Research in Community and Public Health Nursing

Volume 15 (3); September 2004

Original Articles

Analysis of the Effects and Nursing Intervention of Home Health Care in Public Health Centers: Young Ran Chin, In Sook Lee, Hyun Sook Chang; J Korean Acad Community Health Nurs. 2004;15(3):353-364. Published online September 30, 2004

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Abstract PDF: PURPOSE
The purpose of this study was to investigate the types and frequencies of nursing intervention of home health care in Public Health Centers and its effects.
METHOD
The data collection period for this study lasted from March 1 to December 31, 2003. The clients were sampled by a stratified randomized method among those who had been cared for at least 3 months. The data was analyzed by SPSS for description, ANOVA, paired t-test, etc.
RESULT
The types and frequencies of nursing intervention in major chronic health problems were significantly different. The main types of nursing intervention in hypertension and DM patients included education on disease management, regular exercise, stress management, diets, etc. CVA patients were intervened in pain control (ice or hot pack, massage), position changes, and ROM exercise. Cancer patients received imaginary or relaxation therapy, pain control (ice or hot pack, massage), hospice, etc. After the intervention, the drug compliance of hypertension (8.2 days per month) and DM patients (6.2 days per month) improved. Blood sugar levels (FBS 7.6, post-partum 2hrs 21.4 (mg/dl) and blood pressure(systolic 9.8, diastolic 4.3 mmHg) lowered significantly. All aspects of QOL also improved (total 3.68).
CONCLUSION
The types and frequencies of nursing intervention were determined by characteristics of the health problems, and home health care nursing intervention in Public Health Centers was effective to the elderly of the community in many aspects.

A Study on the Development of a Database for a Health Care System: Focusing on Health Care Management for Hypertensive Patients and Middle-aged Women: Jeong Myung Choi, Hae Ja Lee, Chun Mi Kim; J Korean Acad Community Health Nurs. 2004;15(3):365-375. Published online September 30, 2004

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Abstract PDF: PURPOSE
This study intends to make a database for hypertensive patients and middle-aged women who are visiting the Yeojoo County Health Center. While building up the database, the study reviewed the current assessment tools used in the health center, developed appropriate health care programs, and designed a computerized health care system.
METHOD
The modeling of a database for the system was constructed by MS-Access for DBMS (Database Management System) and Visual Basic. The system is to be used only in the health center by being designed as a client-server method, making it possible for many public employees to be interconnected, and enables them to retrieve and search data from the database simul- taneously.
RESULTS
The health management system systematically follows nursing processes including assessment, diagnosis, intervention and evaluation. Diagnosis, once it is done according to the self-determined criteria, saves time and provides appropriate health information for the members. Also, the health education program was developed to follow up on the health status of the members on a continuous basis.
CONCLUSION
Based on these results, it is required to evaluate health care programs provided for the members by using the database system and to develop more practical health care programs. It is also necessary to connect the system to other databases, which contain information about members.

Job Analysis of the CHP Program in the Kangwon Area: Sung Sil Kim; J Korean Acad Community Health Nurs. 2004;15(3):376-384. Published online September 30, 2004

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Abstract PDF: PURPOSE
The CHP program has been evaluated as one of the most successful program in the public health area in Korea. The objects of this study were as follows; 1) to evaluate the job activities of the CHP program, using service contents analysis, 2) to figure out personal factors and the outcome of CHP's activities.
METHOD
Data were collected by sending questionnaires to 130 subjects through the mail from May to December 2003. The response rate was 48.0%. The Data were analyzed by the SPSS WIN program with t-test and Pearson correlation coefficient. In using these methods, independent variables are CHP's personal factors (age, experience, certification of specialty) and regional factors (geographical classification, aged population, village workers, cooperation of community leaders, work- conditions), and a dependent variable is the outcome of CHP's job activities.
RESULT
The results of t-test analysis show that regional differences between factors are influential in the welfare service, the routine job, and the consultation. As a whole, this is shown that CHPs represent experience, the number of village workers and CHPs living condition of work and most of the categories of jobs that influenced over statistical meaning of differences (t=2.417, p=1.043, t=6.123, p= .004, t=4.309, p= .000). There is a significant positive relation between the routine job and the consultation(r= .455, p= .000), the consultation and the education(r= .461, p= .000).
CONCLUSION
Finally, according to the results of this study, the CHP program should be developed and continue to meet the basic health care needs of the residents in accordance with the philosophy of their own primary health care.

