Differences in Factors Associated with Depressive Symptoms between Urban and Rural Female Adolescents in Korea

PURPOSE: To examine the prevalence of depressive symptoms and differentiate factors associated with them in urban and rural areas by applying the Ecological Models of Health Behavior. METHODS: We employed a cross-sectional design and convenience sample of 460 female adolescents. The instruments included the Adolescent Mental-Health Problem-Behavior Questionnaire (AMPQ-II) and the Beck Depression Inventory (BDI). RESULTS: Depressive symptoms were confirmed in 15.7% of urban adolescents and 22.9% of rural adolescents (p < .05). In the urban group, perception of health and stress associated with school performance were significantly associated with depressive symptoms. In the rural group, academic/internet related problems and rule violations were significantly associated with depressive symptoms (p < .05). General life happiness, worry/anxiety, and mood/suicidal ideation were common factors in both urban and rural areas (p < .05). CONCLUSION: Multiple factors were associated with depressive symptoms, and those significant factors differed between urban and rural female youths. Accordingly, tailored approaches are required considering urban and rural differences. The approaches should include intrapersonal, interpersonal, and organizational levels of interventions.

The Relationship between Work-life Conflict and Turnover Intention among Hospital Nurses based on Shift Work / 산업간호학회지

PURPOSE: This study analyzes the relationship between work-life conflict and turnover intention among hospital nurses. Furthermore, it seeks to determine whether the relationship between the two varies depending on the shift work condition of the nurses. METHODS: A total of 435 nurses working at five tertiary hospitals were included in the study. The questionnaire included items on turnover intentions, work-life conflicts, sociodemographic factors, working conditions, and internal and external resources. RESULTS: The level of work-life conflict among shift work nurses was higher than that of non-shift work nurses. The turnover intention was also higher for shift work nurses than for non-shift work nurses. Results from the multivariate logistic regression analysis revealed that the work-life conflict of nurses had a positive relationship with turnover intention. The effect of work-life conflict on turnover intention was greater for shift work nurses than for non-shift work nurses. CONCLUSION: Work-life conflict had a greater impact on the turnover intention of hospital nurses working under shift work conditions. Based on this study's findings, it can be suggested that, in order to reduce high turnover intention, it will be necessary to make specific efforts to balance work-life conflict and improve working conditions.

The Relationship between Work-life Conflict and Turnover Intention among Hospital Nurses based on Shift Work / 한국직업건강간호학회지

PURPOSE@#This study analyzes the relationship between work-life conflict and turnover intention among hospital nurses. Furthermore, it seeks to determine whether the relationship between the two varies depending on the shift work condition of the nurses.@*METHODS@#A total of 435 nurses working at five tertiary hospitals were included in the study. The questionnaire included items on turnover intentions, work-life conflicts, sociodemographic factors, working conditions, and internal and external resources.@*RESULTS@#The level of work-life conflict among shift work nurses was higher than that of non-shift work nurses. The turnover intention was also higher for shift work nurses than for non-shift work nurses. Results from the multivariate logistic regression analysis revealed that the work-life conflict of nurses had a positive relationship with turnover intention. The effect of work-life conflict on turnover intention was greater for shift work nurses than for non-shift work nurses.@*CONCLUSION@#Work-life conflict had a greater impact on the turnover intention of hospital nurses working under shift work conditions. Based on this study's findings, it can be suggested that, in order to reduce high turnover intention, it will be necessary to make specific efforts to balance work-life conflict and improve working conditions.

