Research in Community and Public Health Nursing

Original Articles

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.

Validity and Reliability of the Korean Version of the Diabetes Acceptance and Action Scale (DAAS-K): Kawoun Seo; Res Community Public Health Nurs. 2024;35(1):76-83. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00430

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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 Diabetes Acceptance and Action Scale-Revised (DAAS-R) for Korean patients with type 2 diabetes.
Methods
The survey was conducted from September 1, 2021, to September 30, 2021, through a survey institution for patients diagnosed with diabetes who understood the purpose of the study and voluntarily agreed to participate. A total of 231 individuals with type 2 diabetes participated in this study. After performing forward and backward translations of the original version of the Diabetes Acceptance and Action Scale-Revised (DAAS-R) into Korean, its constructive validity (confirmatory factor analysis), concurrent validity and reliability were assessed. Concurrent validity was confirmed through the correlation between acceptance and action, quality of life, diabetes self-stigma, and experiential avoidance.
Results
Construct validity, measured using confirmatory factor analysis, showed a good fit. The DAAS-K was positively correlated with acceptance and action, quality of life, and negatively correlated with diabetes self-stigma and experiential avoidance. As for internal reliability, the Cronbach’s α of the DAAS-K was .95.
Conclusion
The DAAS-K can be applied to assess diabetes acceptance and action in Korean patients with type 2 diabetes and to compare the levels of psychological flexibility of patients with diabetes internationally.

Factors influencing dementia preventive behaviors of older adults at high risk of dementia: Application of extended health belief model: So Hee Jung, Mee Ock Gu; Res Community Public Health Nurs. 2024;35(1):22-36. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00402

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Abstract PDF: Purpose
The purpose of this study was to identify the factors influencing dementia preventive behaviors of older adults at high risk of dementia based on extended health belief model.
Methods
The subjects were 140 older adults at high risk of dementia living in H-gun, Gyeongsangnam-do, Republic of Korea. The data was collected from April 21 to May 28, 2021 by using structured questionnaires. The data was analyzed using t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and hierarchical multiple regression by SPSS/WIN 24.0 program.
Results
The mean score of dementia preventive behaviors of older adults at high risk of dementia was 3.47±0.49 (range 1-5). The factors influencing dementia preventive behaviors were self-efficacy (β=.82, p<.001), cues to action(β=.17, p=.013), ages 75-79 (β=0.35, p=.003; reference: ages 65-69), ages ≥80 (β=0.27, p=.021; reference: ages 65-69), which together explained 82.0% of total variance in dementia preventive behaviors (F=25.21, p<.001).
Conclusion
Based on the results of this study, it is highly recommended to develop and apply the dementia prevention program that can increase self-efficacy and cues to action for improving dementia preventive behavior of older adults at high risk of dementia.

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.

Home-based walking intervention for middle-aged migrant women using 360-degree virtual videos and a wearable activity tracker: A mixed-methods pilot study: Duckhee Chae, Keiko Asami, Jaseon Kim, Kukhyeon Kim, Jeeheon Ryu, Ardith Z. Doorenbos; Res Community Public Health Nurs. 2024;35(1):10-21. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00339

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Abstract PDF Supplementary Material: Purpose
To sustain behavior change, an intervention strategy that considers the contribution of affect to daily physical activity behavior regulation is needed. Although virtual reality-based physical activity interventions have the potential to improve emotional status, interventions using virtual reality videos in a free-living environment are lacking. This pilot study assessed the feasibility and preliminary efficacy of a home-based intervention using 360-degree virtual videos and wearable activity trackers to improve mood and physical activity.
Methods
A one-group pilot study of 12 middle-aged migrant women asked participants to watch virtual reality videos and perform moderate-intensity walking 5 days per week for 4 weeks, then complete surveys and focus group interviews. The intervention’s feasibility and preliminary efficacy were assessed by examining recruitment, retention, adherence, acceptability, mood, physical activity, and exercise self-efficacy.
Results
A word-of-mouth approach was effective for recruiting participants. Although the weekly intervention adherence rate ranged from 53.5% to 83.5%, retention (92.3%) and acceptability (91.7%) were high. Participants were satisfied with the “visual status indicators,” “sense of accomplishment and confidence,” “emotional engagement and sense of presence,” “joy from exercise,” “external motivation through supervision,” “easy to control virtual reality device,” and “extra benefits” of the intervention. Participants had significant decreases in negative affect (p=.016). Positive affect, physical activity, and exercise self-efficacy showed trends toward improvement.
Conclusion
This home-based intervention employing virtual reality videos and Fitbit activity trackers is feasible and shows preliminary efficacy in improving mood. Further research is warranted to evaluate its effectiveness in a more rigorous randomized controlled trial.

