Research in Community and Public Health Nursing

Original Article

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

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

Review Article

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.

Original Articles

Influencing Factors for Work Engagement of COVID-19 Response Workers in Public Health Centers: Based on the Job Demands-Resources Model: Songran Park, Yeongmi Ha; Res Community Public Health Nurs. 2024;35(1):64-75. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00346

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Abstract PDF: Purpose
This study aimed to identify the influencing factors for work engagement of COVID-19 response workers in public health centers based on the JD-R model.
Methods
The participants were 119 civil servants and professionals of 20 public health centers with at least 6 months of work experience and have experience of COVID-19 response tasks in cities, districts and counties. The collected data were analyzed by descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficient and multiple regression using IBM SPSS 27.0.
Results
The factors influencing work engagement were age, career development opportunity, and person-job fit. The explanatory power of these variables was 61%.
Conclusion
In order to enhance the work engagement of public health center workers in responding to future infectious disease outbreaks, it is necessary to develop various strategies such as assigning job roles that aligned with individual characteristics, providing career growth opportunities even during infectious disease outbreaks, and designing tasks by taking into account age.

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.

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.

A Multi-component Living Lab on Health Engagement for Advancing Self-care Agency among Migrant Workers in South Korea: A mixed methods study: Youlim Kim, Hyeonkyeong Lee, Sookyung Kim, Junghee Kim; Res Community Public Health Nurs. 2023;34(4):281-293. Published online December 29, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00199

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Abstract PDF Supplementary Material: Purpose
Migrant workers battle to access health services and adapt to a new culture. Self-care agency can be essential for health self-management. This study examines the effects of a health engagement program to improve self-care agency using a living lab approach among migrant workers living in South Korea.
Methods
This study used a mixed-methods design, including a non-equivalent pre-post-test control group and three focus group interviews. Participants included 42 migrant workers from nine countries recruited via flyers, posters, and internet bulletins posted by a migrant community organization. During the 12 weeks, only the intervention group participants received four workshops addressing healthy physical activity, healthy dietary habits, effective cultural adaptation, stress management, and two outdoor cultural activities. They also participated in focus group interviews after the second, third, and fourth group activities and discussed the benefits of healthy behaviors and specific ways to implement them in real life.
Results
Participants in the intervention group showed an increase in self-care agency, health literacy, and acculturation after the 12- week intervention. Themes were derived based on the lessons from living lab activities, barriers to health behavior practices, and methods to overcome these.
Conclusion
This study demonstrated that multi-component intervention using a living lab effectively increased migrants’ participation in health promotion activities by strengthening health in their self-care agency. The qualitative and living lab approach effectively obtained comprehensive results on strategies to enhance healthy behavior engagement.

A Structural Equation Model on Health Status in Delivery Workers: Based on the Theory of Salutogenesis: Min Ji Kim, Eun Suk Choi; Res Community Public Health Nurs. 2023;34(3):228-239. Published online September 27, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00171

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Abstract PDF: Purpose
This study aimed to develop and test a structural equation model on health status of delivery workers. The conceptual model was based on the theory of salutogenesis.
Methods
Data were collected from 262 delivery workers working in D and K cities from August 2 to August 27, 2021. The structural equation model was used to assess the relationships among the variables. The model comprised three exogenous variables (working environment, social support, health promotion activities) and two endogenous variables (sense of coherence, health status). The data were analyzed using SPSS 23.0 and AMOS 22.0.
Results
The hypothetical model showed a good fit to the data: χ²/df=2.38, TLI=.91, CFI=.93, SRMR=.08, RMSEA=.07. Out of 10 research hypotheses, 10 were supported, and explained 62.3% of the variance in the health status of delivery workers. The model confirmed that sense of coherence was the most important factor. Health status is directly affected by working environment, social support, and health promotion activities. Health status is indirectly affected by working environment, social support, and health promotion activities through mediation of sense of coherence.
Conclusion
The theory of salutogenesis is adequate to use for developing health promotion programs for delivery workers. There is a need to develop a customized program to increase health status of delivery workers by enhancing sense of coherence.

What Determines the Health-related Quality of Life of Vietnamese Migrant Workers in Korea?: Jihyon Pahn, Heesuk Kim, Youngran Yang; Res Community Public Health Nurs. 2023;34(2):147-157. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00066

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Abstract PDF: Purpose
Over time, the number of migrant workers in Korea has shown a steady increase. Notably, among all migrant workers, those from Vietnam constitute the third largest group in Korea. The main objective of this study was to investigate the factors that influence the health-related quality of life of Vietnamese migrant workers. The study aimed to provide essential data for the development of customized nursing intervention programs and policy preparation in the future.
Methods
A total of 220 Vietnamese migrant workers aged between 18 and 64, who were employed in Korea through the Employment Permit System and had been residing in the country for more than 91 days, participated in this study.
Results
The study results revealed that physical activity (β=.19, p=.002), hope (β=.50, p <. 001), cohabitation with colleagues (β=.16, p =.003), and sleep hour (β=.11, p =. 031) had a statistically significant impact on health-related quality of life. The findings showed that higher levels of physical activity and hope were positively associated with higher health-related quality of life. Moreover, cohabiting with colleagues and sleeping for more than six hours were also significantly related to higher health-related quality of life.
Conclusion
Given these findings, it is imperative to develop programs that encourage physical activity and enhance the health-related quality of life of migrant workers from Vietnam. Policymakers and employers should also consider providing adequate living conditions that facilitate cohabitation with colleagues and sufficient time for sleep to improve the health and well-being of migrant workers.