Transtheoretical Model Based Exercise Counseling Combined with Music Skipping Rope Exercise on Childhood Obesity

PURPOSE: The purpose was to evaluate the effects of a transtheoretical model (TTM) based exercise counseling offered with music skipping rope exercise on components of the TTM (stages of change, decisional balance, and self-efficacy), body mass index, glucose, and lipid profile of overweight/obese children in Korea. METHODS: This study used a nonequivalent pretest and posttest experimental study design. A total of 75 overweight/obese children participated in the study. Eight sessions of exercise counseling combined with music skipping rope exercise for 12 weeks were offered for children in the experimental group, while one session of exercise counseling with music skipping rope exercise for 12 weeks was offered for children in the control group. Outcomes were measured at baseline, and 6 months after the intervention. RESULTS: After the intervention, self-efficacy significantly improved among children in the experimental group (p = .049), while these children maintained their baseline BMI at 6-month follow-up (p > .05). Among children in the control group, BMI significantly increased (p < .05). Fasting blood sugar significantly increased for both groups after the intervention (p < .05). However, a greater increase was observed for the control group. CONCLUSIONS: Our study partially supports the hypothesis that a TTM-based exercise intervention is effective in maintaining BMI and improving self-efficacy of overweight/obese children. The TTM-based counseling combined with exercise classes has potential to control weight among overweight/obese children, while involvement of parents and children in the development of the theory-based intervention may generate further benefits regarding health and well-being of overweight/obese children.

Parent Involvement Intervention in Developing Weight Management Skills for both Parents and Overweight/Obese Children

PURPOSE: The purpose of the study was to evaluate a parent involvement intervention for childhood obesity intended to increase parents' skills in managing children's weight-related behavior and to improve child-parent relationships. Many studies reported on parental influence on childhood obesity, emphasizing parent involvement in prevention and management of childhood obesity. METHODS: A randomized controlled trial was conducted. Forty-two parents of overweight/obese children were recruited from four cities and randomized to the experimental group or control group. The parental intervention was provided only to parents in the experimental group and consisted of weekly news-letters and text messages for a period of 5 weeks. Exercise classes and nutrition education were provided to all children. Lifestyle Behaviour Checklist and the Child-Parent Relationship Scale (CPRS) were used for measurement of parent outcome. For the child outcome, dietary self-efficacy, exercise frequency, and body mass index were measured. A mixed-design analysis of variance was performed with city location entered as a random effect. RESULTS: After the intervention, CPRS of parents and dietary self-efficacy of children showed an increase in the experimental group (p < .05). Intervention effects differed significantly according to the city location regarding the control efficacy of parents and dietary self-efficacy of children (p < .05). CONCLUSIONS: The results support the effectiveness of the parent involvement intervention in promoting child-parent relationship and dietary self-efficacy of children. However, a 5-week parent involvement intervention was not sufficient to produce significant changes in children's body mass index. Further research is needed to investigate effects of parent involvement intervention with long-term evaluation.

Comparing the Needs of Case Management between Medical Aid Beneficiaries with Simple and Multiple Chronic Diseases / 재활간호학회지

PURPOSE: The purpose of this study was to compare the needs of case management between Medical aid beneficiaries with simple and multiple chronic diseases (SCD vs MCD). METHODS: The study employed secondary analysis method using a cross-sectional data from 2009 case management service enrollees. Data on 35,862 beneficiaries who have chronic disease(s) were used in the description of chronic disease characteristics, and data on 20,392 beneficiaries, excluding those who have depression and/or disabilities, were used to compare the group differences. RESULTS: Mean age was 68.8+/-11.63 years, and 73.3% were females. MCD group showed an older age, had more women than SCD group. Self-care ability and appropriateness of health care utilization were significantly different between the groups, but there was no difference in health-related quality of life. In subscales, there were significant differences in general health status, depression, symptom management, healthy lifestyle, hygiene and vaccination, and appropriateness of health utilization. CONCLUSION: Different characteristics between patients with simple and multiple chronic diseases indicate that different case management approaches are required for these groups. The study results could be used as a basis for the development of case management model tailored to the characteristics and needs of medical-aid beneficiaries.

