Research in Community and Public Health Nursing

Most-download articles are from the articles published in 2022 during the last three month.

Original Articles

Factors Related to Health-Related Quality of Life across the Life Cycle in One-Person Households among Korean Adults: Myung-Ock Chae; Res Community Public Health Nurs. 2024;35(2):125-139. Published online June 28, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00304

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Abstract PDF: Purpose
This study is to identify factors related to health-related quality of life in one-person households across the life cycle by analyzing data from the 2021 Korean National Health and Nutrition Examination Survey.
Methods
The subjects of one-person households were divided into 195 young adults, 273 middle-aged people, and 490 elderly people according to life cycle. Data were analyzed by complex sample cross tabulation, complex sample t-test, complex sample ANOVA, and complex sample multiple regression analysis using IBM SPSS 26.0.
Results
In young adults, subjective health status, daily activity limitation, and stress level explained 41% of health-related quality of life, and in middle age, income level, education level, occupation, marital status, subjective health status, stress level, and depression had a 60% explanatory power. In old age, education level, subjective health status, daily activity limitation, stress level, and depression explained 53% of health-related quality of life.
Conclusion
In order to effectively improve the health-related quality of life of one-person households, it is necessary to establish a customized program considering the influencing factors across the life cycle and systematically manage it according to the flow of the life cycle.

The Burden Experience of Family Caregiver of Older Adults with Chronic Illness: Nova Yustisia, Titin Aprilatutini, Tuti Anggriani Utama, Mahmasoni Masdar; Res Community Public Health Nurs. 2023;34(2):85-95. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00304

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Purpose
This study aims to find out further about the burden on families in undertaking caregiving for the elderly with chronic illnesses.
Methods
A qualitative study was developed using in-depth interviews with 12 family caregivers selected by purposive sampling in July 2022. The thematic analysis was then carried out using the Colaizzi method, and N-Vivo 12 Qualitative Data Analysis Software was used to assist with the content analysis.
Results
The result from the experience interview analysis of caregivers participating in this study were 54 codes which were categorized into thirteen categories. Then, they were derived into four themes, as follows: 1) Physical burden of the caregivers for the elderly with chronic illness, 2) Psychological burden of the caregivers for the elderly with chronic illness, 3) Obstacle of caregivers for the elderly with chronic illness, 4) The state of caregivers who perform caregiving for the elderly with chronic illness.
Conclusion
The experience of caregivers in undertaking caregiving for the elderly with chronic disease has many obstacles, such as physical, psychological, and economic burdens. Caregivers often find positive aspects of their experiences while caregiving for the elderly, although their burden also constantly increases. Health facilities should pay serious attention to family caregivers and facilitate programs that can help reduce the burden on family caregivers.

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Relationship between Care Burden and Health Anxiety in the Family Caregivers of the Older Adults with Alzheimer’s Disease
Mohammad Sadegh Sargolzaei, Daniyal Kohestani, Tahereh Alsadat Khoubbin Khoshnazar, Hossein Asghari Asl
Ageing International.2024; 49(2): 280. CrossRef

Prediction model of health checkup and cancer screening experience of elderly population using 2021 Community Health Survey: Myeunghee Han; Res Community Public Health Nurs. 2024;35(2):140-155. Published online June 28, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00500

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Abstract PDF: Purpose
This study was conducted to build a decision tree model composed of factors that predict whether or not the elderly population underwent health or cancer screening using the 2021 community health survey.
Methods
This study included 74,434 and 74,417 subjects who answered for experience of health checkup or cancer screening, respectively. This study used Chi-squared test, independent t-tests, and decision tree analysis to analyze the data.
Results
Regarding the health checkup, 78.1% of women received a health checkup, and among women, those aged 65-74 years who were not recipients of the basic livelihood service showed the highest participation rate of 85.0%. In case of men, those who were married and had no problems in daily activity showed the highest participation rate of 81.4%. In the case of cancer screening, for women, those who were 65-74 years old and were nonrecipients of basic livelihood benefits showed the highest participation rate of 75.3%. For men, the cancer screening rate was the highest at 74.3% in those who had no problems with mobility and were married.
Conclusion
It was found that the general and health characteristics of the elderly had a great influence on the health checkup and cancer screening. In order to develop a more improved screening system, screening rates and effects should be continuously observed and studied.

