Research in Community and Public Health Nursing

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

Original Articles

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.2023;[Epub] CrossRef

School Nurses’ Perception of Job Performance Difficulties, Job Stress, Job Identity and Job Satisfaction: Eun Kyo Cho, Hyun Jung Moon; Res Community Public Health Nurs. 2023;34(1):43-51. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00010

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Abstract PDF: Purpose
To examine school nurses' perception of job performance difficulties, stress, identity, and satisfaction, and to identify the factors that affect job satisfaction. Methods: Data were collected through online survey questionnaires distributed to 189 regular school nurses working in Metropolitan I. The self-report questionnaire consisted of three instruments and demographic questions. The data were collected from June 29 to July 31, 2020, and analyzed using frequency, percentage, mean and standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression statistical techniques. Results: Perception of job performance difficulties showed a significant positive correlation with job stress (r=.20. p=.007), job identity (r=-.55, p<.001) and job satisfaction (r=-.39, p<.001), and each showed a negative correlation. Job stress showed a negative correlation with job satisfaction (r=-.65, p<.001), and job satisfaction and job identity showed a positive correlation (r=.53, p<.001). Job stress (β=-.58, p<.001), job identity (β=.43, p<.001), school-level elementary school (β=.19, p<.001), and middle school (β=.13, p=.011) were found to have a significant effect on job satisfaction. Conclusion: As job stress, job identity, and school level are important factors influencing job satisfaction, interventions are needed to lower the job stress of school nurses and strengthen their job identity. In addition, since the job satisfaction of school nurses can have a great impact on the health and happiness of students as well as the quality of life of future generations, it is necessary to improve policies and systems to increase the job satisfaction of school nurses.

Development and Effectiveness of a Basic Epidemiological Investigation Simulation Program of Emerging Respiratory Infectious Diseases for Nursing Students: Application of Standardized Patients: Jiyun Park, Gye Jeong Yeom; Res Community Public Health Nurs. 2023;34(4):267-280. Published online December 29, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00241

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Abstract PDF: Purpose
This study aimed to develop a simulation-based education program of emerging respiratory infectious diseases using standardized patients for nursing students, and to test the effects on basic epidemiological investigation performed while wearing Level D Personal Protective Equipment (PPE).
Methods
A total of 64 senior nursing students were recruited and assigned to either the experimental group (n=33) or a control group (n=31) in May 2022. This program was developed based on the analysis, design, development, implementation, and evaluation model. The analysis phase consisted of a literature review and target group survey. In addition, learning objectives and a structure were designed, and a scenario was developed with expert consulting. In the implementation phase, the program was conducted the course of 3 hours. The evaluation phase involved verification of the effects on clinical performance, self-efficacy, and anxiety related to basic epidemiological investigation, as well as an assessment of satisfaction with the program.
Results
There were significant differences between the experimental and control groups in clinical performance (Z=-2.15, p=.010) and anxiety related to basic epidemiological investigation (Z=-4.02, p<.001). However, there was no significant difference in self-efficacy related to basic epidemiological investigation.
Conclusion
The results indicate that this simulation-based education program was effective in improving clinical performance and reducing anxiety related to basic epidemiological investigation of nursing students. In addition, this program is expected to be widely used as an epidemiological investigation education for the initial prevention of infectious diseases.

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.

Experience Related to Acceptance of Illness among People with Early-Stage Dementia: A Phenomenological Study: Jaewon Park; Res Community Public Health Nurs. 2023;34(4):241-254. Published online December 29, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00157

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Abstract PDF: Purpose
This study aims to describe the structure of the experience related to acceptance of illness among people with early-stage dementia (PWED).
Methods
Participants were six people who had Alzheimer’s disease or vascular dementia. Their clinical dementia rating scores were 0.5 or 1. Data were collected from individual in-depth interviews. The collected qualitative data were analyzed based on Giorgi’s descriptive phenomenological method.
Results
The five constituents and eight sub-constituents were derived from the experience related to acceptance of illness among PWED; ‘Facing the changed me’, ‘Facing changes in roles and relationships with others’, ‘Conflict between recognizing and denying dementia in daily life’, ‘Perceiving the limits and accepting dementia’, and ‘Reconstructing daily life for the prolongation of the current health status’.
Conclusion
This study contributes to the expansion of the in-depth understanding of the experience related to acceptance of illness among PWED. The results of the study will be helpful as basic data for community health nurses to develop interventions to improve acceptance of illness of PWED.