Factors associated with Patient Activation for Self-management among Community Residents with Osteoarthritis in Korea

PURPOSE: The purpose of this study was to survey patient activation for self-management and to identify factors associated with patient activation for self-management among community residents with osteoarthritis in Korea. METHODS: Cross-sectional study design was used. Survey data were collected from 270 community residents with osteoarthritis through direct interviews. Studied factors included patient activation, joint pain, physical function, depression, and general characteristics. Data were analyzed using chi-squared test, t-test and multivariate logistic regression analysis. RESULTS: The participants' mean score of patient activation was 56.0+/-16.61. The mean score of each factor was 10.6+/-5.89 for joint pain, 5.5+/-3.56 for physical function, and 19.3+/-10.01 for depression. The patient activation level was significantly associated with depression and general characteristics such as education, religion, comorbid hypertension, and use of medical clinics (p<.05). CONCLUSION: The findings suggest that depression, education, religion, comorbid hypertension, and use of medical clinics may be important factors to be considered when developing programs of patient activation for self-management. This is the first study that measured patient activation, and further studies are suggested to find factors associated with patient activation for self-management among community residents with other chronic diseases.

Factors associated with Self-Rated Health in Metabolic Syndrome and Relationship between Sleep Duration and Metabolic Syndrome Risk Factors

PURPOSE: Purpose was to explore associations between sleep duration and metabolic syndrome (MS) risks, and to determine factors associated with self-rated health (SRH) of adults with MS compared to other adults. METHODS: This is a secondary data analysis based on the Fifth Korea National Health and Nutrition Examination Survey KNHANES V (N=12662). Study instruments included sleep duration, MS risk factors, SRH and health-related quality of life (HRQoL). RESULTS: Mean age of participants was 43.68+/-12.26 years. Fifty-eight percent were women, and 18.3% were identified as having MS. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and SRH were significantly different according to sleep duration (p<.05) among all participants. In the non MS group, male gender, younger age (19~30 and 41~50 age brackets) upper income level, sufficient sleep duration, and high density lipoprotein (HDL) were positively associated with SRH, whereas, lower education levels (< or = middle school), glucose level, and waist circumference were negatively associated with SRH (p<.05). In the MS group, lower income, lower education levels (< or = middle school), glucose level, and waist circumference were negatively associated with SRH, whereas, having an occupation was positively associated with SRH (p<.05). CONCLUSION: Results suggest that tailored approaches are required for prevention and control of MS and sleep duration of each individual should be considered rather than applying standardized guidelines. However, as sleep quality was not included in the analysis, further investigations regarding influence of sleep quality on MS and SRH and controlling for other lifestyle and health behavior factors are required.

Factors Affecting Underweight and Obesity Among Elementary School Children in South Korea

PURPOSE: The purpose of the study was to determine factors associated with underweight and obesity in elementary school children in Korea. METHODS: Study participants included 4,895 children attending 59 elementary schools across Korea. Children were grouped into underweight [ or = 85% BMI-for age). The questionnaire included demographic characteristics, health status, and diet and exercise behavior of children, and environmental characteristics of schools. RESULTS: Twelve percent of the children were overweight or obese. The results showed that demographic (age and gender), health status (atopic dermatitis and poor subjective health), and the characteristics of diet and exercise (unbalanced diet and diet experiences) were associated with underweight (p < .05), while demographic (age and gender), health status (poor subjective health), behavioral characteristics (fast food consumption and diet experiences), and school environmental characteristics (rural area) were associated with overweight/obesity (p < .05). CONCLUSIONS: Programs and interventions to reduce underweight and overweight/obesity in Korean elementary schools must consider behavioral and environmental characteristics of children.

The Effect of the Experience of Diabetes Education on Knowledge, Self-Care Behavior and Glycosylated Hemoglobin in Type 2 Diabetic Patients / 한국간호교육학회지

