Research in Community and Public Health Nursing

Original Articles

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.

The Effect of Dual Sensory Impairment on Cognitive Function Decline in the Elderly: The Moderating Effect of Social Support: Soo Jee Yang, Ju Young Yoon; Res Community Public Health Nurs. 2023;34(3):217-227. Published online September 27, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00255

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Abstract PDF: Purpose
This study verified that the dual sensory impairment (DSI) in the elderly is associated with cognitive impairment (CI) and confirmed how change in cognitive function varies depending on the social support (SS).
Methods
For a study sample of Korean older people, data from the Korean Longitudinal Study of Ageing (KLoSA) from the 7th (2018) to the 8th (2020), were included in this cross-sectional descriptive study. Among people who responded in both 2018 and 2020, a total of 2,069 people of those who are 65 years of age or older, and have living children and normal cognitive function, were analyzed. X2 -test, t-test and logistic regression analyses were utilized.
Results
First, the number of elderly with visual impairment (VI), hearing impairment, and DSI increased on 8th data compared with 7th data. In addition, 22.9% of the 2,069 people showed a decrease in cognitive function. Second, compared to the elderly with normal sensory function, the cognitive function of the elderly with only VI was found to be more degraded, and the cognitive function of the elderly with DSI was found to be much more degraded. In addition, among SS, only participation in social gatherings was found to show significant change in cognitive function of the elderly with DSI. Third, the interaction effect of participating in social gatherings was not significant in the CI of the elderly with DSI.
Conclusion
VI and DSI effected cognitive function, but participation in social gatherings such as SS has not significant interaction effect on CI of the elderly with DSI.

Effects of Fatigue and Emotional Labor on Sleep Quality among Apartment Security Guards: Chul-Gyu Kim, Sujeong Jeong, Young Mi Ryu, Seungmi Park, Kyoungmi Moon, Yunjung Kwon, Sun-A Park, Hye Ok Park; Res Community Public Health Nurs. 2023;34(3):205-216. Published online September 27, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00220

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Abstract PDF: Purpose
This study aimed to identify the effects of fatigue and emotional labor on the quality of sleep among apartment security guards.
Methods
A total of 196 apartment security guards working in 10 different regions participated in the study between July and October 2022, completing questionnaire assessing fatigue (physical imbalance, exhaustion, mental fatigue, and nervous system disfunction), emotional labor, and sleep quality. Data were analyzed using descriptive statistics, independent t-test, Mann-Whitney U test, ANOVA including Scheffe’s post hoc, and regression analysis.
Results
183(93.4%) participants were poor sleeper. Regression analysis of the factors influencing sleep quality yielded a significant model (F= 21.56, p<.001) with an explanatory power of 25.0% in the order of fatigue(exhaustion) (β=.28, p<.001), emotional labor (β=.27, p<.001), and subjective economic status (β=.15, p=.017).
Conclusion
It is essential to develop nursing educational programs that reduce exhaustion and emotional labor for improving the quality of sleep.

Gender Differences in Older Adults’ Muscle Strength and Depressive Symptoms: A Relationship Mediated Through Perceived Stress: Gyeong A Kang, Jihye Shin, Ju Young Yoon; Res Community Public Health Nurs. 2023;34(3):196-204. Published online September 27, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00164

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Abstract PDF: Purpose
Preventing the effects of physical vulnerability is a practical approach to improving older adults’ depressive symptoms. This study aims to examine the relationship between gender differences related to muscle strength and depressive symptoms mediated by perceived stress.
Methods
In this cross-sectional study, data from 2,705 older adults (65 years old or older) from the Korea National Health and Nutrition Examination Survey VII 2016 and 2018 were analyzed. The moderated mediation model was developed; the outcome, independent, mediation, and moderated mediation variables in the literature-based research model were depressive symptoms, muscle strength, perceived stress, and gender, respectively.
Results
Perceived stress had a mediating effect on the relationship between muscle strength and depressive symptoms. The indirect effect of muscle strength on depressive symptoms mediated by perceived stress was β = -.02 (95% CI:-0.03~-0.01). The moderated mediation model demonstrated that the interaction term of handgrip strength and gender negatively affected perceived stress, which indicated that gender moderated the mediating model of perceived stress on the association of muscle strength and depressive symptoms (β = -.01, p <.05). The conditional indirect effect model was insignificant in the male group (β = -.00, 95% CI:-0.01~0.01) but significant in the female group (β = -.01, 95% CI: -0.02~0.00). Conclusions: Perceived stress mediated the relationship between muscle strength and depressive symptoms. However, the effect differed by gender. A stress-mediated depressive symptoms intervention program for older adults should be developed to consider women’s needs.

