Research in Community and Public Health Nursing

Original Articles

[English] Impact of Marital Dissolution Timing and Duration on Self-Rated Health of Marriage Immigrants in Single-Person Households in South Korea: Duckhee Chae, Kyeong Hwa Kang, Nakyung Kim, Keiko Asami, Jongdae Kim; Res Community Public Health Nurs. 2025;36(1):122-129. Published online March 31, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01011

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Abstract PDF: Purpose
This study examined associations between timing of marital dissolution, duration since marital dissolution, and self-rated health among marriage immigrants in South Korea who live in single-person households.
Methods
This cross-sectional study employed a secondary analysis of data from the 2021 Korean National Multicultural Family Survey. We performed binary logistic regression analyses to examine the relationships between the variables of interest while controlling for social support, economic well-being, psychological well-being, and sociodemographic characteristics. Data from 407 marriage immigrant single-person households were included in the analyses.
Results
Marriage immigrants’ self-rated health fluctuated over time but generally exhibited a downward trend following marital dissolution. After controlling for confounders, marital dissolution after age 50 and longer duration since dissolution (e.g., 3-6 years and 9+ years) were associated with increased odds of poor self-rated health. Unemployment and depressive symptoms significantly increased the odds of poor self-rated health, while higher social support had a protective effect.
Conclusion
Transitioning to singlehood after marital dissolution may have long-term negative health consequences, particularly for those experiencing this transition later in life. Proactive interventions focusing on social support and health resource acquisition within the initial 3 years of separation may be crucial to mitigate health decline.

[English] Job Analysis of Nurses Working at Dementia Care Centers Using DACUM: Yong-Sun Shin, Jong-Eun Lee; Res Community Public Health Nurs. 2025;36(1):21-34. Published online March 31, 2025; DOI: https://doi.org/10.12799/rcphn.2024.00927

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Abstract PDF: Purpose
The purpose of this study is to conduct job analysis of nurses at dementia care centers and to identify the importance, frequency, and difficulty of each duty and task.
Methods
Through Developing a Curriculum (DACUM) Committee workshop, the committee members developed a job analysis tool using DACUM, and the nurses working at dementia care centers evaluated the importance, frequency, and difficulty of each duty and task.
Results
The jobs of the nurses were derived from 10 duties and 66 tasks, and each duty consisted of 3 to 10 tasks. The important duties were ‘public guardianship project for dementia’ and ‘dementia diagnosis screening,’ the most frequent duties were ‘consultation and registration management,’ and ‘dementia diagnosis screening,’ and the most difficult duties were ‘public guardianship project for dementia’ and ‘project planning and evaluation.’ Based on these results, the core duties and tasks were derived, and the top priority duties were ‘consultation and registration management,’ ‘case management,’ and ‘support for families and carers of dementia patients’.
Conclusion
The most recent duties of nurses, who have the largest proportion of workers at dementia care centers, were identified, and the core duties that should be given priority in selecting the direction of education for job performance and professional improvement were presented. Based on the application method of education and training presented in this study, it is important to detail education and training that is appropriate for and applicable to each duty to support the professionalism of nurses at dementia care centers.

[English] The Effect of Digital Health Literacy, Self-Efficacy on Self-Care Behaviors among Community-Dwelling Elderly: Focusing on Gyeongsangbuk-do: Hyojin Son, Youngran Han; Res Community Public Health Nurs. 2025;36(1):59-72. Published online March 31, 2025; DOI: https://doi.org/10.12799/rcphn.2024.00801

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Abstract PDF: Purpose
This study aimed to explore the relationship between digital health literacy, self-efficacy, and self-care behaviors, and to identify the effects of digital health literacy and self-efficacy on self-care behaviors among the community-dwelling elderly.
Methods
This descriptive study used self-reported questionnaires and was conducted from January to April 2024. This study included 197 participants aged 65 or older, residing in nine cities and counties within Gyeongsangbuk-do. Data were analyzed using SPSS/WIN 23.0, employing descriptive statistics, t-test, One-way ANOVA, Scheffé tests, Pearson correlation coefficients, and hierarchical regression analysis.
Results
The average scores were as follows: digital health literacy, 21.97±8.38 (out of 40 points); self-efficacy, 3.27±0.72 (out of 5 points); and self-care behaviors, 70.22±10.55 (out of 96 points). Self-efficacy (β=.32, p<.001) was identified as the primary factor influencing self-care behaviors. Additionally, job (β=-.20, p=.002) and gender (β=-.18, p=.007) were also significant factors. These factors explained 22.8% of the variance of self-care behaviors.
Conclusion
Based on the above study results, we found that to promote self-care behaviors of community-dwelling elderly people, developing and implementing training programs that enhance self- efficacy are imperative. Furthermore, efforts should be made to overcome regional disparities by developing and implementing various policies and programs at the government, local government, and community levels to enhance the digital health literacy of the elderly.