Analysis of the Current Hypertension Control Program in Public Health Centers: In Sook Lee, Young Ran Chin; J Korean Acad Community Health Nurs. 2004;15(3):385-396. Published online September 30, 2004

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Abstract PDF: PURPOSE
Hypertension has been a major cause of death in Korea since the 1970s, and has resulted in being a significant economic burden to the finances of national health care. The Ministry of Health and Welfare made several efforts, but hypertension control programs in Korea are still non-standardized and ineffective. We wanted to investigate the current hypertension control program in public health centers systematically and suggest the direction for future programs.
METHOD
The design of this study is a cross-sectional investigation. From September to October in 2002, we sent a set of questionnaires to all PHCs, and 179 centers responded (response rate= 74.0 %). The instrument was developed based on components of National health systems.
RESULTS
1) Resources: The department responsible for hypertension control programs is the Department of Health Promotion, Health Education Center, Community Health Center, Citizen's Health Center, etc. The chief personnel of those departments are nurses, but 27.4% of PHCs have no full time nurse for hypertension management programs. PHCs had a lot of teaching materials (nine types per a PHC) and most of the recommended contents were included. But, periodical evaluation and revision were not being made. 2) Management: Nurses' (13.03 9.46 in 23 score) actions for hypertension control were not qualitative, but regular training and evaluation were seldom carried out. Need assessment (25.9%) and evaluation (about 10-20%) for the hypertension control program were indicated as low. 3) Programs: Programs focused on individuals rather than community or public, and 2nd prevention rather than 1st, 3rd prevention.
CONCLUSION
The Ministry of Health and Welfare has to construct the infrastructure for hypertension control programs. Related scholars and committees should develop and declare standardized manuals for hypertension control and the management system, as well.

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

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

A Study on Health Promotion Behaviors of a Group of Middle Aged Men in K-Ku, Incheon City: Eun Joo Kim, Seung Sook Hwang, Jeong Mo Park, Hwa In Lee; J Korean Acad Community Health Nurs. 2004;15(3):408-418. Published online September 30, 2004

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Abstract PDF: This study aims to provide useful basic materials for planning the Health Improvement Program and Policy for men aged 20-40. This study investigated 889 subjects, and at each corresponding age, who were collected among the trainers at the Civil Defense Training Institute in K-ku, Incheon City. The data collection period lasted from April to July of 2003. I revised and complemented the measurement tool for the Health Improvement Life Style developed by Jung Eun-Kyung. For analysis of the acquired data, I used SPSS11.0 program. The study shows that the Health Improvement Action of a group of middle-aged men averaged 2.80, and 0.44 point out of 5. According to the results found during the analysis of the generic characters of differences in behaviors of Health Improvement, It was revealed that there were significant differences in age, regular exercise and health interest, stress management, self-concept as well as degrees of interest in health, and education level. According to monthly income levels, regular exercise and degrees of self-concept degrees were significantly different from each other. According to marital status, balanced diet and regular exercise were related to each other. According to religion, balanced diet, stress management degree, self-concept degree, and degrees of interest in health, significant differences were shown. Based on the earlier mentioned results, we should pay attention to act more, rather than merely recognize the development of the health improvement program of our regional community. Also, it is necessary to find out the cause, which lowers men's interest in health.

Analysis of Gerontological Nursing Researches in Korea from 1997 to 2003: Kyung Mi Yang, Soon Lae Kim, Chai Soon Park; J Korean Acad Community Health Nurs. 2004;15(3):419-436. Published online September 30, 2004

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Abstract PDF: PURPOSE
This study aims to analyze the trends of the gerontological nursing researches in Korea and suggest the direction for research in this nation.
METHOD
A total of 241 dissertations and other published articles in Korea from 1997 to 2003 were analyzed in this study focusing on the design of the research, key words, measurement tools for basic concepts, and the intervention outcomes in the case of the experimental research.
RESULT
Of those analyzed researches, it was found that 80.9% accounted for the published articles and 19.1% dissertations. There were no clear criteria for the classification of the old men. The most popular research design was an exploratory/ descriptive study (54.4%). The major concepts were about 'physical and mental health'. Most of the measurement tools used were developed by foreigners, which were translated into Korean. Among 56 experimental studies, nursing intervention programs in 22 studies were based on physical exercise programs.
CONCLUSION
It is necessary to analyze the trend of gerontological health research in comparison with multidisciplinary researches for elderly people. In addition, the experimental researches for both development and verification of nursing intervention programs are needed. Also, accumulation of research outcomes and development of a standardized instrument for the measurement of Korean elderly people are required.

