Research in Community and Public Health Nursing

Original Articles

[English] Association Between Usual Source of Care Types and Health Behaviors: Smoking Cessation, Alcohol Abstinence, and Physical Activity: Jeong-Hee Kang, Chul-Woung Kim; Res Community Public Health Nurs. 2026;37(1):101-112. Published online March 31, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01445

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Abstract PDF: Purpose
This study explores the relationship between types of usual source of care (USC) and health behaviors.
Methods
It used the 2019–2021 Korea Health Panel Annual Data (Version 2.2), including 11,498 adults aged 19 and older. The dependent variables were three health behaviors: smoking cessation, alcohol abstinence, and engagement in regular physical activity.
Results
Individuals with a usual physician offering either comprehensiveness or coordination (Type 4) were 1.24 times more likely to quit smoking than those with no regular care (Type 1) (p=.047). Those whose physicians provided both functions (Type 5) were 1.25 times more likely to quit smoking (p=.038). For alcohol abstinence, individuals who regularly visited a facility but did not have a usual physician (Type 2), as well as those with a partially functional physician (Type 4), were 1.16 times more likely to abstain than Type 1 (p=.027 and p=.042, respectively). Regarding physical activity, individuals in Types 2 and 4 were more likely to exercise regularly, with odds ratios of 1.24 (p<.001) and 1.23 (p=.001), respectively.
Conclusion
This study highlights that having a usual source of care (USC)—especially one that offers core primary care functions such as comprehensiveness or coordination—is positively associated with healthier behaviors, particularly smoking cessation. These effects may be strengthened by recent government-led incentive programs that support behavioral change. These findings suggest that expanding both access to and the quality of USC may be key to improving population health behaviors.

[English] Structural Barriers and Strategic Directions for the Professional Role of Local Government Public Health Nurses in Integrated Community Care: A Qualitative Study: Han Nah Park, Hye Jin Nam, Sujin Lee; Res Community Public Health Nurs. 2026;37(1):81-89. Published online March 31, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01417

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Abstract PDF: Purpose
Local government public health nurses (LG PHNs) in South Korea deliver integrated community health and welfare services. However, their professional identity is often challenged within welfare-centered administrative structures, and the structural barriers to their role performance have not been fully explored.
Methods
An exploratory qualitative study using focus group interviews was conducted. Seven LG PHNs from various local government divisions participated. Data were analyzed thematically to identify key challenges in role performance.
Results
Three main themes emerged: (1) Systemic unreadiness and structural support gaps in deployment, characterized by inadequate orientation and ambiguous role boundaries resulting from rapid policy implementation; (2) Challenges in professional identity negotiation within integrated welfare-health frameworks, where the underutilization of nursing expertise and overlapping responsibilities within administrative settings led to role confusion and professional marginalization; and (3) Institutional isolation and absence of clinical governance, resulting from a lack of systematic clinical supervision and institutional backing. Participants reported significant difficulty prioritizing specialized nursing tasks due to limited resources and structural hierarchies.
Conclusion
LG PHNs’ effectiveness is hindered by fundamental structural limitations and governance gaps. To prepare for the 2026 nationwide implementation of integrated care, a transition toward nursing-led care management is essential. Policy measures should include establishing a legal role framework, implementing dual-reporting systems for clinical supervision, and promoting inter-professional education (IPE) to empower LG PHNs as proactive community health leaders.

[English] Influence of Health Literacy and Psychological Well-being on Health Promotion Behavior in Military Personnel: Dong Jun Lee, Eun Sun So; Res Community Public Health Nurs. 2026;37(1):90-100. Published online March 31, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01389

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Abstract PDF: Purpose
The purpose of this study is to understand the influence of health literacy and psychological well-being on health promotion behavior in military personnel. Methods: This was a descriptive survey study conducted with 142 military personnel serving in front-line and rear-area divisions located in G-do and G-si. Data were collected from May 13 to May 23, 2025, and analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson correlation analysis, and multiple linear regression analysis. Results: Total military service period of 20 years or more (β=0.39, p=.019), perceived health status (β=0.32, p<.001), psychological well-being (β=0.26, p=.003), gender (β=0.23, p=.014), and university (β=0.21, p=.024) were found to have significant influence on health-promoting behaviors. These variables explained 31% of the variance in health-promoting behaviors (F=5.32, p<.001). Conclusion: It is necessary to develop personalized individual strategies that can promote health-enhancing behaviors among military personnel, while also providing foundational data for establishing military health policies and developing health management programs.