[English] Associations between Self-esteem, Social Support, Family Empowerment, and Health Empowerment among Children during the COVID-19 Pandemic: Hye-Jin Kim; Res Community Public Health Nurs. 2025;36(1):49-58. Published online March 31, 2025; DOI: https://doi.org/10.12799/rcphn.2024.00794

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Abstract PDF: Purpose
This study aimed to identify associations between self-esteem, social support, family empowerment, and health empowerment among children during the COVID-19 pandemic.
Methods
A cross-sectional study was conducted among fifth- to sixth-grade children and their parents who were recruited from C elementary school in Gangwon-do, South Korea. The health empowerment, self-esteem, and social support as reported by children were measured by the Korean version of Health Empowerment Scale (K-HES), Self-Esteem Scale, and Perceived Social Support, respectively. The family empowerment as reported by parents of children was measured by the Family Empowerment Scale. Linear regression analysis was performed.
Results
Of the participants, children’s self-esteem (β=.46, p<.001) and social support (β=.47, p<.001) and parents’ family empowerment (β=.27, p=.008) were significantly and positively associated with children’s health empowerment.
Conclusion
Among children in health-vulnerable environments due to the COVID-19 pandemic, establishing interventions for improving health empowerment needs to be considered as a nursing strategy for self-esteem, social support, and family empowerment at the intrapersonal and interpersonal levels.

[English] Effect of Remote Health Interventions on Blood Pressure Control and Quality of Life for Hypertension Self-management: A systematic review and meta-analysis: YingMei Yuan, MeiLing Song; Res Community Public Health Nurs. 2025;36(1):150-164. Published online March 31, 2025; DOI: https://doi.org/10.12799/rcphn.2024.00570

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Abstract PDF: Objective: To evaluate the effect of remote health interventions on self-management of hypertension.
Methods
We systematically searched the literature for studies published in English in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Cochrane Central Register of Controlled Trials. The database was used to search for relevant studies with full text and evaluate the remote health interventions for hypertension self-management versus usual care for hypertension. RevMan 5.4 was used for data analysis.
Results
A total of 19 studies eventually met our inclusion criteria. The results showed that the remote health interventions group could significantly reduce the levels of SBP (MD=5.67, 95% CI=4.12-7.22, p<.001) and DBP (MD=1.88, 95% CI=1.16- 2.60, p<.001), compared with usual care group, it also significantly improving the patient's quality of life (SMD=0.84, 95% CI=0.32- 1.37, p=.002), reduce waist circumference (MD=2.39, 95% CI=0.35-4.44, p=.020) and BMI (MD=0.49, 95% CI=0.06-0.91, p=.020), and significantly increasing the physical activity of patients (SMD=0.19, 95% CI=0.06- 0.31, p=.004). No obvious publication bias was found in this meta-analysis.
Conclusion
This study showed that remote health interventions for self-management can significantly improve patients’ quality of life with hypertension and better BP control than usual care. Further studies could be assess the long-term clinical effectiveness and economic evaluation of remote health interventions for self-management.

[English] Factors Associated with Subjective Health Status among People with Spinal Cord Injury: An Application of the International Classification of Functioning, Disability and Health Model: Haesun Lee, Hye Jin Nam, Ju Young Yoon; Res Community Public Health Nurs. 2025;36(1):73-84. Published online March 5, 2025; DOI: https://doi.org/10.12799/rcphn.2025.00962

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Abstract PDF: Purpose
This study aimed to identify factors influencing subjective health status among individuals with spinal cord injury (SCI) using the International Classification of Functioning, Disability and Health (ICF) model.
Methods
This study analyzed secondary data from the 2021 Survey on the Status and Needs of Individuals with SCI conducted by the Korea Spinal Cord Injury Association. A hierarchical multiple regression analysis was conducted in four steps. Independent variables included sociodemographic factors, satisfaction with medical services (environmental factor), the need for weight control, the need for nutritional education, the need for dietary management, and disability acceptance (personal factors) along with exercise and activity of daily living (activity and participation factors). These factors were added sequentially at each step based on the ICF model.
Results
A total of 513 participants were analyzed in this study, with an average subjective health status of 5.51±2.39. Higher satisfaction with medical services (β=.27, p<.001), frequent exercise (β=.19, p=.008), and a greater level of activities of daily living (β=.02, p<.001) were significantly associated with improved subjective health status. Conversely, a lower need for nutritional education (β=-.25, p=.042) was negatively associated.
Conclusion
This study highlighted satisfaction with medical services, nutrition education needs, exercise frequency, and activities of daily living as important factors. These findings provide insight into how the health status of individuals with SCI can be enhanced through targeted interventions and support from healthcare providers.

