Research in Community and Public Health Nursing

Volume 9 (2); December 1998

Original Articles

How to Improve the Emergency Medical Service System: Levels of Knowledge and Techniques in Prehospital Care for 119 Relief Squad Members and Emergency Room Nurses: Hayr Ran Kwon; J Korean Acad Community Health Nurs. 1998;9(2):249-261. Published online December 31, 1998

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Abstract PDF: During the past decade or so in Korea, 119 relief squad members were supposed to respord first urgent or emergency cases. The primary purpose of this study was to assess what levels of knowledge and techniques in prehospital care the 119 relief squad members showed. Data regarding the knowledge and technique levels were collected from both the 119 relief squad members (n=63) and the emergency room nurses(n=46). The Results indicated that the 119 relief squad when compared to emergency nurses, showed higher scores for knowledge and techniques in some areas of prehospital care but not in other areas, However, no differences in knowledge and technique were found when the ANOVAs were calculated with two covariates : duration of their career in emergency medical services and frequency of their exposure to lectures on emergency medical technology. In addition, many respondents in the 119 relief squad group rated themselves poorly in knowledge and techniques of prehospital care, The findings imply that qualitatively better curricula should be given to the 119 relief squad members before they are allowed to play an important role in the emergency medical service system. These findings are also discussed in the context of improving the emergency medical service system.

A Study on the Job Satisfaction of Visiting Nurses of Public Health Centers in Korea: Ae Young So, Eun Young Shin; J Korean Acad Community Health Nurs. 1998;9(2):262-279. Published online December 31, 1998

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Abstract PDF: The purpose of this study is to identify job satisfaction and relative factors of job satisfaction in visiting nurses in public health centers. Data were collected by a self-administered questionnaire from May 1 to June 25, 1997. The subjects were 384 visiting nurses of public health centers in Korea. The results of this study were as follows; 1. Job satisfaction of Visiting Nurses was measured by a 5 point rating scale, the whole mean score was 3.08. The level of job prestige was highest among the six components of job satisfaction. The mean score of job perception was 4.05. 2. The factor affecting job satisfaction were job status, educational level and the number of visits home a month. 3. Factors affecting job perception were whether or not they had other certificates, whether they were educated about visiting nursing, and the status of these nurses. 4. Job perception and Job satisfaction had a significant correlation.

An Assessment of the Needs of Crippled Persons Staying at Home: Sook Ja Yang, Hee Jeoung Kim; J Korean Acad Community Health Nurs. 1998;9(2):280-290. Published online December 31, 1998

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Abstract PDF: This study was carried out to idenify the health problems and needs of crippled persons in order to develop a community based rehabilitation service program through public health center. Information on health problems and needs were obtained from 120 crippled persons staying at home by questionaire and a measuring ADL. The results were summarized as follows 1. Among 120 subjects, male crippled (70.3%) outnumbered female crippled (29.7%). Many crippled persons belonged to the 40-49 age group (33.6%) while others were over 60 years (17.4%). There were 36.8% crippled persons with an elementary education, 26.5% had completed high school, 14.5% had completed middle school. 31% of the crippled persons were employed but most of them had unskilled jobs. 80% of the respondents replied that their monthly income was under 800,000 won. 2. The major causes of their handicap were due to acquired factors(92%) such as accidents, in fectious & communicable diseases and chronic diseases rather than congenital factors(8%). Crippled persons who belong to the first grade of disabilities were 14.8%, the second grade 35.7%, the third grade 21.7%, the forth grade 12.2%, the fifth grade 12.2% and the sixth grade 3.5%. 3. This study measured the degree of the ADL of crippled persons by a modified Barthel Index including 11 items. 73.5% of them were fully independent, 8.5% required minimal help, 2.7% required moderate help, 6.0% required substantial help and 9.4% were unable to perform task. In response to the 11 items of ADL, crippled persons required more help in stair climbing, ambulation and bathing than in other items. 4. In responding to concerning health problems, 10.3% of the subjects replied with incontinence, 8.5% malnutrition, 7.6% fecal incontinence and bedsores 2.6%. Chronic diseases which needs treatment were chronic pain(61.0 %), hypertension(16.5%) and diabetes(16.5%) 5. To the question of what type of rehabilitation services subjects required, chronic diseases management(52.1%) and physical therapy (41.2%) were the highest. The most important social welfare services subjects required were economics support (51.3%) and introductions to job opportunities(42%).