PURPOSE: This study was to identify the effect of the experience of diabetes education on knowledge, self-care behavior and glycosylated hemoglobin (HbA1C). Further, this study was held to examine about patient's preferred methods of education and re-education frequency. METHODS: 166 type 2 diabetes patients from two hospitals in Incheon participated in this study. Data were analyzed by using descriptive analysis, t-test, ANOVA, Scheffe's test and multiple regression analysis. RESULTS: 72.3% patients needed re-education and the average interval of re-education was 8.53 months. Patients preferred education methods were lectures, practical training, and studying from pamphlet. Depending on the frequency of diabetes education, there were significant differences in the level of diabetes knowledge (F=10.88, p<.001) and self-care behaviors (F=4.59, p=.012), but there was not significant difference with HbA1C (F=1.53, p=.220). As to how much the diabetes education helped managing diabetes, there was a significant difference in the level of self-care behaviors (t=2.01, p=.049), but there were not significant differences in level of knowledge (t=1.10, p=.275) and HbA1C (t=-.33, p=.746). The experience of diabetes education was a significant factor which influenced patient's knowledge (t=3.93, p<.001) and self-care behaviors (t=2.21, p<.001). But HbA1C was not influenced by the experience of diabetes education (t=-1.68, p=.096). CONCLUSION: It is necessary to provide diabetes education with appropriate interval and methods and subjects that reflect the needs of patient through the study results.

Validation of a Needs Assessment Tool for Case Management in Korean Medical Aid Beneficiaries

PURPOSE: The purpose of this study was to validate the Needs Assessment Tool for Case Management (NATCM) for use with Korean medical aid beneficiaries. METHODS: Psychometric testing was performed with a sample of 645 Korean medical aid beneficiaries, which included 41 beneficiaries who were selected using proportional sampling method, to examine intraclass correlation coefficients (ICC). Data were evaluated using item analyses, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach's alpha, and ICC. RESULTS: Through psychometric testing the final version of NATCM was found to consist of two subscales: 1) Appropriateness of Health Care Utilization (5 items) and 2) Self Care Ability (6 items). The two subscale model was validated by CFA (RMSEA=.08, GFI=.97, and CFI=.93). Internal consistency measured by Cronbach's alpha was .82, and subscale reliability ranged from .79 to .84. The ICC of the NATCM between case managers was .73 and between case managers and health care professionals. .82. CONCLUSION: This study suggests that the final version of NATCM is a brief, reliable, and valid instrument to measure needs of Korean medical aid beneficiaries. Therefore, the NATCM can be effectively utilized as an important needs assessment as well as outcome evaluation tool for case management programs in Korea.

Multilevel Analysis of Health Care Service Utilization among Medical Aid Beneficiaries in Korea

PURPOSE: The current study was done to identify individual- and group-level factors associated with health care service utilization among Korean medical aid beneficiaries by applying multilevel modeling. METHODS: Secondary data analysis was performed using data on health care service reimbursement and medical aid case management progress from 15,948 beneficiaries, and data from 229 regions were included in the analysis. RESULTS: Results of multilevel analysis showed an estimated intraclass correlation coefficient (ICC) of 18.1%, indicating that the group level accounted for 18.1% of the total variance in health care service utilization, and that beneficiaries within the region are more likely to share common features with regard to health care service utilization. At the individual level, existence of disability and types of medical aid beneficiaries showed a significant association, while, at the group level, social deprivation index, and the number of beneficiaries and case managers within the region showed a significant association with health care service utilization. CONCLUSION: The significant influence of group level variables in health care service utilization found in this study indicate a need for group level approaches, such as policy change and/or promotion of community awareness.

Factors Influencing Compliance with Standard Precautions in Intensive Care Unit and Emergency Room Nurses / 기본간호학회지

PURPOSE: The purpose of this study was to investigate the level of knowledge, attitude and compliance with standard precautions and to identify predicting factors of compliance with standard precautions in ICU and ER nurses. METHODS: The participants were 228 ICU and ER nurses working in one of three university hospitals and one general hospital. Collected data included general characteristics, features related to infection risk, and knowledge, attitude and compliance with standard precautions. For the final analysis, 218 questionnaires were used. RESULTS: Within the previous one year, 103 (47.3%) nurses experienced pricking injury from syringe needles or other sharp materials, 111 (50.9%) nurses reported exposure to patients' blood and body fluid. In general, the scores for knowledge, attitude and compliance were all high. Compliance scores for nurses in intensive care units were significantly higher than those of nurses in emergency. There were significant correlations of knowledge, attitude, and compliance with standard precautions. Attitude and work place were significant factors predicting compliance with standard precautions. CONCLUSION: The results indicate that to increase nurse's compliance with standard precautions, continuous efforts to enhance positive attitudes and at the same time, improve work environments and use individualized approaches based on the work units are needed.

