Public Health Center Service Experiences and Needs among Immigrant Women in South Korea

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.

Influencing Factors on Health-related Quality of Life among Japanese Middle-aged Marriage-based Immigrant Women in South Korea: A Cross-Sectional Study

Purpose@#With the first generation of marriage-based immigrant women in East Asia now reaching their middle or old age, the need to focus investigations on their health-related quality of life has arisen. This study aimed to examine the extent to which physical and mental health, and psychosocial variables can predict health-related quality of life among Japanese middle-aged immigrant women. @*Methods@#This study has a descriptive cross-sectional design. A convenience sample of 197 Japanese middle-aged marriage-based immigrant women from two regions of South Korea were recruited between December 2017 and March 2018. Participants completed self-administered questionnaires on health-related quality of life, menopausal symptoms, depression, perceived health status, disease morbidity, social support, and acculturation. The data were analyzed using hierarchical multiple regression. @*Results@#Depression was the strongest predictor of health-related quality of life, followed by perceived health status, social support, and household income. Menopausal symptoms, presence of disease, and acculturation appeared to have no additional impact on participant’s health-related quality of life. @*Conclusion@#In times of rapid growth of global migration and the aging of immigrants in new destination countries, nursing interventions and public health policies for aging marriage-based immigrant women should be prioritized to improve their mental health by facilitating social support and disease management. In addition, social and employment policies that can help immigrant women transition to a healthy midlife are needed.

Comparison of the Effects of an App-based and Poster-based Self-managed Workplace Stretching Program on Musculoskeletal Symptoms of Workers in Small Manufacturing Businesses / 한국직업건강간호학회지

Purpose@#This study aimed to compare the effects of an 8 week, self-managed, app-based and poster-based stretching program on musculoskeletal symptoms, flexibility, stretching frequency, self-efficacy, social support, and musculoskeletal disorder knowledge in small manufacturing business workers. @*Methods@#This was a cluster randomized, two-group pretest-posttest design. Workers were assigned to either an app-based (n=20) or a posterbased (n=25) stretching intervention. Both groups received an educational class. The app group also received mobile phone text messages and an app with stretching videos, stretching alarms, stretching records, and information on musculoskeletal disorders. The poster group received workplace stretching posters. Data were collected from April to September 2018 and analyzed with the χ2 test, paired t-test, and independent t-test. @*Results@#There was only a significant difference in social support. Significant increase in flexibility and musculoskeletal symptoms were noted for both groups, but social support and musculoskeletal disorder knowledge were significantly changed only in the poster group. More than half of the workers practiced stretching at least 3 times a week. @*Conclusion@#The 8 week, self-managed, workplace stretching program was effective to increase flexibility and stretching frequency to at least 3 times a week. However, effective interventions for musculoskeletal symptoms could not be identified.

Agreement on Core Components of an E-Learning Cultural Competence Program for Public Health Workers in South Korea: A Delphi Study

PURPOSE: This study aimed to seek agreement on the core components of an e-learning cultural competence program for Korean public health workers (PHWs) while prioritizing educational content areas. METHODS: A two-round Delphi study was performed with 16 Korean experts from five disciplines. Data were collected between August 30 and November 24, 2017. A questionnaire was developed from literature reviews and previous focus group interviews concerning PHWs. The panel members were asked to rate the importance and urgency of educational content areas and the effectiveness of teaching–learning methods and gave opinions on their appropriate frequency, duration, and target audience. Responses were analyzed using descriptive statistics. A median of 4.0 or greater or a rate of agreement of 75% or greater was considered a “consensus” for the purposes of this study. RESULTS: All consenting participants responded to two-round surveys. Participants reached consensus on thirty-one educational content areas. Of these, the highest priorities were “necessity of cultural competence of PHWs,” “health characteristics according to race and ethnicity,” and “establishing trusting relationships with migrants.” The most effective teaching–learning method was case-based learning, with seven to eight sessions of training and duration of fewer than 30 minutes per session. CONCLUSION: Multidisciplinary experts proposed 12 prioritized educational content areas and effective teaching–learning methods as well as their frequency, duration, and target audiences, reflecting Korea-specific multicultural phenomena and the nature of the work of PHWs. These findings can contribute to preparing PHWs to provide culturally competent services to migrants in their communities.