The 'Nurses Ordinance' of Korea under Japanese Rule: Kod Me Yi, Hwa Joong Kim; J Korean Acad Community Health Nurs. 1998;9(2):291-302. Published online December 31, 1998

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Abstract PDF: The Japanese colonial authorities promulgated the 'Nurses Ordinance(Kanhoboo Kyuchick), in 1914. It was the first act that regulated nurses' licensure in Korea. The gendarme did the administrational work of the ordinance. After the Nurses Ordinance of 1914, nurses without licenses could no longer work with the name of nurse, and Korean nursing gained a more professional status. After the March 1st Movement of 1919, Japan realized that its iron rule had to be more sophisticated. The gendarme gave way to an ordinary constabulary force. The Nurses Ordinance was amended to set the nurses quality as good as that of Japanese nurses, and the nurses licensure of Korea could also be used in Japan. In 1931 the Japanese war against China began, and the Japanese imposed military rule once again. The Nurses Ordinance was amended to 'The Korea Nurses Ordinance'. After the outbreak of the Sino-Japanese War(1937) and of World War II in the Pacific(1941), the Japanese desperately needed additional manpower to re plenish the dwindling ranks of their military and labour forces. To produce more nurses, the colonial authorities amended the 'Korea Nurses Ordinance' and lowered the age and educational status of nurses to produce more numbers. Until the Japanese surrender in August 1945, Korea was under Japanese rule. Koreans had no say in the passing of these acts, and the colonial authority could make and pass any act at will.

A Study of Nurse Legal Obligation and Responsibility Related to their work: Kyung Hee Yang, Jong Hoon Hwang, Young Hee Kim; J Korean Acad Community Health Nurs. 1998;9(2):303-312. Published online December 31, 1998

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Abstract PDF: The purpose of this study was to survey the knowledge level, attitude and practice of nurses toward their work. The subjects of the study were composed of 98 nurses from 3 general hospitals, 1 oriental medical hospital, 2 health centers and several community health posts and schools. Data were collected from May to October, 1998. In data analysis, an SPSS PC program was utilized for descriptions. 1) 16 nurses (16.3%) experienced medical accidents on the 7 nurses(7.1%) 1 time, 6 nurses (6.1%) 2 times, and 3 nurses(3.1%) 3 times. 2) Concerning knowledge of their legal obligations; the prohibition of telling secrets was .89, the prohibition of reading medical records was .58, the keeping of medical records was 1.0 and the teaching of recuperation was. 79. The total mean score was. 86. Concerning attitude and practice; the prohibition of telling secrets was 81.6%, 63.3%. The prohibition of reading medical records was 61.2%, 60.2%. The keeping of medical records was 98%, 98%. The explanation for treatment, care and test was 91.8%, 66.3%. The teaching for recuperation was 63.3%, 63.3%. 3) Knowledge of their legal responsibilities; 29. 6% of the subjects thought that they should report a medical accident to their headnurse, but 75.5% of the subjects actually reported to the headnurse. 39.8% of the subjects thought that nurses were liable for the faults of nursing aides. The total mean score was .45. 46% of the subjects asked a senior staff's advide on difficult affairs. Nurses obeyed legal obligations when concern ing the protection of a client, but were passive when concerning self protection. Also, headnurses were required as adviser, guide and advocate.