Relationships of Self-leadership, Working Environment, and Professionalism among School Health Teachers: Joohee Kim, Young Ko; Res Community Public Health Nurs. 2023;34(4):294-306. Published online December 29, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00297

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Abstract PDF: Purpose
This study was conducted to examine the relationships of self-leadership, working environment, and professionalism, and to identify the factors that influence professionalism among school health teachers.
Methods
This study was a descriptive research study to identify the relationships of self-leadership, work environment, and professionalism among school health teachers. Data were collected from 198 people via an online survey using a structured questionnaire. The data were collected from February 7 to 24, 2023. The relationships of self-leadership, working environment, and professionalism were analyzed using multiple regression analysis.
Results
The score of self-leadership of school health teachers was 3.97 points out of 5, working environment was 3.28 points out of 5, and professionalism was 4.12 points out of 5. Professional accountability and competency development were influenced by behavioral strategies of self-leadership, cognitive strategies of self-leadership, and working environment. These variables explained 35.0% and 29.5% of professional accountability, respectively. Autonomy was influenced by age, cognitive strategy of self-leadership, and working environment, and these variables explained 19.2% of the variance of autonomy. Social recognition was influenced by behavioral strategy of self-leadership, and working environment, and these variables explained 28.0% of social recognition.
Conclusion
To enhance the professionalism of school health teachers, it is necessary to cultivate self-leadership that can overcome difficulties in work and properly self-criticize. Improving the working environment would help enhance the professionalism of school health teachers.

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.

Factors Influencing on Core Competencies in Disaster Nursing by University Hospital Nurses’ Experiences of Caring for Patients with COVID-19: Bo Won Choi, Yeong Mi Ha; J Korean Acad Community Health Nurs. 2022;33(2):247-258. Published online June 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.2.247

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Abstract PDF

Purpose
Considering that nurses perform critical roles for caring for patients during the COVID-19 pandemic, it is important to investigate core competencies in disaster nursing. This study aimed to identify influencing factors on core competencies in disaster nursing by examining relationships between attitudes toward disaster management, disaster preparedness, and core competencies in disaster nursing in university hospital nurses’ experiences of caring for patients with COVID-19. Methods The participants were nurses working in two university hospitals who had either experiences of caring for patients with COVID-19 or no experiences. A questionnaire was distributed to 198 participants between October and November 2021. Results The findings of multiple regression analysis demonstrated that the factors related to core competencies in disaster nursing in the participants were disaster preparedness (β=.80, p<.001) and nurses’ experiences of caring for patients with COVID-19 (β=.11, p=.007). Specifically, the factors related to core competencies in disaster nursing in those having experiences of direct caring for patients with COVID-19 were disaster preparedness (β=.84, p<.001) and marital status (β=.16, p=.001). The factors related to core competencies in disaster nursing in those with indirect caring for patients with COVID-19 were disaster preparedness (β=.75, p<.001) and an intention to participate in disaster response (β=.16, p=.037). Conclusion Based on this study, it is important to develop disaster nursing education programs focusing on the full spectrum of disaster management including disaster preparedness, disaster response, and disaster recovery training.

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Influences of Nursing Professionalism and Nursing Intention on Disaster Nursing Competency among Nurses when a Disaster Occurs in a Community: Response to COVID-19
Hyun-Jung JANG, Yoon-Jung KOO, Sun-Yeon HONG, Jeong-Eon PARK, Soo-Jin BAE, Suk-Jin PARK
THE JOURNAL OF FISHERIES AND MARINE SCIENCES EDUCATION.2023; 35(2): 276. CrossRef
Influence of COVID 19 on Nursing Students’ Career Identity: A Cross-sectional Study
Na-geong Kim, Hye-Ryeon Park
The Open Nursing Journal.2023;[Epub] CrossRef
Effectiveness of an online training program for improving nurses’ competencies in disaster risk management
Jamileh Farokhzadian, Hojjat Farahmandnia, Asghar Tavan, Gülcan Taskiran Eskici, Faezeh Soltani Goki
BMC Nursing.2023;[Epub] CrossRef
The Influence of Infection Control Fatigue and Compassion Competence on Disaster Nursing Core Competencies of Nurses at COVID-19 Designated Hospitals
Jae-Hyun Ha, Hyun-Ju Lee, Ki-Ryeon Kim
Journal of Korean Academy of Fundamentals of Nursing.2022; 29(4): 461. CrossRef

Current Status and Associated Factors of Emotional Distress Due to COVID-19 Among People with Physical Disabilities Living in the Community: Secondary Data Analysis using the 2020 National Survey of Disabled Persons: Bohye Kim, Ju Young Yoon; Res Community Public Health Nurs. 2024;35(1):37-50. Published online February 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00374

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Abstract PDF: Purpose
This study aimed to assess the current situation and factors associated with emotional distress due to COVID-19 among people with physical disabilities living in the community, using a Social-Ecological Model.
Methods
A secondary data analysis was performed using data from the 2020 National Survey of Disabled Persons. The study participants were 1,654 participants aged 19 years or older with physical disabilities. For data analysis, complex sample logistic regression was conducted to identify factors associated with emotional distress due to COVID-19 in people with physical disabilities.
Results
The results showed that 55.7% of people with physical disabilities living in the community experienced emotional distress due to COVID-19. This emotional distress was influenced by various factors, including intrapersonal factors (activities of daily living, difficulty in getting information about COVID-19, difficulty in obtaining and using equipment related to COVID-19), interpersonal factors (satisfaction with the number of friends), and community/policy factor (support related to COVID-19 from national and local governments).
Conclusion
It is recommended to develop tailored interventions to prevent mental health issues among people with physical disabilities by considering the factors related to their emotional distress in the event of future infectious disease disasters.

