Contract Employment Experiences of Visiting Nurses at Public Health Centers in the Metropolitan Area: Focused on Employment Type and Treatment

Purpose@#This study was conducted with a focus group interview that drew out experiences, limitations, and difficulties in the workplace according to the employment conditions of visiting nurses in the public health centers. @*Methods@#A total of 12 visiting nurses are those working in the public sector in Seoul and Gyeonggi province who were willing to participate in the interview. Analysis categories and coding were divided into three categories: compensation system, occupational status, and opinions to improve their treatment. Using the content analysis method, the current working status and compensation system of visiting nurses were described. @*Results@#The main themes derived from the significant statements of visiting nurses were ‘Ten years of frozen salary system’, ‘Full-time workers of their own league’, ‘Excluded from performance benefits’, ‘Every visiting nurses are virtually precarious’, ‘Experience of exclusion and discrimination’, and ‘Reasons and barriers to be a full-time worker’. All of the visiting nurses working in the community insisted on having equal treatment for work of equal value. Visiting nurses in the public health sector wanted to be set to the same payment system and the fair allowance system as well. It is necessary to continuously seek solutions to the problems left in insisting on the civil service of visiting nurses. @*Conclusion@#Visiting nurses who were working in a precarious job position felt job insecurity, and experienced discrimination, alienation, and exclusion. Legal and institutional reform is needed to improve the treatment of visiting nurses.

A Delphi Study for Development of Disaster Nursing Education Contents in Community Health Nursing

Purpose@#This study was conducted to develop the contents of disaster nursing education in community health nursing at universities. @*Methods@#To validate contents, the Delphi method was used. We categorized two domains(indirect disaster management and direct disaster management) and developed 48 draft items. This study applied two round surveys and 23 experts participated in this study. The content validity was calculated using content validity ratio and coefficient of variation. @*Results@#Indirect disaster management domain was composed of three categories including 12 items: 1) Understanding of the disaster, 2) disaster management system, and 3) response by disaster stage and recovery. Direct disaster management domain was composed of nine categories including 30 items: 1) Ethical considerations, 2) communication in disasters, 3) nursing activity by disaster stage, 4) emergency nursing in disasters, 5) patient severity classification in disasters, 6) disaster nursing for vulnerable groups, 7) disaster nursing for victims, 8) psychosocial nursing and health in disasters, and 9) cases of disaster nursing in communities. @*Conclusion@#This Delphi study identified the contents of disaster nursing education curriculum, and confirmed the validity for disaster education program in community health nursing. Based on the results, it will be helpful for training the disaster nursing and improving the competency on disaster nursing of the nursing students.

The Relationship between the Prevalence of Suicidal Ideation among Older Adults and Individual · Regional Factors

Purpose@#The purpose of this study was to find out the suicidal ideation rate of the elderly including individual and regional factors by sex. @*Methods@#This is secondary analysis study that combines the data of the 2017 Community Health Survey with the e-indicator data set of the National Statistical Office, and a descriptive correlation study. Statistical analysis used hierarchical logistic regression by SAS 9.4. @*Results@#The 11.5% of the elderly had suicidal ideation within the last year, and 18.4% in Chungnam is the highest. Individual characteristics include females, older people, lower education levels, no job or housewife, no spouse, less than seven hours of sleep per day on the average, low subjective health, high subjective stress, and the worse their economic conditions, the more they had suicide ideation.Considering regional characteristics, suicidal ideation tended to increase significantly as the number of hospital beds per 1,000 people and the rate of obesity was lower, the rate of stress perception was higher, and the odds value was small. When both individual and regional factors were considered, the model conformity of the suicidal ideation improved (ICC=0.0814). @*Conclusion@#In order to lower the suicidal rate of the elderly, it seems that both individual and community factors need to be comprehensively approached from the stage of suicidal ideation in the community.

The Relationship between the Prevalence of Suicidal Ideation among Older Adults and Individual · Regional Factors

Purpose@#The purpose of this study was to find out the suicidal ideation rate of the elderly including individual and regional factors by sex. @*Methods@#This is secondary analysis study that combines the data of the 2017 Community Health Survey with the e-indicator data set of the National Statistical Office, and a descriptive correlation study. Statistical analysis used hierarchical logistic regression by SAS 9.4. @*Results@#The 11.5% of the elderly had suicidal ideation within the last year, and 18.4% in Chungnam is the highest. Individual characteristics include females, older people, lower education levels, no job or housewife, no spouse, less than seven hours of sleep per day on the average, low subjective health, high subjective stress, and the worse their economic conditions, the more they had suicide ideation.Considering regional characteristics, suicidal ideation tended to increase significantly as the number of hospital beds per 1,000 people and the rate of obesity was lower, the rate of stress perception was higher, and the odds value was small. When both individual and regional factors were considered, the model conformity of the suicidal ideation improved (ICC=0.0814). @*Conclusion@#In order to lower the suicidal rate of the elderly, it seems that both individual and community factors need to be comprehensively approached from the stage of suicidal ideation in the community.