Factors Affecting the Performance of Infection Control of Multi-drug Resistant Organisms in Intensive Care Unit Nurses of General Hospitals based on the Theory of Planned Behavior: The Mediating Effect of Intention: Nam-Sook Kim, So-Eun Choi; Res Community Public Health Nurs. 2023;34(3):183-195. Published online September 27, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00150

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Abstract PDF: Purpose
The purpose of this study is to analyze the factors that affect the performance of infection control of multidrug-resistant organisms (MDROs) by nurses in intensive care units (ICU) in general hospitals.
Methods
Participants were 105 ICU nurses from 6 general hospitals. The questions for the survey performed were based on the theory of planned behavior, such as attitude towards infection control of MDROs, subjective norms, perceived behavioral control, intention, and performance.
Results
In the relationship between subjective norms towards infection control of MDROs and performance, intention showed a significant complete mediating effect; and in the relationship between perceived behavioral control and performance, intention showed a partial mediating effect. The attitude towards infection control of MDROs was excluded from the mediating effect verification because there was no significant correlation between intention and performance.
Conclusion
The results of this study suggest that department atmosphere and perceived behavior control promotion programs should be developed to enhance subjective norms in order to promote the performance of infection control of MDROs.

Review Article

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

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

Original Articles

Assessment of Metabolic Syndrome Risk Based on Body Size Phenotype in Korean Adults: Analysis of Community-based Cohort Data: Ji Young Kim, Youngran Yang; Res Community Public Health Nurs. 2023;34(2):158-170. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00101

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Abstract PDF: Purpose
Body size phenotypes can be regarded as an indicator of cardiovascular incidence risk factors. The aim of this study was to investigate the incidence of metabolic syndrome among metabolically healthy adults according to body size phenotype using Korean Genome & Epidemiology Study [KoGES]-community based cohort from 2001-2002 to 2014.
Methods
A prospective population-based cohort including 5,068 adults aged 40-69 years free from metabolic syndrome was included and divided into three phenotypes: metabolically healthy normal weight (MHNW), metabolically healthy overweight (MHOW), and metabolically healthy obesity (MHO). The time dependent Cox’s proportional hazards regression model was used to estimate the incidence of the metabolic syndrome after a follow-up 14 years.
Results
In the demographic, health related variables-adjusted model (Model 3), the hazard ratio of the metabolic syndrome was 1.92 (CI 1.54-2.40) for MHOW, 2.88 (CI 2.32-3.58) for MHO among males, 1.89 (CI 1.51-2.37) for MHOW, 2.34 (CI 1.88-2.90) for MHO for females compared to MHNW, respectively.
Conclusion
In conclusion, MHOW and MHO in both males and females increased the risk of metabolic syndrome compared to MHNW. Obesity management should be considered even in the absence of metabolic syndrome. Programs and resources should be provided for prevention of cardiovascular diseases and better quality of life.

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.

Cyberbullying among University Students during the E-learning Transformation Era: The Role of the Student-Teacher Relationship and Virtual Classroom Community: Samiha Sayed, Lucy AbuElEla, Ahlam Sarhan, Doaa El Demerdash; Res Community Public Health Nurs. 2023;34(2):135-146. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00038