A Study on the Physical Health Status, Depression and Health Behaviors of the Elderly: Mi Kyung Sim, Jeong Mo Park; J Korean Acad Community Health Nurs. 2004;15(3):438-449. Published online September 30, 2004

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Abstract PDF: PURPOSE
The purpose of this study was to examine the levels of and relationships between physical health status, depression and health behaviors and the factors affecting health behavior in the elderly.
METHOD
The subjects of this study were 118 elderly people aged over 60 living in urban and rural areas. The data were collected by interview through questionnaires from December 1, 2003 to January 30, 2004. The data were analyzed by descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and stepwise multiple regression.
RESULTS
The results of the study are as follows. 1. The mean score of the physical health status was 63.88 out of a total of 78 and the mean score of depression 42.71 out of 80. The mean score of health behaviors was 126 out of 165 and 3.83 point out of 5. In terms of sub-domains of health behaviors, emotional areas showed the highest mean score (3.98). 2. There was a significant positive correlation between health behaviors and the physical health status (r=.491, P<.001), while there was a significant negative correlation between depression and physical health status(r=.626, P<.001), and depression and health behavior(r=.784, P<.001). 3. Stepwise multiple regression analysis revealed that the most powerful predictor of health behaviors was psychological health, namely depression. A combination of depression, perceived health status and religion accounted for 65% of the variance in health behaviors of the elderly.
CONCLUSION
From the results of the study, we recommend that the development of a nursing intervention program for the health behaviors including the factors affecting the elderly. It suggests the need to focus more on psychological and spiritual health and the development of nursing interventions for health promotion among older adults.

Development of a Korean Senile Dementia Management Model: Jung Soon Kim, Myoung Soo Kim, Nam Hee Park; J Korean Acad Community Health Nurs. 2004;15(3):450-459. Published online September 30, 2004

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Abstract PDF: PURPOSE
The purpose of this study is to grasp the welfare service for the demented people staying at home and the service that caregivers want to use. Therefore, we are going to develop a Korean senile dementia-care management model.
METHOD
It analyzed the data of 185 demented people and caregivers, who registered in 16 public dementia-care centers in B city since June 2002.
RESULTS
1) The types of services used by the aged people with dementia staying at home were, in the order of frequency of use, the day-care center (26.5%), and home-help service (21.6%). 2). The types of services according to the degree of dementia were as follows; mild cases: home-care service (5.4%), moderate cases: day-care service (40.0%) and severe cases: day-care service (26.0%). 3). The caregivers who want to use senile welfare institutions accounted for 23.3%, and the major reason they could not use the institutions was due to their economic situation. 4) The Korean senile dementia care management system must be executed, considering caregivers' economic state and severity of dementia. Since the system was actively operated, many small sized welfare service institutions showed development.
CONCLUSION
The welfare services appropriate to the severity of dementia should be provided. With the model developed in this study, the dementia management requires sufficient care and should be achieved to reduce the caregivers' burden.

The Relationship between Computer Game Addiction and the Impulsiveness, Aggression, and Emotional Intelligence of Elementary School Students: Yun Hee Kwon, Chung Nam Kim; J Korean Acad Community Health Nurs. 2004;15(3):460-470. Published online September 30, 2004

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Abstract PDF: PURPOSE
The purpose of this study is to find which variables among impulsiveness, aggression, and emotional intelligence can predict the game addiction of elementary school students best.
METHOD
We conducted the present study during the period from April 15, 2004 through June 5, 2004. The subjects of this study were elementary school students chosen from three elementary schools in the Daejeon area. The subjects were selected randomly from 4th, 5th, and 6th graders in those schools. The number of subjects selected was 601. The measurement tools used were the general information questionnaire, computer game addiction scales, impulsiveness scales, aggression scales, and emotional intelligence scales. The data was analyzed using the SPSS statistics program.
RESULTS
The mean score of the students was 49.94 on the computer game addiction scale, 56.17 on the impulsiveness scale, 141.19 on the aggression scale, while the mean score of the students on the emotional intelligence scale was 162.78. Various factors were significantly different in the levels of computer game addiction: grade (F=7.343, p=.000), sex (t=6.352, p=.000), school record (F=4.263, p=.004), parents' computer use (F=4.097, p=.008), history of playing games (F=10.739, p=.000), frequency of playing games (F=61.254, p=.000), and number of computer game titles (F=61.673, p=.004). The computer game addiction had significant correlations with impulsiveness (r=.401, p=.000), aggression (r=.612, p= .000), and emotional intelligence (r=.536, p=.000). All three factors of impulsiveness, aggression, and emotional intelligence affected the level of game addiction. Among these factors, the aggression affected the level of addiction the most.
CONCLUSION
These results will help the development of a systematic program for the prevention and treatment of computer game addiction by clarifying the effects of the computer game addiction upon the elementary school students' impulsiveness, aggression, and emotional intelligence.