Developing the Joint Employment System of Occupational Health Nurse Practitioners for the Minor Enterprises in Korea (Part 2): Comparison of Opinions between Employers and Occupational Health Nurses: Young Im Kim, Kyung Ja June, Sung Eun Lee, Soon Nyoung Yun; J Korean Acad Community Health Nurs. 1998;9(2):313-323. Published online December 31, 1998

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Abstract PDF: This study is to develop the model on the joint employment system of occupational health nurse practitioners for medium or small sized enterprises in Korea based on the comparison opinions between employers and occupational health nurses (OHN). The data were collected by questionnaires from Oct. to Nov. in 1997. The number of subjects was 210 OHNs and 176 employers, response rate was 47.1% for OHNs and 23.2% for employers. The SAS PC program was used for the descriptive statistics. The results were as follow: 1. More than three years career was preferred for qualification of OHN by employers and OHNs. OHNs preferred that all instruments and materials should be equipped in each industry, but employers preferred that they should be equipped by OHN. 2. For the limit number of industries and employees per one OHN, employers preferred average 2.25 industries and 307 employees, OHNs preferred average 3.0 industries and 448 employees. Both of them preferred two times visit per week for all day long. 3. OHNs wanted that the local office of Ministry of Labor could act as mediator, but employers preferred direct contact individually. For the average wage, employers preferred 887,000 won per month, but OHNs preferred 1,960,000 won per month. 4. OHNs preferred the Korean Association of Occupational Health Nurse as the recruit agency. Finally, employers and OHNs have the opinions that they can choose this system depending on the condition. There is in need of development of effective strategy for this new system such as manpower development, cost-benefit analysis, establishment of occupational health service standard, advertisement for employers, and government supported project.

A Study on Elderly People's Needs in Daycare Centers in the Next Generation: Yeoun Kang Chung, Soon Gyo Yeoum, Hye Jin Kwon, Kyung Hee Kim, In Kook Kim; J Korean Acad Community Health Nurs. 1998;9(2):324-335. Published online December 31, 1998

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Abstract PDF: This study describes the extent of recognition of problems to the aged in a future society, the recognition and necessity of day care facilities, and the service contents and patterns preferred as a method of mediation for nursing the aged and increasing their quality of life. It also tries to certify the relations between those subjects. The result of the study is as follows: 1. Concerning problems of the aged of social significance the aged of the next generation consider the difficulties in nursing the aged to be the most important at 63.6%. 2. Concerning the nursing of parents, 49.4% of those answered 'children should take care of their parents and live together', while 46.7% answered that 'it is enough for children to provide an economic support, not necessarily living together. 3. Concerning information of day care facilities, 66.9% answered that they have no information. 4. Concerning the use of day care facilities, 54.6% answered that 'they would under certain circumstances', and 21.0% that 'they had better use them in the future'. 5. Concerning the feelings of the aged using day care facilities, 46.6% say 'they do not look poor', and 33.4% said that 'they look a little poor'. 6. Concerning the reasons for using day care facilities, 56.1% answered' because children do not proride care', and 48.5% answered 'because their economic ability is not sufficient'. 7. Concerning the programs potentially needed, food supply, medical services and physical therapy were ranked in that order. 8. Concerning social facilities necessary for the aged, centers that specialize in dementia, free day care facilities, home care services, and fee-based day care centers were ranked in that order. 9. Concerning institutions providing day care, welfare centers for the aged, those centers auxiliary to hospitals, asylums, and individuals were ranked in that order. 10. Concerning the responsibity running day care facilities, social workers, doctors/nursing assistants, nurses, and entrusted visitors were ranked in that order. Based on the results of this study, the study proposes that the study of applied cases of therapy in day care facilities for the aged continue.