The Follow-up Study of Changes in Frailty in Elderly Receiving Home Health Care of the Public Health Center

PURPOSE: The purpose of this study was to follow-up the frailty of the old who received home health care by Registered Nurse in Public Health Center over 8 years.METHODS: We used the second wave data which was a comprehensive longitudinal data set, Public Health Information System of a public health center located in Seoul from 2010 to 2018. For statistical analysis, a mixed model of repeated measures by R program was used.RESULTS: Frailty (range: 0~31) was getting worse significantly from 5.38 on registration to 6.54 on 4th year, 7.40 on 7th year, 7.69 on 8th year with adjustment for age, sex, economic status, the number of family, and the number diseases. The coefficient of parameters with frailty change was serviced year (β=0.29, p < .001), age (70~79 to 60~69; β=0.98, p=.018) and sex (female to male; β=2.55, p < .001).CONCLUSION: This study showed that the home visiting health service needs to take attention to aged 70s and over, female. The home health care of public health center need to be extended more practical and effective services in terms of ‘community care’ and ‘ageing in place’.

The Related Factors to Urgent Disease in Triaging Patients with Acute Abdominal Pain in Emergency Department

PURPOSE: Abdominal pain is the most common symptom of patients visiting the emergency department (ED). Abdominal pain is caused by a variety of causes, so it is difficult for a triage nurse to determine the urgency of a patient, but it is still a must. The purpose of this study was to identify the related factors to the urgent diseases of patients with abdominal pain visiting ED.METHODS: This study was a retrospective descriptive study. The study setting was an ED in a tertiary hospital in Korea. Data were collected from September 1, 2017 to October 15, 2017. During the study period, of a total of 6,181 patients visiting the ED, 731 complained of abdominal pain. Patients with obvious cause of pain and patients who could not express detailed symptoms were excluded. The 573 patients were included in the final analysis. We collected demographics, clinical characteristics, and final diagnosis. We divided final diagnoses into urgent diseases which were more likely to be life-threatening without treatment and non-urgent diseases. We identified the related factors to the urgent diseases of patients with abdominal pain using the logistic regression.RESULTS: 173 (30.2%) patients had urgent diseases. Age (OR=1.02, 95% CI=1.00~1.03), referral from other clinics (OR=2.92, 95% CI=1.86~4.60), ambulance utilization (OR=2.00, 95% CI=1.27~3.15), diarrhea (OR=0.44, 95% CI=0.25~0.76), and tachycardia (OR=2.27, 95% CI=1.44~3.58) were related to urgent diseases.CONCLUSION: Triage nurse should take into account the patient's age, mode of visiting, and route of visiting ED; and check the symptom of tachycardia or diarrhea.

Adherence to the Clean Intermittent Catheterization Following a Customized Intensive Education Program for Patients with Emptying Failure

PURPOSE: The purpose of this study is to investigate adherence to the clean intermittent catheterization (CIC) and influencing factors on the adherence following a customized intensive education program (CIEP). METHODS: This work is a retrospective descriptive study. The subjects were 226 emptying failure patients who learned in a CIEP from January 2012 to July 2014. The program developed in 2011 and consisted of 1) customized theoretical education; based on the results of urologic tests, underlying disease, or surgery of the patients, 2) hands-on practice until the trainees were able to master the techniques, 3) questions about the process of catheterization and what he/she needs to know. 4) at follow-up, the survey about adherence and barrier to CIC. Clinical characteristics; the level of satisfaction, understanding, and self-confidence; the barrier in medical records were reviewed. RESULTS: The short-term adherence rate (median 22 days) is 87.6% and the long-term adherence rate (median 112 days) is 50.4%. The biggest obstacle is time management. The levels of satisfaction, understanding, and self-confidence are very high. The variable of Income is the only factor that has influence on adherence. CONCLUSION: Despite the CIEP, the adherence rate is relatively low. In addition to the education, emotional and psychological supports and regular follow-up are needed to improve long-term adherence.

