Research in Community and Public Health Nursing

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Original Article

[English] 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.

Citations

Citations to this article as recorded by

Enhancing Communication and Empathy Skills in Geriatric Care: Nurses' Reflections on Simulation‐Based Training for Patient Interaction and Education
Sobhia Ahmed Abdel Kader Mohammed, Mostafa Shaban
Journal of Clinical Nursing.2025;[Epub] CrossRef
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

Review Article

[English] A Systematic Review of Questionnaire Measuring eHealth Literacy: Jung-Won Ahn, Mi Young Kim; Res Community Public Health Nurs. 2024;35(3):297-312. Published online September 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00752

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Abstract PDF: Purpose
This review aims to summarize the characteristics of currently used questionnaires measuring eHealth literacy and assess the quality of their psychometric properties in self-reported assessments within community settings.
Methods
The systematic analysis was conducted using the COnsensus-based Standards for the selection of health Measurement INstruments checklist to evaluate the methodological quality of studies on measurement properties.
Results
A total of 21 studies, including 19 questionnaires, were reviewed. The findings indicated that the quality of psychometric assessments for eHealth literacy was generally rated as 'good,' with most studies addressing multiple aspects of reliability and validity. Internal reliability, content validity, hypothesis testing, and responsiveness were particularly well-supported, each receiving over 10 sufficient ratings. However, there was limited evidence regarding measurement errors, test-retest reliability, criterion validity, and analyses of floor and ceiling effects.
Conclusion
This study contributes to the enhancement of eHealth literacy measurement tool selection and improves the reporting of their validity and reliability, thereby increasing the credibility of future research.

Original Articles

[English] The Effects of Adverse Childhood Experiences, Benevolent Childhood Experiences, and Community Integration on Resilience in Psychiatric Outpatients: Keum Ran Hong, Hye Kyung Lee; Res Community Public Health Nurs. 2024;35(4):313-324. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00598

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Abstract PDF: Purpose
The purpose of this study is to determine the impact of adverse childhood experiences, positive childhood experiences, and community integration on resilience in psychiatric outpatients.
Methods
The study subjects were 166 psychiatric outpatients in one general hospital in South Korea who were diagnosed with schizophrenia spectrum disorder, bipolar disorder, or depression disorder. The collected data were analyzed with the t-test, ANOVA, Pearson’s correlation coefficient, multiple regression analysis, using the SPSS/WIN 24 program.
Results
There were statistically significant differences in resilience in psychiatric outpatients according to age, religion, occupation, type of household, type of diagnosed disorder. In psychiatric outpatients, resilience showed a significant positive correlation with benevolent childhood experiences and community integration, but had a negative correlation with adverse childhood experiences. Multiple regression analysis for resilience in psychiatric outpatients revealed that the significant factors affecting resilience were community integration, benevolent childhood experiences, adverse childhood experiences, housing facilities (type of household), ages 40-49, and living alone (type of household). These factors explained 52.2% of the variance.
Conclusion
In order to improve the resilience of mentally ill people, a campaign is needed to increase the accessibility of community participation programs in mental health services for community integration and to publicize the influence of benevolent childhood experiences and adverse childhood experiences. Furthermore, it is necessary to identify individual factors such as residence type and age of mentally ill people, build a customized support system by considering their specific needs, and develop intervention programs to strengthen resilience.

[Korean] Development and Evaluation of Eating Traits Scale for Adult in Republic of Korea: Youngwon Kim, Eunok Park; Res Community Public Health Nurs. 2024;35(4):339-350. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00521

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Abstract PDF: Purpose
The purpose of this study was to develop eating traits scale for Korean adults and verify its validity and reliability.
Methods
The initial items were developed based on the literature reviews. The first preliminary scale has consisted of 78 items and the second preliminary scale consisted of 50 items selected by 13 experts who were formed to evaluate the content validity. To review whether they could understand the questionnaires at their reading level, 27 sixth-grade elementary school students were asked to be involved in this study. The questionnaire was revised through the consultation of Korean language teachers, and the final preliminary scale was composed of 50 items. Data were collected from 329 adults aged 19 to 65 years to test validity and reliability of the scale The item analysis and exploratory factor analysis were applied.
Results
Exploratory factor analysis showed 5 factors of 35 items. The factors (No. of items) were ‘Mood states (6)’, ‘Pursuit of health (6)’, ‘Stimulation of food (9)’, ‘Social situations (5)’, ‘Desire satisfaction (9)’. These 5 factors explained 55.04% of the total variance. Eating traits scale developed in this study was established construct validity. The reliability of the scale, Cronbach's alpha coefficient was .92 and the factor’s ranged from .77 to .87.
Conclusions
Eating traits scale developed in this study was verified by content validity, construct validity and reliability. It is expected to be useful measuring eating traits of Korean adults in clinical practice and research.