Patterns of Adolescent Substance Use: A Comparative Study among the United States, Canada, England, and South Korea from 2014-2021: Chaehee Kim, Kihye Han, Jieun Kim, Alison M. Trinkoff, Sihyun Park, Hyejin Kim; Res Community Public Health Nurs. 2024;35(2):179-193. Published online June 28, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00535

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Abstract PDF: Purpose
This study aimed to identify the cross-national estimates of substance use, explore problematic substance use patterns among adolescents across countries and over time, and examine the relationship of individual characteristics on substance use patterns.
Methods
This study employed a time-series secondary data analysis spanning from 2014 to 2021 across four countries (United States, Canada, England, and South Korea). We analyzed the usage of five substances (alcohol, binge drinking, cigarettes, electronic cigarettes, and illicit drugs) alongside demographic characteristics. A descriptive analysis was performed to identify estimates of substance use across countries. Latent class analysis was employed to examine adolescents’ substance use patterns across time and countries. A multinomial logistic regression model was fit to assess the relationship between latent class and demographic characteristics.
Results
Adolescents in the United States and Canada had the highest substance use, while Korean adolescents had the lowest, particularly concerning drugs. Latent class analysis revealed two classes (light-user and heavy-user), with the addition of a third class (moderate-user) in some instances. The substance use patterns, while differing significantly among nations, exhibited consistency over time. During COVID-19, a decrease in heavy-substance users was observed across countries. Male or older participants were more likely to belong to the heavy-user class.
Conclusion
This research offers valuable insights into the variations in substance use patterns between nations and over time. A tailored approach is essential to prevent adolescents from becoming heavy-substance users. This approach should consider country regulations and demographics for a targeted and comprehensive preventive strategy.

Priorities of Family Caregivers in Preserving Functional Abilities of Individuals with Alzheimer's Disease Living at Home: A Best-Worst Scaling Approach: Eunhye Cho, Youngran Yang, Hyun Kyung Kim, Hye Young Kim; Res Community Public Health Nurs. 2024;35(2):156-167. Published online June 28, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00556

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Abstract PDF Supplementary Material: Purpose
The decline in cognitive abilities among individuals with Alzheimer’s disease significantly impacts their Activities of Daily Living (ADLs), creating challenges and stress for their caregivers. This study aimed to investigate the priorities of family caregivers of community-dwelling individuals with Alzheimer's disease concerning the preservation of their loved ones' ADLs.
Methods
We employed a cross-sectional design with a best-worst scaling approach (BWS), and developed a BWS questionnaire utilizing the 10 daily living items from the Disability Assessment for Alzheimer’s Disease scale. This questionnaire was administered to 132 caregivers of individuals with Alzheimer's disease. Data analysis was conducted using SPSS WIN 21.0 and the R statistical program.
Results
The results revealed that "using the toilet without accidents" emerged as the top-ranked ADL that family caregivers preferred to preserve for the longest duration among individuals with Alzheimer's disease living at home. In contrast, "Managing money appropriately" was identified as a daily living activity considered relatively less critical to preserve. The study further indicated a preference among caregivers for preserving physical ADLs over instrumental ADLs.
Conclusion
This research provides clinical evidence shedding light on the priorities of family caregivers in preserving the functional abilities of individuals with Alzheimer's disease within the community.

Factors influencing dementia preventive behaviors of older adults at high risk of dementia: Application of extended health belief model: So Hee Jung, Mee Ock Gu; Res Community Public Health Nurs. 2024;35(1):22-36. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00402

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Abstract PDF: Purpose
The purpose of this study was to identify the factors influencing dementia preventive behaviors of older adults at high risk of dementia based on extended health belief model.
Methods
The subjects were 140 older adults at high risk of dementia living in H-gun, Gyeongsangnam-do, Republic of Korea. The data was collected from April 21 to May 28, 2021 by using structured questionnaires. The data was analyzed using t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and hierarchical multiple regression by SPSS/WIN 24.0 program.
Results
The mean score of dementia preventive behaviors of older adults at high risk of dementia was 3.47±0.49 (range 1-5). The factors influencing dementia preventive behaviors were self-efficacy (β=.82, p<.001), cues to action(β=.17, p=.013), ages 75-79 (β=0.35, p=.003; reference: ages 65-69), ages ≥80 (β=0.27, p=.021; reference: ages 65-69), which together explained 82.0% of total variance in dementia preventive behaviors (F=25.21, p<.001).
Conclusion
Based on the results of this study, it is highly recommended to develop and apply the dementia prevention program that can increase self-efficacy and cues to action for improving dementia preventive behavior of older adults at high risk of dementia.