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.

Needs assessment of community health practitioners for community care competency of older adults: Na Bee Yoon, Hyeon Kyeong Lee, Haesun Lee, Sang Woo Park; Res Community Public Health Nurs. 2023;34(1):32-42. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00360

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Abstract PDF: Purpose
To identify needs and priorities of community care competency for older adults among community health practitioners. Methods: Data were collected from a convenient sample of 326 community health practitioners using an online questionnaire, which included items on community care competencies and personal characteristics. Items were developed through literature review, consultation meeting, content validity verification, and preliminary investigation. The data were analyzed using the t-test, one-way ANOVA, and Scheffe’s test with SPSS 25.0. The analysis of needs and priorities was conducted by using the Borich needs assessment and the Locus for focus model. Results: Three competencies have been identified as high-priority needs; ‘Linkages with resources’, ‘Education to others’, ‘Leadership and management’. Conclusion: The findings of this study indicate the need to develop an educational program for community health practitioners to strengthen community care competencies. The programs will need to be provided, especially for young community health practitioners, to ensure that they are well equipped to care for community-dwelling older adults living in rural areas.

The Effects of Emotional Labor and Workplace Violence on the Somatic Symptoms of Customer Service Employees in Department Stores: Bongsoon Ryu, Bo Hyun Park; Res Community Public Health Nurs. 2023;34(1):61-71. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00339

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Abstract PDF: Purpose
This study was aimed to explore the effects of emotional labor and workplace violence on the somatic symptoms of customer service employees in department stores. Methods: Data from a total of 218 subjects were collected from July 21, 2021 to August 10, 2021, using a self-report questionnaire. The data were analyzed using descriptive statistics, X2-test, and logistic regression. Results: Among 4 sub-scales of workplace violence, a factor affecting the possibility of the moderate or high severity of somatic symptoms was found to be a risk group in "Experience of psychological and sexual violence from customer” (OR: 2.94). On the other hand, emotional labor did not show a statistically significant effect. In addition, education level, monthly income, subjective health status, and working hours per week were also factors affecting somatic symptoms.
Conclusion
In order to reduce the somatic symptoms of customer service employees in department stores, it is necessary to raise the awareness of employers and customers first, and follow-up research is necessary on the development of strategy and systems for the establishment of active and diverse protective devices to protect workers at the organizational level.

Influencing Factors for Sleep Quality among Firefighters: Based on Objective and Subjective Evaluation: Ye Seul Jeon, Hee Seung Choi; J Korean Acad Community Health Nurs. 2022;33(4):396-407. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.396

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Abstract PDF: Purpose
The purpose of this study was to assess insomnia and the quality of sleep, investigate the concordance between objective and self-report sleep patterns, and identify physiological, psychological, and situational factors influencing insomnia and sleep quality among firefighters. Methods: A descriptive, cross-sectional study was conducted with 103 firefighters in Korea. The collected data were analyzed using SPSS 23.0. Descriptive statistics, the independent t-test, and hierarchical logistic regression analysis were performed. Results: Insomnia was found in 66 (64.1 %) of the total subjects, and the average quality of sleep (PSQI) was 5.65 (SD=2.57). Total sleep time (401.00 minutes) and sleep latency (21.60 minutes) measured using self-reported scales were longer than the ones measured using objective measurements by approximately 48.70 and 17.10 minutes, respectively. Factors related to insomnia included the role as a paramedic (OR=4.28, 95% CI: 1.02~17.92), anxiety (OR=1.12, 95% CI: 1.01~1.24), and sedentary lifestyle (OR=0.85, 95% CI: 0.78~0.94), and factors related to sleep quality were physical illness status (OR=5.17, 95% CI: 1.53~17.51) and social support (OR=0.86, 95% CI: 0.78~0.95). Conclusion: The results show a high prevalence of insomnia, poor quality of sleep and the discrepancy between objective and subjective sleep patterns among firefighters. To promote sleep quality and health, early screening and treatment of anxiety and physical illness are required. It is necessary to conduct further studies examining the relationship between physical activity level and sleep.