[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.

[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] 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] 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.

[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] 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.

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.

Citations

Citations to this article as recorded by

Current status of systematic review studies on patient-reported outcome measures published in Korean journals
Duck-Hee Chae, Jiyeon Lee, Eun-Hyun Lee
Research in Community and Public Health Nursing.2025; 36: 1. CrossRef

Original Articles

[English] Knowledge of Healthcare Workers Towards NIPAH Virus: A Cross-Sectional Study: Hadi Al Sulayyim, Manea Alsaleem, Ali Sherjab, Saleh Aldoghman, Husain Alyami, Abdulaziz Al Yami, Mohammad Almeshal, Mohammad Altheban, Dahen Alsinan, Obaid Altheban, Fares Al-Mansour; Res Community Public Health Nurs. 2024;35(3):264-271. Published online September 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00619

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Abstract PDF

Purpose
To evaluate the healthcare workers’ (HCWs) knowledge towards Nipah virus and identify the associated variables with good knowledge.
Methods
A cross-sectional design was conducted in Najran, Kingdom of Saudi Arabia (KSA) to evaluate the knowledge of HCWs towards Nipah virus. A validated questionnaire was employed to collect the data of HCWs. It consisted of two parts: Socio-demographic characteristics of the participants and questions related to the knowledge towards Nipah virus. Percentages and median (Q1, Q3) were used to present the data and were compared by Mann–Whitney and Kruskal Wallis. The associated variables with good knowledge were identified by logistic regression.
Results
The study included 247 participants. The median (Q1, Q3) knowledge score was 45% (10%, 60%), reflecting poor knowledge. About 62% of the HCWs stated that the symptoms of Nipah virus infection could be acute respiratory distress, convulsions, and coma. Only 36.8% reported no available vaccine to prevent Nipah virus infection, and more than 50% identified the virus’s main reservoir (fruit bat) as the possibility of transmission from animal to human. Roughly 57% of them reported that the virus can be transmitted among people through droplets. Less than 40% stated the Nipah virus can cause AIDS. The significantly associated variable with good knowledge was only nationality.
Conclusion
The present study showed a poor knowledge of HCWs. Good knowledge was associated with nationality. Therefore, the implementation of education and training programmes are highly recommended throughout conducting prospective and interventional studies.

Citations

Citations to this article as recorded by

Assessment of the general population knowledge about the emergence of Nipah virus outbreak in Bangladesh: A nationwide cross-sectional study
Mobin Ibne Mokbul, Shuvajit Saha, Samiha Nahar Tuli, Fatema Binte Nur, A.M. Khairul Islam, Tariful Islam, Shirsho Shreyan, Alok Bijoy Bhadra, Golam Dastageer Prince, Irfath Sharmin Eva, Mustari Nailah Tabassum, Ferdous Wahid, Md Irfan Bin Kayes, Nazim Has
Journal of Virus Eradication.2025; 11(1): 100585. CrossRef

[English] Factors Associated with Nurse Self-Leadership: A Cross-Sectional Study of Nurses Working at Public Health Centers and Primary Healthcare Posts: Saeryun Kim, Younkyoung Kim; Res Community Public Health Nurs. 2024;35(3):195-206. Published online September 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00493

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Abstract PDF Supplementary Material: Purpose
This study aimed to analyze the factors influencing self-leadership among public health nurses as they implement health promotion projects in public health centers and primary healthcare posts.
Methods
The study sampled 120 public health nurses from 22 public health centers and their associated primary healthcare posts in J province. Data were collected from October 11 through October 25, 2022.
Results
Employment at a primary healthcare post instead of a public health center (β=.23, p=.012), was significantly associated with self-leadership in model 1 (adjusted R2=.17, F=4.56, p<.001). Furthermore, communicative competence (β=.48, p<.001) and nursing professionalism (β=.26, p=.001) were significantly associated with self-leadership in model 2 (adjusted R2=.51, F=14.77, p<.001).
Conclusion
Open and self-directed work environments, along with opportunities for education and training, are necessary to enhance communicative competence and nursing professionalism. These improvements may, in turn, strengthen self-leadership among nurses, facilitating the implementation of health promotion projects within public health institutions.

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