Relationship between Problematic Drinking Behavior and the Personalities of High School Students: Won Jung Cho, In Sook Kwon, Gwang Suk Kim, Ku Min Seo; J Korean Acad Community Health Nurs. 2004;15(3):471-482. Published online September 30, 2004

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Abstract PDF: PURPOSE
This study intended to identify personality factors and related problematic behaviors of adolescents who drink alcohol in order to provide basic data for developing nursing programs.
METHODS
The data were collected from October to December 2002 from 1,080 high school students in Seoul. The Revised Cloninger's Tri-dimensional Personality Questionnaire (TPQ) was used to measure their personalities. The alcohol expectancy was measured using the tool revised by Cho (1999) and stress levels were measure using a stress tool revised Cho (1998). The data were analyzed with SPSS Windows using Chi square test, independent t-test, and logistic regression analysis.
RESULTS
1. The percentage of fathers who drank was 79.8%, mothers, 54.3%, and friends, 54.3%. The alcohol expectancy averaged 6.36 while the stress levels were 132.79. 2. It was found that there are significant differences (p<.001) in problematic drinking behaviors according to the following variables: second year high school students among all grade variables, more monthly pocket money for the amount of money variables, the group of students who smoked in the case of the variable related to smoking, spending more time using the Internet for the Internet use variable, and having friends who drink 65.6% for the friend variable. The alcohol expectancy scale of those students who showed problematic drinking behaviors was higher than that of those who did not. There are four family-related stress subscales, and there was a significant difference among them (p<.05). Among the personal characteristics, the group who displayed problematic drinking behaviors seeks new experiences and reward dependence more than the group who did not exhibit those behaviors, and there were significant differences between the two groups (p<.001). 3. When the socio-demographic and drinking-related factors were controlled, the tendency of seeking new experiences increased the risk of problematic behaviors 1.07 times (p<.05). Compared to the non-smoking group, the smoking group was found to have a 5.06 time (p<.001) greater risk of displaying problematic drinking behaviors. In comparison with the non-drinking group, the drinking group was also found to have a 5.31 time (p<.001) greater risk of exhibiting problematic drinking behaviors. The group with high alcohol expectancy scores was significantly different from the group with the no alcohol expectancy, showing a 1.26 time (p<.001) greater risk of problematic drinking behaviors.
CONCLUSION
Based on these results, the problematic drinking behaviors were connected with alcohol expectancies, friends and personality types. Therefore, we should develop an alcoholic prevention program for adolescence considering the above results.

An Exploratory Study on the Perimenstrual Discomforts and Dietary Intake Level of Normal Women: Hae Won Kim; J Korean Acad Community Health Nurs. 2004;15(3):483-495. Published online September 30, 2004

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Abstract PDF: PURPOSE
The purpose of this study was to explore the perimenstrual discomforts and dietary intake levels among normal women.
METHOD
A prospective and descriptive study examined 38 women aged 23-46years of age. The data collection period lasted from April 1 to June 30, 2003. The participants were asked to keep a diary recording perimenstrual symptoms and food intake for 50 days.
RESULTS
There was a significant difference in physical symptoms of perimenstrual discomforts (F=6.95, p=.001), but there was no significant difference in dietary intake level according to three different phases of a menstrual cycle. The significant dietary intake variables correlated to PMS included energy, protein, Vitamin E, Vitamin B2, niacin, Vitamin B6, folic acid, phosphorus, iron, and zinc. They were negatively related to perimenstrual discomforts.
CONCLUSION
Balanced diet intake will be necessary for not only the perimenstrual discomforts but also the general health promotion of the entire population. The dietary and nutritional assessment should be done prior to nursing interventions, and nutritional counseling and education should be given based on individual differences. In a further study, the effects of dietary composition on specific symptoms will be replicated with a large sample, and development of a diet intervention program for perimenstrual discomforts is recommended.

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