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.

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

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

The Relation among Uncertainty, Social Support, Care Burden of Mothers having Children with Developmental Disabilities: Kyoung Eun Jeong, Min Hyun Suk; Res Community Public Health Nurs. 2023;34(2):117-126. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00346

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Abstract PDF

Purpose
This descriptive correlation study aimed to confirm the relation among uncertainty, social support, care burden of mothers having children with developmental disabilities.
Methods
The participants were 111 mothers having children with autistic spectrum disorder or intellectual disability. The collected data were analyzed by descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficient and multiple regression using IBM SPSS 23.0 in the study.
Results
Uncertainty and social support were significantly correlated to caregiver burden. As a result of multiple regression analysis, the factors affecting caregiver burden were children’s age, the expense for caring, the period suspected child disabilities, and uncertainty. These factors accounted for 40.8% of caregiver burden.
Conclusion
In order to reduce the burden of caring for mothers with children with developmental disabilities, it is necessary to establish a system that can detect children with developmental disabilities early and to develop and provide an integrated guide suitable for the growth and development stage of children with developmental disabilities.

Citations

Citations to this article as recorded by

Spousal support, parent–nurse partnership and caregiver burden among parents of children with chronic diseases: A cross‐sectional study
Jihye Kim, Heemin Chae, Yoonjung Kim
Journal of Clinical Nursing.2024;[Epub] CrossRef

Work Adaptation Experience of Vietnamese Workers in Korean Workplaces: Constructivist Grounded Theory: HyeJung Jun, GaEon Lee; Res Community Public Health Nurs. 2023;34(2):108-116. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00150

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Abstract PDF: Purpose
The purpose of this study is to find a nursing intervention plan by classifying the body pain areas of the Korean aged and analyzing related factors.
Methods
This study performed the latent class analysis, cross-analysis, and one-way ANOVA using the SPSS 25.0, M-plus 7.0 program on 4,388 older adults aged 65 or over using the data from the 2020 Aging Research Panel.
Results
As a result of the Latent Class Analysis, participants divided into four groups. Group 1 was the 'shoulder and low back pain group' with high shoulder and back pain, group 2 was the 'upper body pain group' with severe pain in the arms, wrists and fingers and chest, group 3 was the 'lower pain focused group' with high pain in the legs and knees, and finally, group 4 was the 'general low pain group' with low pain overall. The result of the study shows that the group that did not exercise regularly, the female group, and the low socioeconomic status group have more pain in general. The upper body central pain group showed a low level of life satisfaction.
Conclusion
This study discusses various nursing interventions for the prevention of chronic pain, especially for the aged female group who has diverse body pain areas, the aged with low socioeconomic status, and the aged who do not exercise.

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.

Factors Affecting the Risk of Cardiovascular Disease in Postmenopausal Women: A Postmenopausal Period-Stratified Analysis: Jui Kim, Choi Hyoungshim; Res Community Public Health Nurs. 2023;34(1):72-82. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00297

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Abstract PDF: Purpose
This study aimed to investigate the factors affecting the risk of cardiovascular disease among postmenopausal Korean women. Methods: This postmenopausal period-stratified analysis used secondary data from the Korea National Health and Nutrition Examination Survey from 2016 to 2018. We selected 1,465 participants with all the relevant data for analysis. The Chi-square test and multiple logistic regression analysis were used to analyze the data. Results: Age, subjective health status, body mass index, and triglyceride level were the factors that influenced the risk of cardiovascular disease for women with a postmenopausal period ≤5 years, whereas age, subjective health status, household income, body mass index, and triglyceride level were the factors that influenced the risk of cardiovascular disease for women with a postmenopausal period >5 years and ≤10 years. Conclusion: Planning health promotion strategies to lower the risk of cardiovascular disease in women must consider the differences among women according to the menopausal status and postmenopausal period.