Development and Cross-Validation of the Short Form of the Cultural Competence Scale for Nurses

PURPOSE: To develop and validate the short form of the Korean adaptation of the Cultural Competence Scale for Nurses. METHODS: To shorten the 33-item Cultural Competence Scale for Nurses, an expert panel (N = 6) evaluated its content validity. The revised items were pilot tested using a sample of nine nurses, and clarity was assessed through cognitive interviews with respondents. The original instrument was shortened and validated through item analysis, exploratory factor analysis, convergent validity, and reliability using data from 277 hospital nurses. The 14-item final version was cross-validated through confirmatory factor analysis, convergent validity, discriminant validity, known-group comparisons, and reliability using data from 365 nurses belonging to 19 hospitals. RESULTS: A 4-factor, 14-item model demonstrated satisfactory fit with significant factor loadings. The convergent validity between the developed tool and transcultural self-efficacy was significant (r = .55, p < .001). The convergent validity evaluated using the Average Variance Extracted and discriminant validity were acceptable. Known-group comparisons revealed significant differences in the mean scores of the groups who spent more than one month abroad (p = .002) were able to communicate in a foreign language (p < .001) and had education to care for foreign patients (p = .039). Cronbach's a was .89, and the reliability of the subscales ranged from .74 to .91. CONCLUSIONS: The Cultural Competence Scale for Nurses-Short Form demonstrated good reliability and validity. It is a short and appropriate instrument for use in clinical and research settings to assess nurses' cultural competence.

Factors Affecting the Social Distance between Minority Groups and Nursing Cadets / 간호행정학회지

PURPOSE: The purpose of this study was to identify factors affecting the social distance between minority groups and nursing cadets. METHODS: A cross-sectional survey design was used. A questionnaire was distributed to the entire Armed Forces Nursing Academy cadets. Data from 273 nursing cadets were analyzed using t-test, ANOVA, Pearson correlation coefficients and Stepwise multiple regression. RESULTS: Social distance had positive correlations with collective identity (r=.28) and multiculturalism (r=.37). A negative correlation was found between social distance and perceived threat (r=-.38). Perceived threat, multiculturalism, collective identity, and frequency of contact with minorities were identified as factors affecting the social distance. The model explained 24% of the variables. CONCLUSION: To effectively respond to the minority groups' nursing needs in the army, educational programs which help to reduce the perceived threat, to strengthen multiculturalism, and to establish a healthy collective identity of nursing cadets need to be developed.

Experiences of Middle-aged Korean-Chinese Female Migrant Workers in Korea: With Focus on Risk Factors in Work-related Musculoskeletal Diseases

PURPOSE: This study was to explore situations that might put the middle-aged Korean-Chinese female migrant workers at risk for work-related musculoskeletal diseases (WMSDs). At the development phase of a continuing health project, the study aimed to clarify health promotion program needs of the migrant population. METHODS: A qualitative description research design was used with three focus groups of 23 Korean-Chinese female migrant workers. Each focus group interview was conducted for 70-minutes using semi-structured interview guidelines. The data were analyzed using directed qualitative content analysis techniques. RESULTS: The majority of the participants were household workers and their work included heavy material handling, standing for a long time, and working in awkward postures. They experienced discrimination from employers, lack of control at work, limitations in open-communication, job insecurity, and acculturation. They had needs to have health promotion programs for preventing and managing chronic diseases, depression and menopause as well as WMSDs. CONCLUSION: The participants were situated in work environments with physical demanding tasks, acculturative and job-related stress and lack of opportunities to participate in health promotion programs. It is suggested to develop a comprehensive program to better meet the needs of middle-aged Korean-Chinese female migrant workers rather than targeting the reduction of WMSDs.