[English] Effects of a School-Based Health Education for Cardiovascular Disease Prevention Among High School Girls: Minah Kang, Jina Choo; Res Community Public Health Nurs. 2024;35(4):363-374. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00647

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Abstract PDF: Purpose
We aimed to evaluate effects of a school-based health education for cardiovascular disease (CVD) prevention among high school girls.
Methods
Non-randomized cluster trial was conducted by recruiting two female high schools located in Seoul and allocating one school as a cluster to an experimental group and the other school as the other cluster to a control group. Participants were 169 first-year female high school students in two clusters. Of the participants, 84 were recruited in the experimental group and 85 in the control group. An intervention was an eight-week "School-based Health Education for CVD prevention". The experimental group received the intervention, while the control group received a CVD prevention handout. Measures were knowledge, self-efficacy, and health behaviors for CVD prevention. The pre-test and post-test were conducted.
Results
The experimental group participating in "School-Based Health Education for CVD Prevention" had significantly higher changes in knowledge, self-efficacy scores to prevent CVD, and health behaviors than the control group over eight weeks.
Conclusions
The "School-based Health Education for CVD Prevention" program may improve high school students' knowledge and self-efficacy as determinants of health behaviors as well as health behaviors to prevent cardiovascular disease.

[English] Effects of Virtual Reality Cardiopulmonary Resuscitation Practice on the Knowledge, Skills, and Attitudes of Nursing Students: A single-blind randomized controlled trial (RCT): Jui Kim, Jung-Hee Song, Young-Ok Ha; Res Community Public Health Nurs. 2024;35(4):415-423. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00689

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Abstract PDF: Purpose
This study aimed to assess the effects of virtual reality (VR) cardiopulmonary resuscitation (CPR)—as compared to those of face-to-face Basic Life Support (BLS) education—on nursing students’ knowledge, skills, and attitudes.
Methods
Forty-four participants were recruited from nursing schools in Gyeonggi-do, Republic of Korea, and randomized into two groups: VR CPR (experimental group) and BLS (control group). The participants’ CPR knowledge, cardiac compression quality, self-efficacy, confidence, and attitudes toward education were evaluated.
Results
At enrollment, the control and experimental groups showed similar results for all the variables. After the intervention, results showed that the cardiac compression score and the hand position accuracy in the experimental group were significantly higher than in the control group. Meanwhile, knowledge, self-efficacy, and confidence were improved in both groups, though there was no significant difference between the two groups.
Conclusion
The study results showed that VR CPR education is just as effective as face-to-face BLS training for nursing students. Therefore, developing high-quality VR educational content in the future is necessary.

[English] Digital Health Literacy and Associated Factors Among Older Adults Living Alone in South Korea: A Cross-Sectional Study: Minhwa Hwang, Gahye Kim, Seonghyeon Lee, Yeon-Hwan Park; Res Community Public Health Nurs. 2024;35(4):389-400. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00766

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Abstract PDF: Purpose
This study aimed to examine the level of digital health literacy and identify factors associated with digital health literacy among older adults living alone in South Korea.
Methods
A cross-sectional study was conducted on 140 older adults aged 65 and above who live alone. Descriptive statistics and non-parametric methods were used to explore the relationship between digital health literacy and independent variables. A generalized linear model was used to identify factors associated with digital health literacy.
Results
Among 140 smartphone-owning older adults living alone, 52.1% were using the Internet via digital devices, and the participants’ average digital health literacy score was 6.64±7.46. Univariate analysis results showed significant differences in digital health literacy according to age, education level, and multimorbidity. The factors associated with digital health literacy were identified as gender (B=−0.36, p=.031), age (B=−0.06, p<.001), education level (B=0.12, p<.001), and sleep problems (B=−0.06, p=.006).
Conclusion
Despite widespread Internet and smartphone use, older adults living alone with chronic diseases showed low levels of digital health literacy, which were significantly associated with gender, age, education level, and sleep problems. Enhancing digital health literacy among vulnerable populations is crucial for the effective implementation of digital health services. Collaborative efforts, including tailored digital health interventions to enhance the digital health literacy of vulnerable populations and supportive policies, are essential to bridge the digital divide and promote health equity.

[English] Malnutrition Risk in Community-Dwelling Older Adults with Dual Sensory Declines: Focusing on Social Determinants of Health: Ha Na Jeong; Res Community Public Health Nurs. 2024;35(4):325-338. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00675

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Abstract PDF: Purpose
As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines.
Methods
The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines.
Results
1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk.
Conclusion
These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.