Public Health Center Service Experiences and Needs among Immigrant Women in South Korea: Duck Hee Chae, Hyun Lye Kim, Min Jeong Seo, Keiko Asami, Ardith Doorenbos; J Korean Acad Community Health Nurs. 2022;33(4):385-395. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.385

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Abstract PDF

Purpose
To support implementation of comprehensive, person-centered healthcare, this study aimed to explore immigrant women's public health center (PHC) service experiences and needs while considering Photovoice's feasibility for this purpose. Methods: This qualitative study included 15 marriage-based immigrant women. Participants were recruited from churches and multicultural family support centers using purposive and snowball sampling. Data were collected through four focus group interviews and were subjected to inductive content analysis. Results: Five categories of experiences were identified: language barriers, hectic environment, affordable and practical primary healthcare, feeling ignored and discriminated against, and feeling frustrated. In addition, five categories of needs were identified: language assistance services, ease of access, healthcare across the lifespan, expansion of affordable healthcare, and being accepted as they are. This study provides preliminary evidence that the Photovoice approach can facilitate the interview process in a qualitative inquiry involving participants with limited ability to express their perspectives in the researchers' language. Conclusion: Study findings highlight the need to implement institutional policy and procedural changes within PHCs and to provide culturally competent, personcentered care for South Korea's marriage-based immigrant women and other ethnic minority populations. The findings also provide evidence-based direction for PHC service planning.

Citations

Citations to this article as recorded by

The Evolution of Phenomenology in Korean Nursing Research: A Scoping Review
Minjeong Seo, Yunekyong Kim, Jinryung Park, Guiyeon Sim, Youngshim Ko
Asian Nursing Research.2024; 18(1): 3. CrossRef

Educational Status and Needs of Premature Birth Prevention and Its Association with Preconception Health Behavior among Women of Childbearing Age in Korea: Sun Hee Kim, Ji-Yeon Hong, Mi Kyung Park; J Korean Acad Community Health Nurs. 2022;33(4):372-384. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.372

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Abstract PDF

Purpose
The aim of this study was to investigate the educational status and needs of premature birth prevention, and to identify factors associated with preconception health behaviors. Methods: The study design was a crosssectional descriptive study. Data were collected through an online questionnaire survey, and the subjects were 192 women of childbearing age in Korea. Data were analyzed using the Mann-Whitney U test, Kruskal-Wallis test, Spearman's correlation coefficients, and multiple regression. Results: The proportion of subjects who received education on premature birth prevention was 8.9%, and 75.5% of subjects answered that they needed education on premature birth prevention. They demanded education through online media, small groups, cases, cartoons (webtoon) with stories, pictures, and videos. A related factor of preconception health behavior was self-efficacy for high-risk pregnancy health care (β=.20, p=.012), which accounted for 8.2% of the total variance related to preconception health behavior. Conclusion: There was a need for more development of education programs to prevent premature birth for women of childbearing age. Its education programs should be applied with online, small group activities using various educational media. It is also required to promote preconception health behavior through self-efficacy for high-risk pregnancy health care.

Citations

Citations to this article as recorded by

Factors associated with clinical nurses’ preconception health behavior in Korea: a cross-sectional survey
Yoon-Jung Park, Sun-Hee Kim
Women's Health Nursing.2024; 30(1): 79. CrossRef
Examining the Effectiveness of Interactive Webtoons for Premature Birth Prevention: Protocol for a Randomized Controlled Trial (Preprint)
Sun-Hee Kim, Jennie C. DE GAGNE
JMIR Research Protocols.2024;[Epub] CrossRef

The Retention Factors among Nurses in Rural and Remote Areas: Lessons from the Community Health Practitioners in South Korea: Hye Jin Park, Kyung Ja June; J Korean Acad Community Health Nurs. 2022;33(3):269-278. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.269

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Abstract PDF: Purpose
This study analyzed the retention factors of Korean community health practitioners who sustained over 20 years based on a multi-dimensional framework. This study suggests global implications for nurses working in rural or remote areas, even during a worldwide pandemic. Methods: The participants were 16 Korean community health practitioners who worked in rural or remote locations for over 20 years. This study identified nurses' key retention factors contributing to long service in rural and remote areas. This is a qualitative study based on the narrative method and analysis was conducted using grounded theory. A semi-structured questionnaire was conducted based on the following: the life flow of the participants' first experience, episodes during the work experience, and reflections on the past 20 years. Results: First, personal 'financial needs' and 'callings' were motivation-related causal conditions. The adaptation of environment-work-community was the contextual condition leading to intervening conditions, building coping strategies by encountering a lifetime crisis. The consequences of 'transition' and 'maturation' naturally occurred with chronological changes. The unique factors were related to the 'external changes' in the Korean primary health system, which improved the participants' social status and welfare. Conclusion: Considering multi-dimensional retention factors was critical, including chronological (i.e., historical changes) and external factors (i.e., healthcare systems), to be supportive synchronously for rural nurses. Without this, the individuals working in the rural areas could be victimized by insecurity and self-commitment. Furthermore, considering the global pandemic, the retention of nurses is crucial to prevent the severity of isolation in rural and remote areas.

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