The Effects of Music Therapy on Cognitive Function and Depression in Demented Old Adults: Ja Youn Gwon, Jung Soon Kim; J Korean Acad Community Health Nurs. 1998;9(2):336-349. Published online December 31, 1998

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Abstract PDF: The purpose of this study was to test the effects of music therapy on cognitive function and depression in demented old adults. This study was made with one-group in a pre- and post-test design. The subjects were seven demented old adults over, sixty-five years and with mild to moderate cognitive impairment, residing at a nursing home. Music therapy was given by one researcher and one research assistant for thirty to forty minutes twice a week for 4 months. Music therapy was conducted with the subjects both listening and singing with a cassette player and a double-handed drum. In order to evaluate the effects of music, we measured the level of cognitive function and depression at the beginning and at the end of the music therapy session by means of an MMSE-K developed by Kwon and Park and the Depression Inventory developed by Chon. The Data were analyzed using descriptive statistics and a paired t-test analysis using a SPSS PC package. The results are as follows: 1) The subjects of the music therapy showed improvement in cognitive function. The MMSE-K score was significantly increased after music therapy. Especially, memory recall was very significantly. 2) The subjects of the music therapy showed a slight decrease in depression. However, there was no significant difference in the degree of depression between mean scores measured before and after music therapy. The results suggest that music therapy is effective in improving and maintaining cognitive function in demented old adults. And we suggest that long-term music therapy will be required to improve depression in demented old adults. These findings are encouraging the idea that music therapy may improve cognitive impairment.

A Study for Risk Factors of Mild and Moderate.Severe Hypertension: Eun Ju Kim; J Korean Acad Community Health Nurs. 1998;9(2):350-361. Published online December 31, 1998

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Abstract PDF: In an attempt to examine the risk factors and analyze an odds ratio for risk factors associated with mild and moderate. severe hypertension, this study was carried out from August, 1987 to September, 1997. From periodic health examinations of insured adults, 747 subjects were assigned to nomotensives, mild hypertensives and moderate.severe hypertensives. Major findings obtained from the study are as follows: 1. The Body mass index(BMI) was revealed a significant difference among the 3 groups. Also, there was a significant positive correlation between the BMI and systolic, dyastolic blood pressure. 2. Cholesterol was revealed to be significantly different among the 3 groups. Also, there was a significant positive correlation between the cholesterol and systolic, dyastolic blood pressure. 3. Urine protein and a cardiovascular family history was revealed to be significantly different among the 3 groups. The presence of urine protein and cardiovascular family history were significantly higher in hypertensives than nomotensives. 4. A preference for salty food, a preference for flesh and the frequency of flesh eating were not significantly different among the 3 groups. 5. Smoking habits, frequency and duration of cigarette smoking were not significantly different among 3 groups. 6. The habit of alcohol consumption and the frequency and duration of alcohol consumption were not significantly different among the 3 groups. 7. The habit of exercise and its frequency and duration were not significantly different among the 3 groups. 8. Statistically significant elevated odds ratios were noted in the following BMI(mild hypertensives; 2.48, moderate.severe hypertensives ; 4.65), urine protein(mild hypertensives ; 2.37, moderate.severe hypertensives; 6.77), cholesterol(moderate.severe hypertensives ;1.64), cardiovascular family histoy(moderate.severe hypertensives; 4.77). Based on these results, the significant risk factors of mild, moderate. severe hypertension were BMI, cholesterol, urine protein, and family history, but diet, smoking, alcohol consumption, and exercise had no significant association.

The Degree of Burden of Family Caregivers as Related to the Level of ADL of Patients with Strokes: Hyun Mi Kim, Jum Hee Park, Gun Ja Jang; J Korean Acad Community Health Nurs. 1998;9(2):362-373. Published online December 31, 1998

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Abstract PDF: This study was designed and undertaken to identify the degree of burden of family caregivers for patients who had a stroke as the burden is related to the ADL of the patients. The data were collected from October 3rd, 1997 to March 20th, 1998. The subjects in this study were 126 caregivers as family members and 126 patients with strokes who were hospitalized in two oriental medicine hospitals and four general hospitals located in Taegue and Pusan City. The questionnaires consisted of questions regarding burden(25 items) of caregivers and ADL (25 items) of patients with strokes. Data were analyzed using percentages, mean, t-test and ANOV A done with the SPSS program. The results of this study were as follows: 1. The score for family caregiver's burden was higher than the middle score. 2. The family caregivers' age had statistically significant differences in the degree of burden. 3. The age and sex of patients affected the burden of caregivers significantly. That is, caregivers felt more of a burden when caring for the patient group in their sixties than in any other age group and female patients created more of a burden than male patients. 4. There was a statistically significant difference in the degree of caregiver burden according to the level of patient ADL.