[English] Reliability and Validity of the Korean Version of 8-item Health Literacy Assessment Tool (K-HLAT-8): Mirae Jo, Eun-mi Kwak; Res Community Public Health Nurs. 2024;35(4):351-362. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00682

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Abstract PDF: Purpose
The purpose of this study was to evaluate the validity and reliability of the Korean version of the Health Literacy Assessment Tool (K-HLAT-8) for Korean adults.
Methods
The survey was conducted from April 1, 2020 to May 30, 2020 at a university hospital, a university, and one community picnic area with adults who understood the purpose of the study and voluntarily agreed to participate. A total of 220 adults participated in this study. After forward and backward translation of the original version of the Health Literacy Assessment Tool 8 (HLAT-8) into Korean, construct validity (confirmatory factor analysis), convergent validity, and reliability were evaluated. Convergent validity was confirmed through the correlation between the K-HLAT-8 and the Self-As Carer Inventory (SCI).
Results
Construct validity, evaluated using confirmatory factor analysis, showed good fit. The K-HLAT-8 showed a positive correlation with the SCI score. In terms of internal consistency, Cronbach’s α of the K-HLAT-8 was 0.85. For test-retest reliability, the intraclass correlation coefficient (ICC) was .99 (95% CI: 0.97~0.99).
Conclusion
The reliability and validity were confirmed, so K-HLAT-8 can be applied to evaluate the health literacy of Korean adults. Furthermore, these assessment results should be used as basic data to implement programs that can improve health literacy.

Review Articles

[English] Optimistic bias: Concept analysis: Miseon Shin, Juae Jeong; Res Community Public Health Nurs. 2024;35(1):112-123. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00360

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Abstract PDF: Purpose
The purpose of this study was to analyze and clarify the concept of ‘optimistic bias.’
Methods
A review of the literature was conducted using several databases. The databases were searched using the following keywords: optimistic bias, optimism bias, and concept analysis. The literature on optimistic bias was reviewed using the framework of Walker and Avant’s conceptual analysis process.
Results
Optimistic bias can be defined by the following attributes: 1) underestimation of personal risk, 2) vague confidence, 3) positive future prediction and 4) lack of risk recognition. The antecedents of optimistic bias are as follows: 1) risk perception, 2) self-efficacy, and 3) risk controllability. The consequences of optimistic bias are as follows: 1) reduced anxiety, 2) providing emotional stability, 3) negative consequences for preventive health behavior, 4) lack of attention to risk-related information, and 5) negative consequences for self-protection behavior.
Conclusion
The definition and attributes of optimistic bias identified by this study can provide a common understanding of this concept and help to develop a nursing intervention program effective in preventing, protecting, and improving health of subjects in the field of nursing practice.

[English] Factors Related to Diabetes Self-Care among Immigrants in the United States: A Scoping Review: Jung Eun Kim; Res Community Public Health Nurs. 2023;34(2):171-182. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00094

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Abstract PDF

Purpose
The purpose of this scoping review was to explore related factors in diabetes self-care among immigrants in the U.S. Diabetes is one of the fastest-growing chronic illnesses, but little is known about factors in self-care among minority immigrants in the U.S.
Methods
The Arksey and O’Malley (2005) methodological framework guided this review, which examined 16 articles, including qualitative, quantitative, and mixed-methods designs. PRISMA guidelines were used with five Databases. Search terms included: immigrants in the U.S., type 2 diabetes, self-care, and self-management.
Results
Factors related to diabetes self-care among immigrants were identified: (1) changed dietary lifestyle, (2) low economic and health insurance, (3) social support and resources, (4) low English proficiency, (5) psychological contexts, and (6) gender roles.
Conclusion
Given the culturally unique related factors in diabetes self-care among immigrants, healthcare professionals must be knowledgeable and responsive to the ethnic minority immigrants’ needs to promote effective diabetes self-care.

Citations

Citations to this article as recorded by

Educational Needs and Priorities of People with Diabetes and Healthcare Providers in South Korea: A Mixed-Methods Study
Shinae Seo, Chun-Ja Kim, Hee Sun Kang, Elizabeth A. Schlenk
Journal of Transcultural Nursing.2025; 36(2): 195. CrossRef

Original Articles

[Korean] Factors Influencing Participation in Hypertension Management Education Among Diagnosed Hypertensive Patients in Busan: Utilizing the 2021 Community Health Survey: Hye Jung Jun, Kyoung Mi Kim; Res Community Public Health Nurs. 2024;35(4):424-433. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00759

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Abstract PDF: Purpose
This study investigated the completion rate of hypertension management education and its influencing factors among adults in the Busan region, utilizing data from the 2021 Community Health Survey.
Methods
The study included 3,660 adults aged 19 years or older who had been diagnosed with hypertension. Data were analyzed using SAS 9.4, focusing on demographic, socioeconomic, and health status characteristics.
Results
The results indicated that 22.1% of participants had completed hypertension management education. Key influencing factors varied by region: in the Western region, age, income, education level, marital status, and life satisfaction were significant factors associated with participation in hypertension management education. In the Southern region, income and education level were identified as relevant factors. Additionally, in the Central and Eastern regions, education level was a significant determinant.
Conclusion
Therefore, tailored hypertension management education programs that consider age, income, marital status, and life satisfaction are essential for residents in the Western region of Busan. Moreover, it is critical to enhance access to hypertension management education for low-income populations in the Southern region. Educational programs should also be designed to align with the educational levels of Busan residents to ensure effective hypertension management education.

