, Kyung Hui Yu, Tae Ok Jeong; J Korean Acad Community Health Nurs. 2004;15(2):228-236. Published online June 30, 2004

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Abstract PDF: PURPOSE
This study attempted to see the trend of researches in nursing old people.
METHOD
We analyzed a total of 105 articles that were published in The Journal of Korean Community Nursing, J. Korean Community Health Nursing Academic Society, The J. of Korea Acad. Soc. of Home Care Nursing from 1987 to June 2003.
RESULT
1. It was found that researches on old people nursing had increased every year since 1995 and most largely in 1995~1999. 2. It was known that the majority of researches were designed to be non-experimental and their subjects were old people over 65 living at home. 3. Nursing interventions used in experimental studies were music therapy and various health promotion programs. 4. Major research concepts are physical activities, mental health, physical health, medical management, social health, quality of life and family health.
CONCLUSION
The number of studies has increased in community nursing journals, but there have been not many studies about polices and management for old people living in community society and suggestions of practical alternatives. Thus it is necessary to carry out more community nursing studies about management and education for old people.

A Study on the Correlations among the Depression, Social Support and Quality of Life of the Elderly in Rural Areas: Yeon Hee Choi; J Korean Acad Community Health Nurs. 2004;15(2):237-245. Published online June 30, 2004

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Abstract PDF: PURPOSE
This study was to identify the relationships among the depression, social support and quality of life of the elderly in rural areas.
METHOD
The subjects of this study were 199 people aged over 60 who had been living in three rural area. Data were collected through a questionnaire survey from the 10th of July to the 10th of August 2003. Collected data were analyzed using descriptive statistics, t-test, ANOVA, Duncan's multiple-range test, Pearson's correlation coefficient and multiple stepwise regression with SPSS & SAS.
RESULT
The average depression score was 11.09. As for the score of social support by supporter, the score of spouse' support was 13.36 out of 18 points, children's support 13.27, friends' support 11.40, neighbors' support 10.21 and siblings' support 10.20. The average score of quality of life was 132.26 out of 220 points. As for the score of the sub-areas of quality of life, the score was highest in economic status(32.18) and lowest in neighbor relationship (16.42). The score of quality of life was negatively correlated with the score of depression (r=-.014) and positively with the score of social support (r=.338). The suitable regression from the results of the multiple regression analysis to investigate factors influencing quality of life was expressed by y=58.341-0.361chi1+ 1.492chi2 (chi1: social support, chi2: depression) and R2=.327.
CONCLUSION
These results suggest that elderly people in rural areas with high quality of life is likely to be low in depression and high in social support. Therefore, it is necessary to develop health promotion programs in due consideration of depression and social support in order to enhance the quality of life of elderly people in rural areas.

College Students' Understanding of Elderly's Sexual Life: Inn Sook Lee; J Korean Acad Community Health Nurs. 2004;15(2):246-254. Published online June 30, 2004

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Abstract PDF: PURPOSE
This study was to measure college students' understanding of elderly's sexual life.
METHOD
For this study, questionnaires were distributed to 423 students in 'K' college of Chungcheongbuk-do during the period from November 17 to December 3 2003.
RESULT
With regard to elderly 's sexual life, 38.5% of the respondents answered 'very important' or 'important'. With regard to disturbances of elderly's sexual life, 56.7% of the respondents answered 'because of aging', and 53.4% answered 'because of social and moral dignity'. Of the respondents, 95.0% agreed on elderly's acquaintance with the opposite sex, and 50.8% of respondents who agreed on it answered that the reason of elderly's acquaintance with the opposite sex was to get friends. The score of college students' understanding of elderly 's sexual life was 2.64 out of 4 points. Among the areas in the questionnaire on understanding of elderly 's sexual life, college students' attitude toward sexual life showed the highest score. The score of the necessity of education and counseling for elderly on sexuality and acquaintance with the opposite sex was 3.11 out of 4 points. Of the respondents, 84.4% agreed on education and counseling on sexuality for elderly, and 90.0% agreed on education and counseling on acquaintance with the opposite sex for elderly. There were statistically significant differences in the scores of college students' understanding of elderly's sexual life according to their grade(F=14.241, p=.000), major(t=4.751, p=.000) and sexual attitudes(F=5.395, 0=.005).
CONCLUSION
The survey result suggests that college students have open-hearted understanding of elderly's sexual life. But to make ordinary people accept elderly's sexual life more open-heartedly, it is necessary to develop various education and counseling programs for elderly's sexual health.