Gender Differences in Factors Influencing Quality of Life among Patients with Coronary Artery Disease / 기본간호학회지

PURPOSE: The purpose of this study was to identify the level of quality of life and gender differences in predictors of quality of life among patients with coronary artery disease. METHODS: Participants for this descriptive survey were 67 men and 65 women who signed informed consents. They were patients who had undergone coronary artery bypass graft surgery or percutaneous transluminal coronary angioplasty, or were on medication therapy after a heart attack. The Short-Form Health Survey (SF-36), Personal Resource Questionnaire-part (II), and the Center for Epidemiologic Studies Depression Scale were used to measure quality of life, social support, and depression respectively. Gender and age were controlled because they were reported as influencing factors in previous studies. RESULTS: There were significant differences in depression and quality of life between men and women however, social support was not significantly different by gender. In multiple regression analysis, depression was a significant predictor and explained 51.9% of quality of life for men. In women, depression and social support were significant predictors and explained 50.9% of quality of life. CONCLUSION: Factors influencing quality of life for men and women were different, and therefore, nurses need to consider their patients' gender and use specific strategies to improve quality of life for patients with coronary artery disease.

Factors Related to Fall in Elderly Patients with Osteoporosis / 성인간호학회지

PURPOSE: The purpose of this study was to identify risk factors of fall and to examine its results among patients aged 60 and over diagnosed with osteoporosis. METHODS: A retrospective descriptive survey was conducted with 91 patients admitted in a university hospital in a city. Data were collected using an interview method with a structured questionnaire, and were analyzed using descriptive statistics and multiple logistic regression. RESULTS: In patients with osteoporosis, the intrinsic risk factors of falls were aging (OR = 3.742), gait disturbance (OR = 12.565), taking one or fewer medicine (OR = 7.873), and having two or more diseases (OR = 5.173). The extrinsic risk factors included the use of a bed (OR = 3.093), slippery floors (OR = 12.130), bathroom mat without anti-slip rubber backing (OR = 3.564), and presence of a night light on the passage from the bedroom to the bathroom (OR = 2.980). CONCLUSION: For the elderly aged over 70 who are most vulnerable to falls, screening tests such as bone mineral density (BMD) should be conducted in health examinations and the risk of fracture caused by osteoporosis should be communicated to the vulnerable elderly. Besides, development of new exercise programs combining weightbearing exercise is needed to prevent bone loss and increase functional activities.

A Exploratory Study on the Personality Type, Problematic Drinking Pattern, and Stress Coping Style of the Nasal Bone Fracture Patients Due to Violence / 성인간호학회지

PURPOSE: This study was conducted to identify the personality type, problematic drinking pattern, and stress coping style of the nasal bone fracture patients by comparing those with general fracture patients. METHODS: 50 nasal bone fracture patients due to violence and 50 general fracture patients due to simple trauma, such as fall and traffic accident were conveniently selected. RESULTS: The study results showed that nasal bone fracture patients due to violence significantly presented higher level of A type personality and more problematic drinking pattern than general fracture patients due to simple trauma. Stress coping style, however, did not show significant difference between two groups. CONCLUSION: In order to prepare prevention strategies for basal bone fracture in the future, health education alter problematic drinking habit to sound drinking pattern may be offered and provided nursing interventions tailored to A type personality.

