Research in Community and Public Health Nursing

Most-download articles are from the articles published in 2021 during the last three month.

Original Articles

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.

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.

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.

School Nurses’ Perception of Job Performance Difficulties, Job Stress, Job Identity and Job Satisfaction: Eun Kyo Cho, Hyun Jung Moon; Res Community Public Health Nurs. 2023;34(1):43-51. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00010

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Abstract PDF: Purpose
To examine school nurses' perception of job performance difficulties, stress, identity, and satisfaction, and to identify the factors that affect job satisfaction. Methods: Data were collected through online survey questionnaires distributed to 189 regular school nurses working in Metropolitan I. The self-report questionnaire consisted of three instruments and demographic questions. The data were collected from June 29 to July 31, 2020, and analyzed using frequency, percentage, mean and standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression statistical techniques. Results: Perception of job performance difficulties showed a significant positive correlation with job stress (r=.20. p=.007), job identity (r=-.55, p<.001) and job satisfaction (r=-.39, p<.001), and each showed a negative correlation. Job stress showed a negative correlation with job satisfaction (r=-.65, p<.001), and job satisfaction and job identity showed a positive correlation (r=.53, p<.001). Job stress (β=-.58, p<.001), job identity (β=.43, p<.001), school-level elementary school (β=.19, p<.001), and middle school (β=.13, p=.011) were found to have a significant effect on job satisfaction. Conclusion: As job stress, job identity, and school level are important factors influencing job satisfaction, interventions are needed to lower the job stress of school nurses and strengthen their job identity. In addition, since the job satisfaction of school nurses can have a great impact on the health and happiness of students as well as the quality of life of future generations, it is necessary to improve policies and systems to increase the job satisfaction of school nurses.

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.

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.

The Effects of Self-efficacy and Self-stigma on Self-care in People with Diabetes: Ka Woun Seo; J Korean Acad Community Health Nurs. 2021;32(1):86-94. Published online March 31, 2021; DOI: https://doi.org/10.12799/jkachn.2021.32.1.86

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4 Citations

Abstract PDF

Purpose
This descriptive study investigated the effects of self-efficacy and self-stigma on self-care in people with diabetes. Methods: The study included a total of 377 patients with diabetes enrolled in university hospitals in D city and public health centers in S city. Data were collected from 1 July to 31 August, 2017, and were analyzed using descriptive statistics, t-test, analysis of variance, Pearson’s correlation coefficient, and hierarchical multiple regression. Results: Diabetes self-care was positively correlated with diabetes self-efficacy, whereas it was negatively correlated with diabetes self-stigma. Participants’ education level, marital status, perceived health status, type of medication, self-efficacy, and self-stigma explained 42.4% of the variance in diabetes self-care. Conclusion: The findings indicate that diabetes self-efficacy and self-stigma are important factors for improving self-care in patients with diabetes. Therefore, systematic programs for enhancing self-efficacy and reducing self-stigma of these individuals should be developed.

Citations

Citations to this article as recorded by

“Shame on Me”: Exploring the Role of Self-Stigma in Psychological Outcomes Among Type 2 Diabetes Patients in Hong Kong
Nelson C. Y. Yeung, Eric Kam Pui Lee, Alice Pik Shan Kong, Maria Kwan Wa Leung
International Journal of Behavioral Medicine.2023;[Epub] CrossRef
Type 2 diabetes stigma and its association with clinical, psychological, and behavioral outcomes: A systematic review and meta-analysis
Samuel Akyirem, Emmanuel Ekpor, Diana Namumbejja Abwoye, Janene Batten, LaRon E. Nelson
Diabetes Research and Clinical Practice.2023; 202: 110774. CrossRef
Stigma perception and determinants among patients with type 2 diabetes mellitus in Iraq
Taqi M. J. Taher, Hussein A. Ahmed, Ali A. Abutiheen, Shaymaa A. Alfadhul, Hasanain F. Ghazi
Journal of the Egyptian Public Health Association.2023;[Epub] CrossRef
The Mediating Effect of Acceptance Action in the Relationship between Diabetes Distress and Self-stigma among Old Adults with Diabetes in South Korea
Hyesun Kim, Kawoun Seo
Journal of Korean Academy of Community Health Nursing.2022; 33(4): 446. CrossRef

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.