A Comparative Study between American Public Health Nurse Core Competency and Community Health Nursing Practicum in a Province

PURPOSE: This study attempts to examine the extent to which competencies were identified in a Korean community nursing practice based on the 11 core competencies required by US health nurses. METHODS: This was a descriptive research study, and the subjects of this study were 11 students who were in a four-year nursing course. Data were collected by means of a questionnaire from October 19 to November 22, 2016. RESULTS: Core competencies in total were practiced in 60.0% to 98.5% of schools in Korea. Among these, competencies corresponding to the practice level of ‘high’ were identified as ‘communicating effectively with community nursing subjects and colleagues, and accepting various personal characteristics without criticism or prejudice’. On the other hand, competencies corresponding to the practice level of ‘low’ were identified as ‘to comply with social justice, public good, public health principles, and leadership in a community nursing practice’. CONCLUSION: This study can be used as a resource to categorize the competence of nursing students expected in the field of community nursing. Based on a careful review of core competencies with low practice, it is necessary to seek specific practical strategies to strengthen these competencies in the future.

Direction of the Community Health Nursing Practice Education Focusing on the Nursing Education Accreditation Criteria

PURPOSE: The purpose of this study was to seek the direction of community health nursing practice education focus on the nursing education accreditation criteria. METHODS: We collected data through e-mail survey to all of 202 Korean nursing baccalaureate education institute in April, 2016. The 93 professors teaching community health nursing was responded about their affiliated institute (response rate 46.0%). RESULTS: The Korean nursing graduates in Feb. 2016 was practiced 3.01 credits, 131.6 hours in community health nursing course. Community health nursing practice agency was public health center (98.9%), Public health center post (43.0%), Public health center branch (32.3%) in order. The possibility to achieve the course objectives up to national examination was recognised Public health center (3.4), Public health center post (3.3), Public health center branch and school (3.2) from 5 score likert scale. A lot of nursing education institute have difficulty in clinical placement in community health nursing practice agency that meet eligibility of preceptor and space gaining for only nursing students. CONCLUSION: The nursing education accreditation criteria in 3rd cycle have to be considered real community health nursing practice situation and newly emerging community health nursing fields.

The Effects of an Integrated Health Care Program on the Physical, Psychosocial, and Spiritual Health of People with Mental Disorder in Community

PURPOSE: This study was conducted in order to investigate changes in the physical, psychosocial and spiritual health of people with mental disorder in community participating in the Integrated Health Care Program (IHCP). METHODS: This study applied the non-equivalent control group pretest-posttest quasi-experimental design. The participants were 37 chronic psychiatric patients who had been clinically diagnosed with mental disorder and visiting a mental rehabilitation center located in S City (17 in the experimental group, and 20 in the control group). The experimental group participated in the IHCP consisting of 24 sessions for eight weeks. RESULTS: After the intervention, only the participants in the experimental group reported significant improvement in physical (body mass, triglyceride), psychosocial (mental symptoms, depression, self-esteem, ability of problem solving), and spiritual wellbeing when compared with those in the control group. CONCLUSION: These results indicate that IHCP is effective in improving the physical, psychosocial, and spiritual wellbeing of people with mental disorder. Therefore, IHCP developed in this study is considered a useful nursing intervention for raising the comprehensive health level of people with mental disorder in community.

Effects of Hypertension, Diabetes, and/or Cardiovascular Disease on Health-related Quality of Life in Elderly Korean Individuals: A Population-based Cross-sectional Survey

PURPOSE: This study explored health-related quality of life (QoL) in Korean elderly individuals with hypertension, diabetes, and/or cardiovascular disease (CVD). METHODS: This study used a population-based cross-sectional design. Data were obtained from the Fourth Korean National Health and Nutrition Examination Survey 2008, which involved a nationally representative sample. Data on health-related QoL were collected using the EuroQoL-5 Dimension instrument and via health interviews. The sample consisted of 1,467 Korean individuals aged 60 years and older. A multiple linear regression model was used to analyze health-related QoL. RESULTS: After controlling for sociodemographic and lifestyle variables, individuals with one of the aforementioned chronic diseases had lower EuroQoL-5 Dimension scores, ranging from 0.186 among those with only hypertension to 0.469 among those with hypertension plus CVD, compared with those without a chronic disease (higher scores are indicative of more limitations). The impact of comorbid diseases was greater than that of any single disease except diabetes. CVD had a stronger negative impact on QoL than did any other single disease studied. Whereas the physical elements of QoL were influenced by all diseases, the psychological components were influenced only by hypertension plus diabetes and hypertension plus CVD. CONCLUSION: We found that both the number and the type of diseases affected QoL scores. Efforts to prevent or manage diabetes, CVD, and related risk factors should include psychological support.