A Study on the Instrumental Activities of Daily Living, Self-Efficacy, and Social Support in Urban and Rural Elderly: Yeon Hee Choi; J Korean Acad Community Health Nurs. 1998;9(2):374-384. Published online December 31, 1998

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Abstract PDF: This study was designed to investigate and compare levels of Instrumental Activities in Daily Living(IADL), Self-efficacy and Social support, and their relationships among the aged who lived in urban and rural areas. The subjects consisted of 239 persons (urban=120, rural=119), aged 65 over. Data was collected through interviews and questionnaires from July 20 to August 30, 1998, and analyzed by frequency, percentage, means, Pearson Correlation, t-test chi2-test and ANOVA, using an SAS program. The Results of this study were as follows. 1) The mean score of IADL was 2.06/5, the mean score of Self-efficacy was 49.61/100 and the mean score of Social support was 2.37/5. 2) Concerning house ownership, the group of urban elderly were significantly higher than rural elderly while in the handling of pocket money, the rural elderly were significantly higher than the urban elderly. 3) Concerning Self-efficacy, the group of urban elderly were significantly higher than rural elderly. 4) The IADL was significantly related to Self-efficacy and to Social support. 5) Concerning the demographic characteristics of the subjects, age, educational level, religion, living with a spouse, money and participation in social activities were significantly resated to the IADL scores, to Self-efficacy and to Social support.

The Relationship between Self Efficacy and a Health Locus of Control in University Student Smokers: Hye Jin Hyun; J Korean Acad Community Health Nurs. 1998;9(2):385-395. Published online December 31, 1998

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Abstract PDF: This study was conducted to investigate the relationship between self efficacy and a health locus of control. We conveniently sampled 204 university students who smoke. We invastigated by using questionaries and collected data that were analyzed using a t-test, an analysis of variance, a Pearson product-moment correlation. The results are as follows: 1. The average score of self efficacy was 66.16 (out of a total score of 100.00) in university students who smoke. In relation to the health locus of control, the internality score was highest at 25.22, the influence of others was 20.39, and the effect of chance was 15.86. 2. In a significant test of the general character other and aspect related to the smoking of the subjects and in the score of the health locus of control, the internality score of subjects who had been never been asked to quit smoking was higher than that of subjects who had been. There are significant differences in the scores concerning the influence of powerful others, especially religion. In chance occurrences, the score of subjects in medical school was higher than in other schools. The lower the age one beginns smoking, the higher the score of chance. 3. In a significant test of the general character and other aspects related to smoking and the score of self efficacy, there was no significant relationship. 4. Considering the relation of self efficacy to a health locus of control, a positive relationship between self efficacy and internality, and the influence of others, but not between self efficacy and the effect of chance. With these results, we can conclude that the higher the level of self efficacy, the higher the internality, the higher the influence of powerful others. Consequently, it is necessary to identify the relationships clearly among self efficacy the health locus of control by repeated research. It can be used to support, revise and develop health behavior theory.

A Study on the Health Promoting Behavior of University Students: Soon Gyo Yeoum, Eunn Hee Her, Yeoun Kang CHung, Hye Jin Kown, Kyung Hee Kim, Eune Sun No, Kyung Soon Han, Seung Eui Han; J Korean Acad Community Health Nurs. 1998;9(2):396-409. Published online December 31, 1998