The Mediating Effect of Acceptance Action in the Relationship between Diabetes Distress and Self-stigma among Old Adults with Diabetes in South Korea: Hye Sun Kim, Ka Woun Seo; J Korean Acad Community Health Nurs. 2022;33(4):446-455. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.446

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Abstract PDF

Purpose
This study investigated the mediating effects of acceptance action on the relationship between diabetes distress and self-stigma in older adults with diabetes. Methods: A descriptive research approach was adopted using 187 patients diagnosed with diabetes mellitus by an endocrinology doctor. The data were collected from 26 to 31 March, 2020 and were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient analysis, and hierarchical multiple regression. Results: The mean scores for diabetes distress, self-stigma, and acceptance action were 2.98±0.64, 2.54±0.74, and 4.16±0.35, respectively. Acceptance action partially mediated the relationship between diabetes distress and self-stigma (z=1.98, p=.024), with an explanatory power of 51.0%. Conclusion: To reduce diabetes self-stigma among old adults in diabetes distress situations, it is necessary to improve their acceptance action and develop step-by-step differentiated acceptance action enhancement programs through multidisciplinary collaborations.

Citations

Citations to this article as recorded by

The relationship between stigma and psychological distress among people with diabetes: a meta-analysis
Xiajun Guo, Sijia Wu, Haishan Tang, Yuanyuan Li, Wanglin Dong, Guangli Lu, Shuang Liang, Chaoran Chen
BMC Psychology.2023;[Epub] 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 Effectiveness of a mHealth Program Using Wearable Devices and Health Coaching among Bus Drivers for Promoting Physical Activity: Yeong Mi Ha, Sang Ho Lee, Su Yeon Lee, Yeo Joo Chae; J Korean Acad Community Health Nurs. 2022;33(3):332-339. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.332

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Abstract PDF: Purpose
Bus drivers are at high risk of chronic diseases due to risk factors associated with poor diet, physical inactivity, high levels of sedentary behaviors, and unfavorable working environments. This study developed a mHealth program for bus drivers, and examined the effectiveness of a mHealth program for promoting physical activity among bus drivers using wearable devices and health coaching. Methods: Forty-seven workers from two bus companies were allocated to the experimental group and the control group. Participants were asked to wear a wearable device (Fitbit Charge HR) during waking hours for a day. Participants in the experimental group were provided with a Fitbit, weekly face-to-face health coaching, a mHealth workbook, and text and photo messaging for 12 weeks. The control group only received a Fitbit. Results: By week 12, there were significant differences between the experimental and control groups in exercise self-efficacy (p<.015) and daily walking steps (p<.001). Conclusion: The findings have demonstrated that the mHealth program using wearable devices and health coaching is effective for bus drivers for promoting physical activity. Based on our findings, it is recommended to encourage the mHealth program using wearable devices and health coaching for bus drivers' wellness.

Family and Community Factors Associated with Life Satisfaction of the Urban Community-dwelling Elderly across Age Groups: Focusing on the Importance of Social Capital: Hyeon Sik Chu, Han Yi Lee; J Korean Acad Community Health Nurs. 2022;33(2):207-216. Published online June 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.2.207

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Abstract PDF: Purpose
The aim of this study was to identify differences and influencing factors in the level of life satisfaction among the urban community-dwelling elderly by age group. Methods The study was conducted utilizing the secondary data of 2017 Seoul Survey in a cross-sectional design. Of 42,688 participants in total, the data of 7,927 adults aged 65 or older were analyzed. The data were analyzed using descriptive statistics, independent t-test, chi-square test, Pearson’s correlation coefficients, and multiple linear regression. Results There were significant differences between age groups, and it was found that the old elderly groups had significantly higher life satisfaction than the oldest elderly group (t=8.37, p<.011). In common, family and community factors influencing life satisfaction in the two age groups were companion animals (old elderly: β=.03, p=.002; oldest elderly: β=.06, p=.021), social network (old elderly: β=.10, p<.001; oldest elderly: β=.08, p=.008), and social support (old elderly: β=.05, p<.001; oldest elderly: β=.08, p=.005). Conclusion Based on these results, social welfare and nursing care services focusing on social capital and age group-specific interventions are needed to improve life satisfaction of the elderly. This study might provide the possibility and evidence for a program to improve life satisfaction for the urban community-dwelling elderly, including social capital elements.

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