[English] Spatial Distribution and Determinants of Hypertension Prevalence at The Subdistrict Level: A Small-Area Ecological Cross-Sectional Study: Bongjeong Kim; Res Community Public Health Nurs. 2026;37(1):49-60. Published online March 31, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01340

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Abstract PDF: Purpose
This study aimed to analyze the spatial distribution of hypertension prevalence and identify the demographic, behavioral, and community environmental factors associated with regional variation across 153 eup-myeon-dong administrative units in Chungcheongbuk-do, South Korea.
Methods
Secondary data analysis was performed using Community Health Survey data from 62,411 adults aged ≥ 30 years (2017-2021). The prevalence of hypertension was defined as the proportion of individuals diagnosed with hypertension by a physician. Spatial statistical indicators were obtained from the Statistical Geographic Information Service (SGIS). Descriptive statistics, Pearson’s correlation, choropleth mapping, global Moran’s I, local indicators of spatial association (LISA), and ordinary least-squares (OLS) regression analyses were performed.
Results
The prevalence of hypertension showed statistically significant spatial clustering (global Moran’s I=0.442, p<.001), with high-high clusters concentrated in rural eup-myeon areas and low-low clusters in urban dong areas. Despite confirmed clustering, the LM lag and error tests indicated no statistically significant spatial dependence in the regression residuals. The regression analysis showed that the prevalence of hypertension increased in areas with a higher proportion of older adults, greater obesity prevalence, and higher satisfaction with public transportation, whereas stronger trust among neighbors and greater satisfaction with healthcare access were associated with a lower prevalence.
Conclusion
These findings support a shift toward tailored nursing and public health interventions at the sub-district level, prioritizing rural high-risk areas and reflecting the distinct demographic, behavioral, and environmental contexts of each community.

[English] National Identity and Self-Rated Health Trajectories Among Multicultural Adolescents in Korea: A Piecewise Latent Growth Model: You-Jung Choi; Res Community Public Health Nurs. 2026;37(1):27-38. Published online March 31, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01312

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Abstract PDF: Purpose
This study examined whether changes in national identity are associated with contemporaneous changes in self-rated health (SRH) among multicultural adolescents in Korea, with particular attention to the transition from elementary to middle school.
Methods
This study utilized five time-point data (2019-2023) from the second panel of the Multicultural Adolescents Panel Study (MAPS) conducted by the National Youth Policy Institute (NYPI). Piecewise latent growth modeling was applied to estimate trajectories before and after the elementary-middle school transition and to test whether piecewise change in national identity predicted piecewise change in SRH, adjusting for gender, body mass index, parental nationality, self-rated economic condition, and stress.
Results
In unconditional models, national identity increased across the elementary-school years and decreased in middle school, whereas SRH declined throughout, with a steeper drop during middle school. In conditional models, national identity showed positive, period-specific associations with SRH: higher initial national identity was linked to higher initial SRH, a greater increase in national identity during elementary school corresponded to a minor decline in SRH during the same period, and less decline in national identity during middle school was associated with a smaller concurrent decline in SRH.
Conclusion
Among multicultural adolescents, national identity and SRH are intimately associated within developmental periods, and both are sensitive to school-level transitions. Continuous, school- and community-based support that fosters stable, positive national identity across the elementary-middle school transition may promote adolescents’ health.

[English] Influence of Smartphone Dependence, Mental Health, and Resilience on Military Life Adjustment Among Soldiers: A Cross-Sectional Study: Soonnam Shin, Kyungja Kang; Res Community Public Health Nurs. 2026;37(1):1-13. Published online March 31, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01291

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Abstract PDF: Purpose
This study aimed to examine the influence of smartphone dependence, mental health, and resilience on military life adjustment among soldiers.
Method
Data from a total of 173 subjects were collected from February 11, 2025 to March 8, 2025, using a self-report questionnaire. The data were analyzed using independent t-tests, one-way ANOVAs, the Scheffé test, Pearson’s correlation coefficient, and multiple linear regression analysis.
Results
Resilience (β=.65, p<.001), high-risk smartphone dependence (β=-.17, p=.001), mental health (β=-.14, p=.027), and the experience of difficulties in military life (β=-.12, p=.001) were identified as factors influencing military life adjustment. These variables accounted for 83.0% (F=67.92, p<.001) of the variance in military life adjustment.
Conclusion
The findings of this study demonstrate the necessity of developing integrated intervention programs to enhance military life adjustment among soldiers. In particular, as resilience was identified as the most influential factor, interventions aimed at strengthening resilience, along with strategies for regulating smartphone use, promoting mental health, and alleviating service-related stress, are warranted.