Relationship Between Health-related Behavioral and Psychological Factors and Cardiovascular and Cerebrovascular Diseases Comorbidity Among Korean Adults With Diabetes

PURPOSE: This study aims to explore the relationships between health-related behavioral and psychological factors and cardiovascular and cerebrovascular diseases (CCVD) comorbidities among Korean adults with diabetes mellitus (DM). METHODS: Data included in the Fourth Korean National Health and Nutrition Examination Survey were used. This study compared three groups: those diagnosed with DM only, DM and hypertension, DM, hypertension and CCVD using multinomial logistic regression analyses and the classification and regression tree (CART) model. RESULTS: Weight control (OR = 4.01) and depression (OR = 2.37) are related with increased odds of having hypertension and CCVD comorbidity in those with DM. The CART model suggested that the high prevalence risk groups for hypertension or CCVD comorbidities were diabetic adults aged between 51 and 69 with a body mass index of 25 and above and those aged 70 and above. CONCLUSION: For effective control of CCVD comorbidities among diabetic Korean adults, psychological support for depression and weight control need to be prioritized when managing DM. Weight control intervention needs to be reinforced for DM patients aged between 51 and 69 and that even if BMI is below 25, the occurrence of comorbidities needs to be carefully monitored for DM patients aged 70 or older.

Analysis of the Nursing Interventions Performed by Public Health Nurses in Health Centers Using the NIC / 간호학회지

PURPOSE: The purpose of this study was to identify nursing interventions performed by public health nurses in health centers. METHOD: Data was collected by the taxonomy of Nursing Intervention Classification (NIC 3rd: 486 nursing interventions) from 131 public health nurses in health centers and analyzed using descriptive statistics. RESULT: As its result, more than 50% of public health nurses performed 137 nursing interventions at least monthly. The most frequently used intervention class was 'activity and exercise management', followed by 'physical comfort promotion', 'community health promotion', 'life span care', 'coping assistance', 'Self care facilitation', 'information management', 'nutrition support', 'community risk management' and 'patient education'. One hundred twenty nursing interventions were rarely performed by 90% or more of the nurses. Most of them were the physical complex domain. CONCLUSION: In conclusion, 137 interventions were performed by public health nurses at least monthly. NIC is helpful to build a standardized language for public health nursing.

A Study on the Development of the Korean Family Functioning Scale / 간호학회지

PURPOSE: The purpose of this study was to develop the instrument to measure family functioning for Korean family with a chronic ill child, and to test the validity and reliability of the instrument. METHOD: The items of instrument were consisted based on researchers' previous study of concept analysis of the Korean family functioning. Twenty six item scale was developed with six domains. In order to test reliability and validity of the scale, data were collected from the 231 families, who have a child with a chronic illness. Data was collected between August and September in 2001 in a General Hospital in Seoul, Korea. RESULT: The results were as follows:As a result of the item analysis, 24 items were selected from the total of 26 items, excluding items with low correlation with total scale. Six factors were evolved by factor analysis. Six factors explained 61.4% of the total variance. The first factor 'Affective bonding' explained 15.4%, 2nd factor 'External relationship' 11.8%, 3rd factor 'Family norm' 10.5%, 4th factor 'Role and responsibilities' 8.3%, 5th factor ' Communication' 7.9%, and the 6th factor 'Financial resource' explained 7.3%. Cronbach's alpha coefficient of this scale was .87 and Guttman spilt- half coefficient was .84. CONCLUSION: The study support the reliability and validity of the scale. There were distinct differences in dimensions of family functioning scales developed in the U. S.

A Study on the Development of the Korean Family Resilience Scale / 간호학회지

PURPOSE: The purpose of this study was to develop an instrument to measure family resilience for Korean families with a chronically ill child, and to test the validity and reliability of the instrument. METHOD: The items of instruments used based on the researchers' previous study of concept analysis of Korean family resilience. Nineteen item scales were developed with five domains. In order to test reliability and validity of the scale, data were collected from 231 families, who had a child with a chronic illness. Data was collected between August and September of 2001 in a 3rd level University Hospital in Seoul, Korea. RESULT: The results were as follows: As a result of the item analysis, 19 items were selected from the total of 37 items, excluding items with low correlation with the total scale. Five factors were evolved by factor analysis, which explained 56.4% of the total variance. The first factor 'Family strength' explained 28.5%, 2nd factor 'Family maturity' 8.7%, 3rd factor 'The ability to use of external resources' 7.0%, 4th factor 'Control' 6.6%, 5th factor 'The driving force for finance' 5.7%. The attributes in these factors were different with those identified by concept analysis of the family resilience in Korean families from the previous study. Cronbach's alphacoefficient of this scale was .8039 and Guttman spilt- half coefficient was .8184. CONCLUSION: The study support the reliability and validity of the scale. Because the main concept of family resilience was family strength, there were distinct differences in dimensions of family functioning scales.