Factors Affecting the Performance of Infection Control of Multi-drug Resistant Organisms in Intensive Care Unit Nurses of General Hospitals based on the Theory of Planned Behavior: The Mediating Effect of Intention: Nam-Sook Kim, So-Eun Choi; Res Community Public Health Nurs. 2023;34(3):183-195. Published online September 27, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00150

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Abstract PDF

Purpose
The purpose of this study is to analyze the factors that affect the performance of infection control of multidrug-resistant organisms (MDROs) by nurses in intensive care units (ICU) in general hospitals.
Methods
Participants were 105 ICU nurses from 6 general hospitals. The questions for the survey performed were based on the theory of planned behavior, such as attitude towards infection control of MDROs, subjective norms, perceived behavioral control, intention, and performance.
Results
In the relationship between subjective norms towards infection control of MDROs and performance, intention showed a significant complete mediating effect; and in the relationship between perceived behavioral control and performance, intention showed a partial mediating effect. The attitude towards infection control of MDROs was excluded from the mediating effect verification because there was no significant correlation between intention and performance.
Conclusion
The results of this study suggest that department atmosphere and perceived behavior control promotion programs should be developed to enhance subjective norms in order to promote the performance of infection control of MDROs.

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Causal Model of Factors Influencing Adherence to Standard Precautions Practices Among Chinese Emergency Nurses: A Cross-sectional Study
Yanfang Huang, Wanchai Lertwatthanawilat, Pimpaporn Klunklin, Akeau Unahalekhaka
Pacific Rim International Journal of Nursing Research.2024; 28(3): 525. CrossRef
Nurses in Iraq Show Alarmingly Low Infection Control Adherence
Alyaa H. Ali
Academia Open.2024;[Epub] CrossRef

Smartphone dependency latent profile classification and association with emotional and behavioral difficulties among high school students in Korea: Eunjoo Kim, Min Kyung Song; Res Community Public Health Nurs. 2024;35(1):84-98. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00465

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Abstract PDF: Purpose
The pervasive integration of smartphones into adolescents’ daily lives has resulted in a concerning upsurge in smartphone dependency among high school students. Due to the diverse types and severity levels of smartphone dependency, there is a critical need for research to explore its heterogeneity. This study aimed to identify latent profile of smartphone dependency in high school students based on the four subdomains of smartphone dependency: disturbance of adaptive functions, virtual life orientation, withdrawal, and tolerance. In addition, we explored how emotional and behavioral difficulties differ according to the profiles.
Methods
We used data from 2,195 Korean high school students from the Korean Children and Youth Panel Survey 2018. Latent profile analysis (LPA) was performed to identify smartphone dependency latent profile. Statistical analysis including chi-square test, Analysis of Variance (ANOVA), and ranked Analysis of Covariance (ANCOVA) confirmed differences in smartphone use characteristics and emotional-behavioral difficulties according to the classified latent profile.
Results
LPA identified four distinct latent profiles of smartphone dependency among high school students; 1) Underdependent type, 2) Moderate type, 3) Habitual user type, and 4) Virtual space dependent type. The results of ranked ANCOVA, controlling for gender, geographical location, economic status, parental smartphone dependency, and relational variables, revealed that habitual user type exhibited significantly higher rates of attention deficit hyperactivity disorder, social withdrawal, and depressive symptoms compared to other types.
Conclusion
The identification of these profiles provides a foundation for developing tailored intervention programs for adolescents with different levels and patterns of smartphone dependency.

Experience of Nurses Responding to the COVID-19 Outbreak at a Long-term Care Hospital in Korea: Eun Jo Kim, JaHyun Kang; Res Community Public Health Nurs. 2024;35(2):168-178. Published online June 28, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00409

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Abstract PDF: Purpose
The COVID-19 pandemic uncovered the fundamental vulnerability of Long-term Care Hospitals (LTCHs) regarding infection control. This study aimed to describe the experiences of nurses who responded to the COVID-19 outbreak on the front lines while working at a LTCH.
Methods
This qualitative study was conducted with nine nurses. The data from in-depth individual interviews using semi-structured questions was analyzed thematically.
Results
Three themes and 11 sub-themes were extracted. The first theme, “the sudden onset of the outbreak,” included finding themselves desensitized to COVID-19 as the pandemic persisted; embarrassed by the unavoidable occurrence; and worried about becoming a spreader and aggravating the outbreak. The second theme, “physically and mentally worn out,” involved increased fatigue from overtime work; exhaustion from responding to inquiry calls pouring in; tension while monitoring and controlling infection control compliance among nursing assistants, caregivers, and elderly patients with cognitive impairment; and increased discomfort while taking on all the extra work with stifling personal protective equipment. The third theme, “awakened perspectives while responding to the outbreak,” covered increased compassion for patients; paying attention to infectious diseases and having confidence in infection control principles; realization of the need for isolation rooms, supplies, and a full-time infection control nurse; and pride as an LTCH nurse who responded to the COVID-19 pandemic.
Conclusion
To enhance the level of prevention and response to infectious disease outbreaks in LTCHs in the future, it is necessary to establish infection control infrastructure, including personnel, isolation facilities, supplies, and continuing education for the LTCHs’ nursing workforce.