The Effects of Group Art therapy on Old Adults' Powerlessness, Loneliness, Depression and Self-image: Young Soon Choi, Hyun Li Kim; J Korean Acad Community Health Nurs. 2004;15(2):255-265. Published online June 30, 2004

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Abstract PDF: No abstract available.

Factors Influencing Middle-aged Women's Depression: So Ja Jun, Hee Kyung Kim, Sun Mi Lee, Su A Kim; J Korean Acad Community Health Nurs. 2004;15(2):266-276. Published online June 30, 2004

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Abstract PDF: PURPOSE
This study purposed to supply basic data for nursing intervention plan for middleaged women healthcare and for finding solutions to nursing problems through understanding middle-aged women's depression, and to examine whether middle-aged women's depression is related with self-concept, self-efficacy, physical condition and social support.
METHOD
The subjects were 200 middle-aged women aged between 35 and 60 and living in Daejon city and K city in Chungcheongnam-do, and the questionnaire survey was conducted from the 15th of August to the 18th of September in 2003 using a structured questionnaire. Collected data were analyzed through descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression.
RESULT
Middle-aged women's depression was found to be in a negative correlation at a statistically significant level with self-concept (r=-.679, p=0.000), self-efficacy(r=-.489, p= 0.000), physical condition(r=-.650, p=0.000) and social support(r=-.526, p=0.000). The most significant variables of middle-aged women's depression was self-concept(46.2%). Combining with physical condition(13.2%) and self-efficacy(0.9%), the three variables together explained 60.3% of middle-aged women's depression.
CONCLUSION
The results show that middle-aged women's depression is closely related with self-concept, self-efficacy and physical condition. Thus this study suggests that the goal of nursing intervention for middle-aged women to overcome depression should be to help them to have positive self-concept, high self-efficacy and sound physical condition.

High School Students' Knowledge and Attitude About Smoking according to Their Smoking Status: Kyung Shin Paek, Yeon Hee Choi; J Korean Acad Community Health Nurs. 2004;15(2):277-288. Published online June 30, 2004

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Abstract PDF: No abstract available.

The Effects of Job Stress on Workers' Physiological Somatic Complaints: Jong Eun Lee, Soon Lae Kim, Hye Sun Jung, Bok Im Lee; J Korean Acad Community Health Nurs. 2004;15(2):289-297. Published online June 30, 2004

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Abstract PDF: PURPOSE
This study was conducted to determine factors affecting workers' physiological somatic complain using the Job Stress Model proposed by the National Institute for Occupational Safety and Health (NIOSH).
METHOD
Data were collected from the 1st to the 30th of December 1999. The subjects were 2,123 workers employed at 155 work sites. Collected date were analyzed through SAS/PC program.
RESULT
According to individual characteristics, younger and women groups showed significantly higher physiological somatic complaint than elder men groups. By work condition, groups with higher physiological somatic complaint included workers of irregular shift work. Dark lighting, improper temperature in winter, improper ventilation, inappropriate humidity, unpleasant work environment and crowded work place were significantly related with physiological somatic complaint. By work-related factor, physiological somatic complaint was high in those with higher variance in work load, quantitative work load, role conflict, job burden, role ambiguity and future ambiguity. On the other hand, physiological somatic complaint was low in those with little underutilization of ability. As for the relationships between physiological somatic complaint and non-work related factors, physiological somatic complaint was high in workers who had a side job, were bringing up infants alone, cleaned the house alone, cared for the elderly and disabled persons, were studying, were volunteering at another organization, and were spending 5-10 hours in religious activities per week. Physiological somatic complain was in significantly negative correlations with overall social support, supervisory support and family support, but in significantly positive correlations with co-worker support.
CONCLUSION
The main predictors of physiological somatic complain were gender, shift work pattern, overtime work, ventilation, role ambiguity, role conflict, future ambiguity, job control, variance in work load, overall social support, worker with side job, worker who cleans the house alone, worker who is studying. These predictors explained 19.10% of the total variance of physiological somatic complain.