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Abstract PDF: The purpose of this study is to inquire into the degree of health promotion activity of university students, and to confirm the general factors of health promotion behavior in order to offer basic data for a nursing strategy to improve health promotion behavior. For this research, data was collected from university men and women through questionnaires from February 18 to March 20 in 1998. The author develop a measuring instrument on the basis of related reviews of health promoting behavior in the prevention of chronic disease, as well as accounting for demographic factors, biological factors, and circumstanctial factors. The content validity of the instrument was authenticated by two professors of the science of nursing,. and the reliability was confirmed by a 'cronbach' alpha after moditying the content through a pre-test on 30 students. 475 persons were analyzed in terms of an average, percentage, t-test, ANOVA by 'SPSS-PC'. The analyzed data was the following. 1. The acting degree of health promoting behavior was 3.26 point out of 6. Among the sub-levels of health promoting behavior, the order of importance was the following. self-actualization (4.62), interpersonal(4.60), stress management (4.0l), nutrition(3.68), responsibility(3.1l), liquid and cigaretles ues(2.85), and exercise (2.33). 2. The differences in health promoting behavior according to subject's general character were the following. Age(F=6.012, p=.003), major (F=7.243, P=.000), sex(t=7.60, P=.000), religion(F=2.454, p=.045), living status(F=2.849, p=.024), health concern of parents(F=7.596, P=.000), taking health programs(F=2.710, p=.007), case history of the family( t=-1.980, p=.048). Health promoting behavior is affected by a higher age, majoring in the social sciences, having religion, male, living in the relatives' home, having to take health programs and a higher health concern of the parents. Suggestions: 1. The degree of health promoting behavior appears low in this study. It is crucial, therefore, to develop a health program to improve health promoting behavior and to study how to center the daily health life of students.

A Study on the Correlation between Perceived Social Support and Health Behavior of Girl High School Students in All Girl Schools: Mee Ja Lee; J Korean Acad Community Health Nurs. 1998;9(2):410-424. Published online December 31, 1998

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Abstract PDF: The purpose of this study was to determine the relationship between social support and health behavior in girl high school students in all girl schools. The subjects were 190 girls in 2 Kunsan schools. The instruments used for this study were the social support scale developed by Park(1985) and the health behavior scale developed by Walker etc(1987). As modified by Lee & Han(1996). The data were analysed by correlation coefficient, regression coefficient using an SAS program. The results of this study were as follows: 1. The mean score of social support was 3.96 and the mean score of health behavior was 3.33. 2. 1) General characteristics were related to the degree of social support: personality, spending money, friend number, exercise(p<0.05). 2) General characteristics were related to the degree of health behavior: personality, spending money, friend number, exercise, stress(p<0.05). 3. The hypothesis of this study, "The higher the degree of social support perceived by the student, the higher the degree of health behavior" was supported(r=0.5730, p=0.0001). For these subjects, there was a significant relationship between social support and the degree of health behavior. Nurses should plan interventions in promotion health behavior with social support as a significant factor in adolescents. If so, their coping ability and well-being may be promoted.

A Comparative Study of the Awareness of Sexual Violence between Male and Female College Student: Kyu Eun Lee, Yang So Yoon; J Korean Acad Community Health Nurs. 1998;9(2):425-440. Published online December 31, 1998

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Abstract PDF: This comparative study was conducted to compare the attitudes of sexuality and knowledge of sexual violence between male and female college students. The subjects of this study were 222 male students and 200 female students. The survey was conducted using a questionnaire of 3 general characteristics, 11 items to test attitudes on sexuality, 10 items to test knowledge of sexual violence, 1 item on the cause of sexual violence and 1 item to check knowledge of sexual violence countermeasures. According to the SPSS/PC Program, Frequency, mean, percentage, t-test, Pearson correlation coefficient were used in analyzing the data. The results of the study are summarized as follows. 1. The result of the comparison between two groups was significantly different in their attitude on sexuality(t=-4.16, P<.000). Female students had higher scores than male students. 2. The result of the comparison between two groups was significantly different for their knowledge on sexual violence(t=-6.82, P<.000). Female students had higher scores than male students. 3. As a countermeasure for prevention, sex educations is needed(27%). 4. Very high correlations were observed between a subject's sex and his/her sexuality(r=.1990, P<.0001), between a subject's sex and his/her knowledge of sexual violence(r=.3157, P<.0001), between a subject's attitude on sexuality and his/her knowledge of sexual violence(r=.2538, P<.0001).

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