[English] The Moderating Effect of Korean Language Proficiency on the Relationship Between Self-Rated Health Status and Quality of Life Among International Students in Korea: Hanyi Lee, Jiyeon An; Res Community Public Health Nurs. 2026;37(1):39-48. Published online March 31, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01242

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Abstract PDF: Purpose
This study aimed to examine whether Korean language proficiency moderates the relationship between international students' self-rated health status and quality of life (QoL) in South Korea, given the critical role of language skills in cultural adaptation and well-being.
Methods
A secondary analysis was conducted using data from the 2023 Seoul Survey on Foreign Residents. The sample included 409 international students residing in Seoul. Hierarchical multiple regression and PROCESS macro (Model 1) were used to examine the moderating effect of Korean language proficiency on the relationship between self-rated health status and QoL.
Results
Self-rated health status and Korean language proficiency were each positively associated with QoL, and the moderating effect of language proficiency was statistically significant. Among international students with low Korean proficiency, the association between self-rated health status and QoL was strong, whereas this relationship was negligible among those with high proficiency. These findings suggest that Korean language proficiency buffers the negative impact of poor health on QoL.
Conclusion
Korean language proficiency is a protective factor for international students' QoL, mitigating the negative effects of poor self-rated health status. These findings underscore the need for integrated, culturally sensitive health policies and support programs that reduce language barriers and promote language acquisition to enhance the well-being of international students.

[English] Socio-Demographic and Psychological Factors Influencing the Happiness of Gyeongsangbuk-do Residents: Sung Jung Hong, See Jo Kim, Nam Hyun Cha; Res Community Public Health Nurs. 2025;36(4):435-446. Published online December 31, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01277

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Abstract PDF: Purpose
This study examined the effects of sociodemographic factors, health behavior, and psychological-emotional characteristics on stress, depression, and happiness among residents of Gyeongsangbuk-do and explored the relationships among these variables.
Methods
A cross-sectional analysis was conducted using data from the 2022 Korean Community Health Survey. The sample included 21,490 residents of Gyeongsangbuk-do. Multiple linear regression and Pearson correlation analyses were performed to identify predictors of psychological well-being.
Results
Participants showed high prevalence of health risk behaviors, including alcohol consumption (76.4%) and smoking (15.7%), while a majority engaged in regular physical exercise (79.3%). Despite this, the proportion reporting good or very good subjective health was lower than the national average (34.0% vs. 53.1%). Stress was positively correlated with depression (r=.24, p<.001) and negatively correlated with happiness (r=-.25, p<.001). Multiple regression analysis revealed that happiness was significantly associated with subjective health status (β=.07 to .27), stress (β=-.19), depression (β=-.17), suicidal thoughts (β=-.11), educational attainment (β=.03 to .10), smoking (β=-.08), physical exercise (β=.04), and income level (β=-.03 to .04). The final model explained 25.6% of the variance in happiness (adjusted R²=.256, F=337.76, p<.001).
Conclusion
Happiness among Gyeongsangbuk-do residents was influenced by a combination of sociodemographic, health behavioral, and psychological-emotional factors. These findings provide foundational evidence for developing regionally tailred strategies to improve community mental well-being.

[English] Effects of a Flipped Learning-Based Integrated Theory and Practice Educational Program on Excretion Care Robot: Yoo Jin Sim, Mi Young Kim; Res Community Public Health Nurs. 2025;36(4):407-419. Published online December 31, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01214

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Abstract PDF: Purpose
This study aimed to develop a flipped learning–based integrated education program that combines video-based prelearning, theoretical lectures, and hands-on training on excretion care robots. The program was applied to nurses to verify its effects on their knowledge, attitudes, and skills related to excretion care and the use of such robots. Methods: A randomized controlled trial was conducted with 50 nurses working at a hospital in Seoul, Republic of Korea. The experimental group received a flipped learning–based integrated education program, which included asynchronous pre-learning, in-person didactic session, and in-person hands-on session. The control group received basic education on the use of excretion care robots. Outcome variables included knowledge, attitudes (self-efficacy, perceived usefulness and ease of use, anxiety, intention to use), and skills (proficiency, accuracy of execution and outcomes). The data were analyzed using independent t-tests. Results: Compared to the control group, the experimental group showed significantly higher scores in knowledge, self-efficacy, perceived usefulness and ease of use, intention to use, proficiency, and accuracy of the performance. Additionally, their level of anxiety regarding excretion care robots was significantly lower (p<.05). Conclusion: The integrated education program combining video, theoretical, and practical components was effective in enhancing nurses' knowledge, attitudes, and skills. These results suggest that such a program can serve as a valuable educational strategy to facilitate the clinical adoption of technology-based care devices like excretion care robots.