Effects of Depression, Social Support of Tuberculosis Patients on Self-care: Go Un Lee, Hye Kyung Lee; J Korean Acad Community Health Nurs. 2022;33(4):456-464. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.456

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Abstract PDF

Purpose
The purpose of this study was by understanding the correlation between the depression, social support and self-care of tuberculosis patients and by identifying the factors that influence the self-care. Methods: The study subjects were 119 outpatients who were diagnosed with pulmonary and respiratory tuberculosis at a university hospital in D city. The survey questions measured depression, social support, self-care. Using the SPSS/WIN 23.0 program, the collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlations and multiple regression analysis. Results: As a result of correlation analysis, there was a statistically significant negative correlation between self-care and depression (r=-.53, p<.001), and there was a significant positive correlation between self-care and social support (r=.68, p<.001). Factors affecting self-care of the subjects were social support (β=.51, p<.001), depression (β=-.32, p<.001), drug discontinuation experience (β=-.30, p<.001) and drug resistance (β=-.14, p<.001). These factors explained 62% of the variance. Conclusion: In order to improve the self-care ability of tuberculosis patients, it is necessary to develop education and nursing intervention programs that can lower patients' depression and strengthen social support.

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Factors Influencing the Medication Adherence in Patients with Pulmonary Tuberculosis in the COVID-19 Pandemic
Bongsil Lim, Min Young Kim
The Korean Journal of Rehabilitation Nursing.2023; 26(2): 87. CrossRef

Bidirectional Relationship Between Depression and Frailty in Older Adults aged 70-84 years using Random Intercepts Cross-Lagged Panel Analysis: Ji Hye Shin, Gyeong A Kang, Sun Young Kim, Won Chang Won, Ju Young Yoon; Res Community Public Health Nurs. 2024;35(1):1-9. Published online February 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00381

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Abstract PDF: Purpose
Depression and frailty are common health problems that occur separately or simultaneously in later life. The two syndromes are correlated, but they need to be distinguished to promote successful aging. Previous studies have examined the reciprocal relationship between depression and frailty, but there are limitations in the methods or statistical analysis. This study aims to confirm the potential prospective bidirectional and causal relationship between depression and frailty.
Methods
We used data from 887 older adults aged 70 to 84 from the Korean Frailty and Aging Cohort Study (KFACS) in 2016, 2018, and 2020 (3 waves). We separated the within-individual process from the stable between-individual differences using the random intercepts cross-lagged panel model.
Results
Significant bidirectional causal effects were observed in 2 paths. Older adults with higher depression than their within-person average at T1 had a higher risk of frailty at T2 (β=.22, p=.008). Subsequently, older adults with higher-than-average frailty scores at T2 showed higher depression at T3 (β=.14, p=.010). Autoregressive effects were only significant from T2 to T3 for both constructs (Depression: β=.16, p=.044; Frailty: β=.13, p=.028). At the between-person level, the correlation was significant between the random intercepts between depression and frailty (β=.47, p<.001).
Conclusions
We find that depressed older adults have an increased risk of frailty, which contributes to the onset of depression and the maintenance of frailty. Therefore, interventions for each condition may prevent the entry and worsening of the other condition, as well as prevent comorbidity.

Prevalence and Risk Factors of Diabetic Retinopathy in Diabetes People using Korean National Health and Nutrition Examination Survey VII: Ihn Sook Jeong, Chan Mi Kang; J Korean Acad Community Health Nurs. 2022;33(4):408-417. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.408

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Abstract PDF: Purpose
This study aimed to investigate the prevalence and risk factors of diabetic retinopathy (DR) in people with diabetes mellitus (DM) using Korean National Health and Nutrition Examination Survey VII (2017~2018). Methods: DM was defined as in two ways; 1) doctor's diagnosis (Group 1, n=549), 2) one of doctor's diagnosis, medication, or hyperglycemia (Group 2, n=849). The DR prevalence was measured as the prevalence proportion (%). Risk factors for developing DR were analyzed using multiple logistic regression, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: The prevalence of DR was 25.87% in Group 1 and 20.14% in Group 2. Risk factors for DR were identified as insulin therapy (Group 1: OR=5.31, Group 2: OR=5.27), DM duration ≥10 years (Group 1: OR=2.20, Group 2: OR=3.10), and systolic blood pressure ≥140 mmHg (Group 1: OR=2.26, Group 2: OR=2.23) for both groups. Conclusion: Considering the DR prevalence, eye examinations education is highly recommended as part of a diabetes management programs in the community. It is also proposed to shorten the eye examination cycle for people with risk factors and establish a referral system to link between screening to treatment.