[English] Illness Experience of Glaucoma Patients: Hyeon ae Lee, Seon Nyeo Kim, Hwa Young Kim, Sue Kyung Sohn; Res Community Public Health Nurs. 2024;35(1):99-111. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00458

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Abstract PDF: Purpose
The purpose of this study was to understand and describe the experiences of patients with glaucoma.
Methods
Data were collected from March to April in 2023, through individual in-depth interviews with 10 glaucoma patients. Verbatim transcripts were analyzed using Colaizzi’s phenomenological analysis.
Results
Six theme clusters were extracted that described patients’ experiences: 1) The frightening disease unexpectedly discovered; 2) A dismal life gradually trapped in darkness; 3) Fear of the unseen; 4) Following treatment without any other options; 5) Grateful for the help but feeling miserable; 6) Realizing the importance of eyes and health.
Conclusion
The results of this study provide a deep understanding and insight into the experience of Glaucoma patients. Glaucoma patients experienced physical, mental, and social pain through the disease process. Therefore, psychological nursing interventions are needed to understand and reduce mental pain along with medical treatment to relieve physical symptoms in glaucoma patients. Furthermore, it will be necessary to prepare institutional support measures to minimize various social restrictions.

[English] Social Network Analysis of Adults’ Obesity-Related Health Behaviors According to Life Cycle Stage: Seung-bin Park, Insoon Kang; Res Community Public Health Nurs. 2024;35(4):375-388. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00738

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Abstract PDF: Purpose
This secondary data analysis study examined adults’ levels and networks of obesity-related health behaviors according to the life cycle stage.
Methods
Participants included 5,203 adults aged 19–79 years who participated in the third year of the eighth Korea National Health and Nutrition Examination Survey (2021). Life cycle stages were divided into young, middle-aged, and older adult groups. Obesity status was classified based on a body mass index of 25 kg/m2. Selected obesity-related health behaviors included alcohol abstinence, not smoking, proper sleep, eating breakfast, fruit intake, vegetable intake, not eating out, aerobic physical activity, walking, and weight training. Obesity-related health behavior networks were analyzed for density, inclusiveness, degree, and degree/closeness/betweenness centrality using social network analysis.
Results
Participants’ obesity rate was 37.6%, with the highest rate observed in the older adult group (39.2%). In all life cycle stages, the non-obese group had a higher density and average degree in the obesity-related health behavior network than the obese group. The young adult group showed higher centrality for vegetable intake, not smoking, alcohol abstinence, and proper sleep. The middle-aged group generally had higher centrality for health behaviors, whereas the older adult group had lower overall centrality for health behaviors, especially proper sleep and physical activity-related behaviors.
Conclusion
There were differences in the levels and network structures of obesity-related health behaviors according to the life cycle stage, indicating a need for differentiated obesity-management strategies according to the life cycle stage.

[English] Developing a community-based, multicultural-friendly prenatal education pilot program: EunSeok Cha, Sojung Lee, Gui-Nam Kim, Byung Hun Kang, Minsun Jeon; Res Community Public Health Nurs. 2024;35(3):226-239. Published online September 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00507

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Abstract PDF: Purpose
The purpose of this study was to examine the acceptability, availability and sustainability of a pilot prenatal program developed by an interdisciplinary team.
Methods
Out of 19 multicultural women participated in the 6-session prenatal program, 6 women took part in an exit- focus group interview as a part of formative evaluation. The verbatim transcriptions of semi-structured interview data were analyzed using conventional content analysis.
Results
In general, the participants expressed high satisfaction with program content, educators and education methods. A hybrid model including health professionals and community health workers and using online and offline education modes was suggested as a way to disseminate the program at a national level. Interventions using aesthetic approaches such as music and an integrated method such as the introduction of available social services in pregnancy and during the postpartum period may play a role as the facilitator of the program participation of multicultural women. These approaches may also help them develop healthy coping skills, problem solving skills and empowerment in multicultural childbearing women who need to adjust to life in a new country simultaneously taking a new role as a mother.
Conclusion
An interdisciplinary prenatal program using a holistic approach contributes to enhancing multicultural women’s empowerment to become a mother in a new country.

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