A Study on Soldiers' Knowledge, Attitude and Health Belief about AIDS: Eun Sue Moon, Hye Sun Jung, Eun Sook Choi; J Korean Acad Community Health Nurs. 2004;15(2):298-307. Published online June 30, 2004

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Abstract PDF: PURPOSE
This study purposed to investigate the relationship between soldiers' general characteristic and their knowledge, attitude and health-belief about AIDS.
METHOD
This study conducted a survey of 197 soldiers using a structured questionnaire. Data were collected from the 10th to 30th of May 2003.
RESULT
The average age of the participants was 21.6 years, 78.2% of them were undergraduates of universities, and by religion the number of Christians was largest. In addition, 81.2% of them had lived with their parents and siblings before they joined the army and most of them were unmarried. Of the subjects, 75.1% finished education about AIDS, 64.5% experienced a sexual intercourse and 6.3% experienced a venereal disease. The participants' knowledge level about AIDS was 14.6 out of 20 points and their attitude about AIDS is 3.96 out of 5 points on the average. Their health-belief about AIDS was 4.0 out of 5 points in "perceived benefits," 2.9 in "perceived barriers," 2.6 in "perceived seriousness" and 2.6 in "perceived sensitivity. Among the subjects' general characteristics, religion was found to be a statistically significant variable for their knowledge level about AIDS. A variable that is statistically significant for the subjects' attitude toward AIDS was families they had lived together before joining the army. Statistically significant variables for the subjects' healthbelief about AIDS were perceived sensitivity and experience in venereal diseases, perceived benefits and AIDS education and perceived barriers and marital status. The subjects' knowledge about AIDS was in a statistically significant correlation with their attitude toward AIDS, and their attitude toward AIDS with perceived benefits.
CONCLUSION
According to the results of this study, those who had had AIDS education appeared to have high attitude and health-belief concerning AIDS. Thus it is necessary to execute AIDS education systematically and continuously in order to have right attitude and high health-belief concerning AIDS.

A Study on Nursing Students' Volunteer Experience in Visiting Ambulatory Bathing Service: Seoung Sook Hwang; J Korean Acad Community Health Nurs. 2004;15(2):308-322. Published online June 30, 2004

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Abstract PDF: No abstract available.

Nursing Students' Experiences in Visiting Care Practice: J M Park, S J Lee, S Y Min, S K Park; J Korean Acad Community Health Nurs. 2004;15(2):323-331. Published online June 30, 2004

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Abstract PDF: PURPOSE
To examine nursing students' experiences in visiting care practice in community.
METHOD
According to phenomenological method and Collaizzi's data analysis, all data were collected from March to June 2002 through written daily reports by 56 students in the visiting care unit of four public health centers. Four researchers had sought the daily reports for significant data.
RESULT
In the research, 118 significant statements were selected and 33 subject groups were organized from the statements. From the 33 groups were identified 10 categories finally, which were as follows: stress, reflecting the nursing identity, considering the meaning of life, importance of family, necessity of social interest, compassion, worth of visiting care, the limits of visiting nursing care, identified characteristics of clients, both sides of the role model.
CONCLUSION
Through visiting care practice, nursing students experienced stress, nursing identity, both sides of role model, and the worth and limits of visiting care. students felt the necessity of systems for lower classes and considering general characteristics of the clients. Above all, they came to have a wider perspective of the society through the practice.

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