A Path Analysis for Health-related Quality of Life in Long-term Care Insurance In-home Service Users: Je Hyun Kim, Seung Mi Park; Res Community Public Health Nurs. 2023;34(1):1-11. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00283

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Abstract PDF: Purpose
The purpose of this study is to construct and verify a path model for the factors affecting on quality of life in long-term care insurance in-home service users.
Methods
Total 246 participants using long-term care insurance in-home service were recruited from long-term care agencies. Data collection was conducted using a structured questionnaire from March 1st to March 31st 2021. The collected data were analyzed using SPSS 26 and AMOS 26 programs.
Results
The hypothetical path model was suitable for explaining the health-related quality of life in long-term care insurance in-home service users and has an explanatory power of 39.8%. Long-term care grade, depression, perceived health status, social support, age and living arrangement had a significant total effect on the quality of life in long-term care insurance in-home service users.
Conclusion
Long-term care insurance in-home service policies need to be expanded, such as screening and relieving depression, strengthening social support, and fostering a positive perception of health to improve the quality of life of the elderly.

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

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 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.

The Effects of Non-pharmacological Interventions on Sleep among Older Adults in Korean Long-term Care Facilities: A Systematic Review and Meta-analysis: Sun Ok Jung, Hye Young Kim, Eun Ju Choi; J Korean Acad Community Health Nurs. 2022;33(3):340-355. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.340

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Abstract PDF: Purpose
This study aimed to examine the effects of non-pharmacological sleep intervention programs in improving sleep quality among older adults in long-term care facilities. Methods: A literature search and selection was performed on nine different databases using the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Overall, 14 studies met the inclusion criteria and were systematically reviewed. For the metaanalysis, the effect size was estimated using the random-effects model in Review Manager (RevMan) desktop version 5.4 of the Cochrane Library. Results: The meta-analysis of overall non-pharmacological interventions obtained a total effect size of 1.0 (standardized mean difference [SMD]=1.0, 95% confidence interval [CI]: 0.64~1.35), which was statistically significant (Z=5.55, p<.001). The most frequently studied non-pharmacological intervention was aroma therapy, with an effect size of 0.61 (SMD=0.61, 95% CI: 0.14~1.08), which was statistically significant (Z=2.55, p=.010). In the subgroup analysis, group-based interventions, interventions for >4 weeks, and untreated control studies were more effective. Conclusion: This study confirms that non-pharmacological interventions are effective in improving sleep quality among older adults in long-term care facilities. However, the sample size was small and the risk of bias in assessing the interventions of individual studies was unclear or high, thereby limiting the generalizability of the results. Further reviews that evaluate randomized control trials, evidence-based interventions that consider older adult participants' physical activity levels, different intervention methods and durations, and different control group intervention types are needed to obtain more conclusive evidence.

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.

Development and Effects of a Community-Based Death Education Program for Older Adults: Sook Nam Kim, So Young Kim; J Korean Acad Community Health Nurs. 2021;32(4):445-456. Published online December 31, 2021; DOI: https://doi.org/10.12799/jkachn.2021.32.4.445

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Abstract PDF: Purpose
This study was conducted to investigate the effects of a community-based death education program for older adults.
Methods
The study was conducted as a quasi-experimental study with a non-equivalent control group and pretest-posttest design. The subjects were community elders aged over 65 registered at a community health center and were convenience sampled. The experimental group consisted of 33 participants and the control group consisted of 32 participants. Experiments are conducted from June 18 to July 24, 2020. We tested our hypothesis using an independent t-test, and paired t-test.
Results
The experimental group had significantly higher scores for psychological well-being than the control group after treatment (t=2.24, p=.028). In general attitude toward the use of life-sustaining technology, however, only the experimental group had a significant difference before and after the experiment with lower scores compared to the control group (t=-5.41, p<.001).
Conclusion
We found that the community-based death education program developed in this study was partially effective in improving older adults’ psychological well-being and general attitude toward the use of life-sustaining technology.

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