The Impact of Different Endotracheal Suction Methods on Respiratory Function: Normal Saline with Chest Vibration vs Normal Saline with Expectorant Mixture / 성인간호학회지

PURPOSE: Regarding the respiratory function of patients with an artificial airway, this study compared the effects between normal saline with chest vibration and normal saline with expectorant mixture, administered before endotracheal suction. METHODS: The study was conducted in the ICUs of one university hospital located in Incheon. The experimental group I received normal saline with chest vibration administered before endotracheal suction while the experimental group II received normal saline with expectorant mixture administered before endotracheal suction. For respiratory function, PaO2, PaCO2, and O2 saturation were measured by ABGA at 3 minutes after endotracheal suction for both pre-test and post-test. RESULTS: The two groups were not different significantly regarding PaO2 level and O2 saturation after the treatments, while, the experimental group II had lower PaCO2 level than the experimental group I after the treatments (t = 2.075, p = .042). For experimental group II, post-test score of PaCO2 level was significantly lower than that of the pre-test score (t = 1.842, p = .075). CONCLUSION: The administration of normal saline with expectorant mixture before endotracheal suction reduced PaCO2 level and improved the respiratory function.

The Impact of Different Endotracheal Suction Methods on Respiratory Function: Normal Saline with Chest Vibration vs Normal Saline with Expectorant Mixture / 성인간호학회지

PURPOSE: Regarding the respiratory function of patients with an artificial airway, this study compared the effects between normal saline with chest vibration and normal saline with expectorant mixture, administered before endotracheal suction. METHODS: The study was conducted in the ICUs of one university hospital located in Incheon. The experimental group I received normal saline with chest vibration administered before endotracheal suction while the experimental group II received normal saline with expectorant mixture administered before endotracheal suction. For respiratory function, PaO2, PaCO2, and O2 saturation were measured by ABGA at 3 minutes after endotracheal suction for both pre-test and post-test. RESULTS: The two groups were not different significantly regarding PaO2 level and O2 saturation after the treatments, while, the experimental group II had lower PaCO2 level than the experimental group I after the treatments (t = 2.075, p = .042). For experimental group II, post-test score of PaCO2 level was significantly lower than that of the pre-test score (t = 1.842, p = .075). CONCLUSION: The administration of normal saline with expectorant mixture before endotracheal suction reduced PaCO2 level and improved the respiratory function.

Stages and Processes of Smoking Cessation among High School Students in Rural Community

PURPOSE: The purpose of this study was to describe stage distribution of current and former smokers and to analyze significant variables that used by adolescents at each stage using the Transtheoretical Model. METHODS: A cross-sectional study was performed with 145 students attended to five high schools in one rural area. The survey instruments included stages and processes of change, decisional balance, self-efficacy, and knowledge related to smoking. RESULTS: Among the participants, 47.6% were in the precontemplation and contemplation stages, 20.7% were in the preparation stage, and the other 31.7% were in the action and maintenance stages. Analysis of variance tests revealed that behavioral processes, pros and cons of smoking, and self-efficacy were significantly associated with the stages of smoking cessation, while among 10 processes of change, self-reevaluation, self-liberation, and reinforcement management were significantly different by the stages. CONCLUSIONS: The study results suggest that smoking cessation programs should emphasize behavioral strategies, self-efficacy, and decisional balance to help students adopt and maintain smoking cessation

An Analysis of Trends in Exercise-Related Studies in Nursing and Non-Nursing Fields in Korea / 기본간호학회지

PURPOSE: This study was done to analyze the trends in excercise-related research in nursing and non nursing research studies published in Korea. METHOD: Two hundred and ten research studies published in Korea between January, 1990 and December, 2002 were analyzed according to the criteria of methological characteristics, pattern of excercise-related program, and measurement index of exercise effect. RESULTS: There were twice many papers from nursing compared to other fields, and many experimental studies in nursing were done with more variety than in non nursing fields. Aspects of exercise pattern, such as excercise type, duration, and frequency, exercise-intervention pattern, and applying theory were especially included. When patterns of excercise therapy and index of exercise effect were analyzed, each researcher used their own unique excercise contents and intervention patterns(excercise time per week, exercise duration at each time period, excercise, intervention time, and etc). CONCLUSION: For the importance of exercise therapy to health improvement and the proper suggestion of exercise therapy on the basis of this research, meta-analysis of exercise effect are needed, and with this analysis, intervention patterns of exercise, development of standard exercise therapy, and identification of exercise effects are required.