Effects of Fatigue and Emotional Labor on Sleep Quality among Apartment Security Guards: Chul-Gyu Kim, Sujeong Jeong, Young Mi Ryu, Seungmi Park, Kyoungmi Moon, Yunjung Kwon, Sun-A Park, Hye Ok Park; Res Community Public Health Nurs. 2023;34(3):205-216. Published online September 27, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00220

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Abstract PDF: Purpose
This study aimed to identify the effects of fatigue and emotional labor on the quality of sleep among apartment security guards.
Methods
A total of 196 apartment security guards working in 10 different regions participated in the study between July and October 2022, completing questionnaire assessing fatigue (physical imbalance, exhaustion, mental fatigue, and nervous system disfunction), emotional labor, and sleep quality. Data were analyzed using descriptive statistics, independent t-test, Mann-Whitney U test, ANOVA including Scheffe’s post hoc, and regression analysis.
Results
183(93.4%) participants were poor sleeper. Regression analysis of the factors influencing sleep quality yielded a significant model (F= 21.56, p<.001) with an explanatory power of 25.0% in the order of fatigue(exhaustion) (β=.28, p<.001), emotional labor (β=.27, p<.001), and subjective economic status (β=.15, p=.017).
Conclusion
It is essential to develop nursing educational programs that reduce exhaustion and emotional labor for improving the quality of sleep.

The Relation among Uncertainty, Social Support, Care Burden of Mothers having Children with Developmental Disabilities: Kyoung Eun Jeong, Min Hyun Suk; Res Community Public Health Nurs. 2023;34(2):117-126. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00346

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Abstract PDF

Purpose
This descriptive correlation study aimed to confirm the relation among uncertainty, social support, care burden of mothers having children with developmental disabilities.
Methods
The participants were 111 mothers having children with autistic spectrum disorder or intellectual disability. The collected data were analyzed by descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficient and multiple regression using IBM SPSS 23.0 in the study.
Results
Uncertainty and social support were significantly correlated to caregiver burden. As a result of multiple regression analysis, the factors affecting caregiver burden were children’s age, the expense for caring, the period suspected child disabilities, and uncertainty. These factors accounted for 40.8% of caregiver burden.
Conclusion
In order to reduce the burden of caring for mothers with children with developmental disabilities, it is necessary to establish a system that can detect children with developmental disabilities early and to develop and provide an integrated guide suitable for the growth and development stage of children with developmental disabilities.

Citations

Citations to this article as recorded by

Spousal support, parent–nurse partnership and caregiver burden among parents of children with chronic diseases: A cross‐sectional study
Jihye Kim, Heemin Chae, Yoonjung Kim
Journal of Clinical Nursing.2024; 33(7): 2649. CrossRef

A Study on Outcomes of the Utilization of Visiting Nursing Service at the Integrated Visiting Nursing Center in Bucheon-si: Hyun-Kyung Park, Ae Jung Yoo, Ju Young Yoon, Jae Woo Choi; Res Community Public Health Nurs. 2023;34(2):127-134. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00045

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Abstract PDF: Purpose
The government has implemented a pilot project for community care for older adults and the integrated visiting nursing center in Bucheon-si operated by public fund of government to provide visiting nursing service for older adults. This study aimed to analyze the outcomes of the utilization of visiting nursing service at the integrated visiting nursing center in Bucheon-si.
Methods
This study linked the personal data from the pilot project for community care with the National Health Insurance data. The final subjects comprised 30 participants and 110 of the matched control group. The length of home stay, hospitalization, and the admission for long-term care facilities or convalescent hospitals were measured. Statistical analysis was performed through difference-in-differences analysis using generalized estimating equation and Cox proportional hazards model.
Results
The results indicated an increase of 28.2 days for length of home stay and a reduction of 69% in hospitalization from medical institutions and 81% in admission of long-term care facilities or convalescent hospitals among participants compared to the control group.
Conclusion
The visiting nursing service of the integrated visiting nursing center was effective in extending length of home stay and lowering the hospitalization of medical institutions and admission of long-term care facilities or convalescent hospitals.

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