[English] Education Needs for Public Health Crisis Using an Importance-Performance Analysis and Borich Needs Assessment Model: Focused on Aircraft Quarantine Officials: Jiyun Park, Gye Joung Yeom, Seok Hwan Kim; Res Community Public Health Nurs. 2025;36(4):361-372. Published online December 31, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01193

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Abstract PDF: Purpose
This study aimed to investigate the importance and performance levels of the duties related to public health crisis response of the aircraft quarantine officials and to analyze their educational needs for public health crisis. Methods: The subjects were quarantine officials at Incheon airport in Korea, and data from a total of 121 individuals were utilized for analysis. Data were analyzed by an independent t-test, paired t-test, and one-way ANOVA for the importance and performance of duties regarding public health crisis according to general characteristics. An Importance-performance analysis (IPA) and Borich needs assessment model were used to analyze public health crisis education needs. Results: The IPA analysis revealed that the area requiring focused improvement efforts (concentrate here), where importance is high, but performance is low, primarily includes epidemiological investigation of emerging infectious diseases. The Borich needs assessment was used to identify the following priority items: epidemiological investigation of emerging infectious diseases, occurrence of social disaster after patient isolation, donning and doffing of personal protective equipment (PPE), and epidemiological investigation of respiratory infectious diseases. Conclusion: Based on these results, it will be necessary to develop and implement practical education and training programs for aircraft quarantine officials.

[English] Impact of Leisure Activities on Physical, Mental, and Cognitive Function Among Older Adults: Gyeong-Suk Jeon, Kyungwon Choi; Res Community Public Health Nurs. 2025;36(4):420-434. Published online December 31, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01165

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Abstract PDF Supplementary Material: Purpose
This study aimed to classify types of leisure activity and examine their associations with self-rated health, depression and cognitive function among older adults in Korea.
Methods
Data were drawn from 7,804 participants in the 2020 National Survey of Older Koreans. Types of leisure activity were identified through K-means cluster analysis using respondents' first and second choices of leisure activities. Multivariable logistic regression analyses, adjusted for sociodemographic and health-related covariates were conducted to assess the primary associations between leisure types and dichotomized health outcomes.
Results
Five distinct groups were identified: religious activity-oriented, varied physical activity-oriented, walking and rest-oriented, gardening and sedentary activity-oriented, and social activity-oriented. Compared to the religious activity-oriented group, the varied physical activity-oriented (OR=0.71, 95% CI=0.59–0.85), walking and rest-oriented (OR=0.55, 95% CI=0.39–0.77), and social activity-oriented groups (OR=0.46, 95% CI=0.29–0.72) showed significantly lower odds of poor self-rated health. All four types exhibited significantly lower odds of depression; notably, the social activity-oriented (OR=0.40, 95% CI=0.28–0.57) and walking and rest-oriented (OR=0.40, 95% CI=0.28–0.57) groups showed the strongest protective effect. None of the leisure groups showed a significant link to cognitive function risk when compared with the religious activity-oriented group. Conclusions: Leisure patterns involving diverse physical activities and social engagement are strongly associated with favorable health outcomes. Health promotion strategies should prioritize accessible community-based programs that encourage diverse physical and socially engaging activities, while developing targeted interventions (e.g., combining cognitive stimulation with sedentary leisure) to reduce disparities and mitigate cognitive risk among older adults.

[Korean] Perceptions of Home-visit Care Helpers and Informal Caregivers on the Importance and Performance of Care Helper Duties: Jiyong Choi, Suyon Baek; Res Community Public Health Nurs. 2025;36(4):373-385. Published online December 31, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01074

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Abstract PDF: Purpose
This study examined differences in perceptions of the importance and performance of care helper duties between home-visit care helpers and informal caregivers, providing data to improve service quality in home-based care.
Method
This study employed a cross-sectional comparative descriptive design. A total of 128 participants (64 home-visit care helpers and 64 informal caregivers) completed a structured questionnaire assessing the perceived importance and performance of care duties across six domains. Data were analyzed using SPSS version 28.0. In addition, open-ended questions were included to identify reasons for gaps between perceived importance and performance, and the responses were analyzed through descriptive content analysis.
Results
Significant differences were found between the two groups. Caregivers perceived "special care assistance" as more important (t=-5.01, p<.001), whereas care helpers reported higher performance in "physical care assistance" (t=0.85, p=.041). Among the reasons identified exclusively by care helpers was “role confusion arising at the boundary of professional care.” In contrast, reasons identified only by informal caregivers included “insufficient care due to indifference” and “limited performance capacity due to lack of training.” Reasons commonly identified by both groups were “lack of balance between caregiving and household tasks” and “burden of care, an unbearable reality”
Conclusion
Discrepancies in perceived importance and performance between care helpers and caregivers highlight the need for clearer role definitions and targeted training. A dual-track system in care helper roles and the standardization of tasks may enhance service consistency and strengthen trust between home-visit care helpers and informal caregivers.