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Abstract PDF: Purpose
The current study assesses cyberbullying among university students and explores the role of the student-teacher relationship and virtual classroom community.
Methods
A descriptive exploratory study on four randomly selected colleges at Damanhour University/Egypt. Participants were recruited conveniently using an equal allocation of 150 students/college (600 students). The European Cyberbullying Intervention Project Questionnaire (ECIPQ), Rovai's Classroom Community Scale (RCCS), and the Student Version of The Teacher-Student Relationship Inventory (S-STRI) were used for data collection.
Results
Low cyber victimization was reported by 66.5% of the students, while 39.8% reported low cyberaggression behaviors. The highest percent reported average virtual class connectedness (77.3%), learning experience (70.3%), and overall virtual classroom community (80.8%). Besides, highly satisfying teacher relationships (82.3%); average (38.8%) and low (35.8%) instrumental help; low conflict (68.0%); and average total teacher-student relationship (70.5%). Regression analysis revealed that the increased scores of the total teacher-student relationship scale (p<0.05) with its two domains [satisfaction and instrumental help (p<0.01)] and the total classroom community scale (p<0.05) with its domains [connectedness (p<0.01) and learning experience (p<0.05)] decreased the likelihood of cyber victimization and cyberaggression. However, perceived conflicting teacher relationships increased the likelihood of cyber victimization (p<0.05) and cyberaggression (p<0.01).
Conclusion
Cyberbullying is a concern among university students, and the students’ perceived nature of their relationships with their teachers and sense of virtual classroom community play a pivotal role in shaping their involvement in cyberaggression and exposure to cyber victimization. Thus, developing mass media campaigns to enhance awareness about cyberbullying and cyber civility regulations is recommended.

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.

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.

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.

The Prediction Model of Body Image Distortion in Korean Adolescent in the Era of COVID-19 Using Decision Tree Analysis: Myeunghee Han; Res Community Public Health Nurs. 2023;34(2):96-107. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00052

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Abstract PDF: Purpose
Body image distortion (BID) in adolescents is a crucial problem that causes both abnormal eating habits and unhealthy weight control behaviors. COVID-19 has had a negative impact on adolescents’ psychological and behavioral status, and this might influence the onset of BID in adolescents. This study aimed to develop a prediction model for BID in Korean adolescents using decision tree analysis.
Methods
The decision tree analysis was used to develop a prediction model for BID in Korean adolescents using the data of 2021 Korea Youth Risk Behavior Survey Web-based (KYRBS).
Results
In the present study, about one-third of the study subjects (31%, n=6,316) showed BID. The BID rate was higher in females (37.2%, node1) than in males (21.2%, node2). Female students with severe GAD-7 level and smartphone use on the weekend over 12h showed the highest rate of BID (66.9%). As to males, the BID rate was the highest (33.1%) among middle school male students who did strength training once a week or none.
Conclusion
In order to reduce BID, there is a need to develop a customized BID education and management programs.

The Burden Experience of Family Caregiver of Older Adults with Chronic Illness: Nova Yustisia, Titin Aprilatutini, Tuti Anggriani Utama, Mahmasoni Masdar; Res Community Public Health Nurs. 2023;34(2):85-95. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00304

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Abstract PDF: Purpose
This study aims to find out further about the burden on families in undertaking caregiving for the elderly with chronic illnesses.
Methods
A qualitative study was developed using in-depth interviews with 12 family caregivers selected by purposive sampling in July 2022. The thematic analysis was then carried out using the Colaizzi method, and N-Vivo 12 Qualitative Data Analysis Software was used to assist with the content analysis.
Results
The result from the experience interview analysis of caregivers participating in this study were 54 codes which were categorized into thirteen categories. Then, they were derived into four themes, as follows: 1) Physical burden of the caregivers for the elderly with chronic illness, 2) Psychological burden of the caregivers for the elderly with chronic illness, 3) Obstacle of caregivers for the elderly with chronic illness, 4) The state of caregivers who perform caregiving for the elderly with chronic illness.
Conclusion
The experience of caregivers in undertaking caregiving for the elderly with chronic disease has many obstacles, such as physical, psychological, and economic burdens. Caregivers often find positive aspects of their experiences while caregiving for the elderly, although their burden also constantly increases. Health facilities should pay serious attention to family caregivers and facilitate programs that can help reduce the burden on family caregivers.

Corrigendum

Corrigendum: 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; Res Community Public Health Nurs. 2023;34(1):83-84. Published online March 31, 2023; DOI: https://doi.org/10.12799/jkachn.2022.33.4.372.e1

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