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.

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.

Good subjective health status and health-related quality of life in people with chronic kidney disease: A secondary analysis using the Korea National Health and Nutritional Examination Survey in 2019 and 2020: Jena Lee, Yujin Suh; Res Community Public Health Nurs. 2023;34(4):255-266. Published online December 29, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00262

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Abstract PDF: Purpose
This cross-sectional study aimed to describe subjective health status of people with chronic kidney disease (CKD), identify factors that affect good subjective health status and investigate the relationship between good subjective health status and health-related quality of life (HRQOL) in people with CKD.
Methods
This secondary analysis utilized data from the Korean National Health and Nutrition Examination Survey in 2019-2020. Participants (N=295) had an eGFR of ≤59 mL/min/1.73 m². Descriptive and inferential statistics were used to analyze the data. Univariate and multivariate logistic regression analyses were performed to identify factors affecting good subjective health status and examine the association between good subjective health status and HRQOL.
Results
Among all participants, 61.4% had good subjective health status, and the HRQOL index was 0.88 in people with CKD. Household income, activity limitation, stress, and the number of comorbidities in people with CKD were associated with good subjective health status. People with better subjective health status were more likely to be satisfied with self-care, usual activities, and pain/discomfort in HRQOL.
Conclusion
Good subjective health status is associated with better HRQOL. Therefore, subjective health status should be assessed early, and a nursing intervention program should be developed considering factors that can improve subjective health status in people with CKD.

Cyberbullying among University Students during the E-learning Transformation Era: The Role of the Student-Teacher Relationship and Virtual Classroom Community: Samiha Sayed, Lucy AbuElEla, Ahlam Sarhan, Doaa El Demerdash; Res Community Public Health Nurs. 2023;34(2):135-146. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00038

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Abstract PDF: Purpose
The current study assesses cyberbullying among university students and explores the role of the student-teacher relationship and virtual classroom community.
Methods
A descriptive exploratory study on four randomly selected colleges at Damanhour University/Egypt. Participants were recruited conveniently using an equal allocation of 150 students/college (600 students). The European Cyberbullying Intervention Project Questionnaire (ECIPQ), Rovai's Classroom Community Scale (RCCS), and the Student Version of The Teacher-Student Relationship Inventory (S-STRI) were used for data collection.
Results
Low cyber victimization was reported by 66.5% of the students, while 39.8% reported low cyberaggression behaviors. The highest percent reported average virtual class connectedness (77.3%), learning experience (70.3%), and overall virtual classroom community (80.8%). Besides, highly satisfying teacher relationships (82.3%); average (38.8%) and low (35.8%) instrumental help; low conflict (68.0%); and average total teacher-student relationship (70.5%). Regression analysis revealed that the increased scores of the total teacher-student relationship scale (p<0.05) with its two domains [satisfaction and instrumental help (p<0.01)] and the total classroom community scale (p<0.05) with its domains [connectedness (p<0.01) and learning experience (p<0.05)] decreased the likelihood of cyber victimization and cyberaggression. However, perceived conflicting teacher relationships increased the likelihood of cyber victimization (p<0.05) and cyberaggression (p<0.01).
Conclusion
Cyberbullying is a concern among university students, and the students’ perceived nature of their relationships with their teachers and sense of virtual classroom community play a pivotal role in shaping their involvement in cyberaggression and exposure to cyber victimization. Thus, developing mass media campaigns to enhance awareness about cyberbullying and cyber civility regulations is recommended.

Risk Perceptions of Noncommunicable Diseases among Cambodian Adults: A Cross-Sectional Study: Sung Heui Bae, Ok Nam Hwang, Ji Eun Jeong, Young Ran Yang; J Korean Acad Community Health Nurs. 2022;33(2):259-268. Published online June 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.2.259

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Abstract PDF

Purpose
In Cambodia, noncommunicable diseases (NCDs) account for 64% of all deaths. A lack of risk perception of NCDs leads to poor measures of their prevention and management. This study aimed to investigate Cambodians’ risk perceptions of NCDs based on the health belief model. Methods A cross-sectional design was used, and using convenience sampling, participants included 200 Cambodians aged 40 years or older. A face-to-face administered structured questionnaire was used to assess demographic characteristics, health behaviors, and risk perceptions of NCDs. Results Of the constructs of NCD risk perception, perceived severity (88.2%) and benefits (86.3%) were high, but relative to these, perceived cues to action (64.1%), barriers (63.5%), and self-efficacy (58.1%) were low. Conclusion It is important to improve perceived self-efficacy in government health promotion, outreach, and improvement programs and to reduce perceived barriers through medical tests either by facility-based delivery or via outreach health services in Cambodia.

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Under-utilisation of noncommunicable disease screening and healthy lifestyle promotion centres: A cross-sectional study from Sri Lanka
Thilini Herath, Manuja Perera, Anuradhani Kasturiratne, Pracheth Raghuveer
PLOS ONE.2024; 19(4): e0301510. CrossRef

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