[English] Factors Influencing Care Coordination for Chronic Disease Patients with a Usual Source of Care: Hyunsang Kwon, Ju Young Yoon; Res Community Public Health Nurs. 2025;36(3):339-351. Published online September 30, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01186

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Abstract PDF: Purpose
Care coordination is a key function that enables consistent and integrated care by connecting various medical, welfare, community resources throughout a patient’s healthcare journey. This study was aimed at examining the provision of care coordination and its associated factors among adult patients with hypertension or diabetes who have a usual source of care, using Andersen’s Behavioral Model. Methods: A total of 2,576 adults with hypertension or diabetes who reported having a usual source of care were analyzed by using data from the 2021 Korea Health Panel Survey. Both patient-level and provider-level variables were categorized into predisposing, enabling, and need factors based on Andersen’s model. Complex sample logistic regression analysis was performed. Results: Only 44.7% of participants reported experiencing care coordination. The likelihood of receiving care coordination was significantly lower among females, and higher among those not currently employed, those not engaging in regular physical activity, individuals with multiple chronic conditions, and those whose usual source of care was a general practitioner. Conclusion: Care coordination is essential for ensuring continuity of care and effective management among patients with chronic conditions, and it is influenced by both patient and provider characteristics. As Korea prepares to launch a nationwide community-based integrated care system in 2026, care coordination will serve as a vital foundation for linking local resources and delivering comprehensive care. Based on the patient and provider factors identified in this study, effective support at the policy and system levels will be necessary to operate and sustain this function.

[Korean] The Midwifery Training Program at Ilshin Women’s Hospital and Its Meaning: From 1953 to 1978: Eunyoung Kim, Jihyun Lee; Res Community Public Health Nurs. 2025;36(3):292-303. Published online September 30, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01109

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Abstract PDF: Purpose
The purpose of this study is to examine the meaning of the midwifery training program initiated by Australian missionaries at Ilshin Women’s Hospital in 1953. Methods: Historical methodology using the annual reports (1953-1970) published by Ilshin Women's Hospital and related newspapers, magazines, and books as the primary source. Results: The Ilshin Women’s Hospital was established in 1952 by Australian missionaries Helen P. Mackenzie and Catherine M. Mackenzie. In response to the exigencies of the Korean War, the hospital initiated a program to train midwives in 1953. The objective of midwifery training program was to improve the health of women and children by providing nurses with sufficient education and training to be responsible for prenatal care and normal delivery service. As of December 1978, a total of 1,037 nurses had received midwifery training over a period of 26 years. These midwives have advanced into urban and rural areas across the country to take charge of maternal and child health care, contributing to reducing the gap in maternal and child health practice. Conclusion: The midwifery training program at Ilshin Women's Hospital has had an impact on enhancing maternal and child health at the community and national levels by graduating professional healthcare personnel through hands-on training that can be put into practice. It has also improved the level of maternal and child health in Korea through its systematic midwifery education and management system.

[Korean] Korea’s First Manual of Public Health Nursing: A Foundation for Public Health Nursing Practice in Korea: Junho Jung, Kyunghee Yi; Res Community Public Health Nurs. 2025;36(3):245-256. Published online September 30, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01102

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Abstract PDF: Purpose
This study aims to understand the functions and roles of public health nursing, which played a key role in public health center activities during the formative years of the organizations in Korea. It does so by analyzing the structure and content of Manual of Public Health Nursing, the first of its kind published in Korea, as well as its authors’ records—particularly the U.S. nurse advisors. Methods: Manual of public health nursing was investigated from the cover to the appendix with other related records from the U.S. National Archives and Records Administration (NARA). Results: The manual was published in response to the expansion of health centers and the increasing need for standardized practice for public health nurses. It includes theoretical and practical guidelines on maternal and child health, communicable disease control, school health, health education, etc. as well as the qualifications of public health nurses. The manual was influenced by U.S. nursing education and international public health manuals. Conclusion: The manual played a critical role in shaping early public health nursing practices in Korea by providing essential knowledge and standardizing public health services. It reflected Korea’s evolving public health system, heavily influenced by U.S. aid and technical assistance. Despite its significance, challenges such as a shortage of trained public health nurses and an underdeveloped administrative structure remained unresolved.

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