Structural Equation Modeling on Healthy Menopausal Transition

PURPOSE: This study was designed to construct and test structural equation modeling on healthy menopausal transition in middle-aged women in order to identify variables affecting healthy menopausal transition. METHODS: Participants, 276 women, 45 to 60 years of age, with menopausal symptom score higher than 5 on the Korean version of Menopause Rating Scale, were recruited in three cities and one county of Gyeongnam Province. Research data were collected via questionnaires and analysed using SPSS version 18.0 and AMOS version 20.0. RESULTS: After confirmatory factor analysis, one of the observed variables was excluded due to relatively low factor loading. The model fit indices for the hypothetical model were suitable for the recommended level: GFI=.93, CFI=.92, RMSEA=.05. Self-efficacy, self-differentiation, and menopausal symptoms explained 67.7% of variance in menopausal transition, and self-differentiation was the most influential factor for menopausal transition. Self efficacy and menopausal symptoms explained 9.6% of variance in menopausal management, although "menopausal symptoms" was not significant. CONCLUSION: These results suggest that nursing interventions to improve self-differentiation, self efficacy, menopausal management and decrease menopausal symptoms are critical for healthy menopausal transition in middle-aged women. Continued development of a variety of community-based nursing interventions to facilitate healthy menopausal transition is suggested.

Health Status of Vulnerable Preschool Children and Their Mothers' Health Management

PURPOSE: The purpose of this study is to find out preschool children's health status and their mothers' health management in the vulnerable classes. METHODS: The assessment tool was developed, taken into consideration existing studies, materials produced by the customized visiting health care system, and review of visiting nurses of health centers and related experts. Data were collected January to February 2010 from 259 mothers by visiting nurses, and analyzed using SAS program for descriptive statistics. RESULTS: Body weight less than 3 percentile was found for 5.0% children and over 97 percentile for 7.7%. Atopy was found in 17.8% children, no hand-washing after toileting and before meal in 30.9% and 36.7% respectively, no breakfast in 15.8%, and irregular meal in 32.0%. Sex education was made by 45.7% mothers, regular dental check by 56.6%, and hearing and eyesight test by 61.1% and 66.8% respectively. Home environment for upbringing is 34.3 in the scale of 41, and accident prevention 17.5 in the scale of 22. CONCLUSION: It is necessary to make an intervention on children's weight, personal sanitation and meal time in the vulnerable classes. Mothers need to be educated for appropriate health care, and home environments to improve upbringing and accident prevention.

Job Stress, Job Satisfaction, and Organizational Commitment of Customized Home Health Care Nurse / 農村醫學 地域保健

OBJECTIVES: This research was done to identify relationships among job stress, fatigue, job satisfaction, and commitment to organization in customized home health care nurses. METHODS: Research participants were 130 nurses who worked in the customized home health care of 20 county in Gyeongnam province. Data collection for this descriptive correlational study was done at August 2010 using self report questionnaires, and analyzed using descriptive statistics, t-test, ANOVA, and we analyzed a four step approach in which several regression analyses were conducted and significance of the coefficients is examined at each step. RESULTS: The results from step 1 showed that, the effect of each job stress was significantly related to job satisfaction. In step 2, the direct effect of commitment to organization on job satisfactions were all significant too. Step 3 analysis showed that the total effect of each job stress on commitment to organization symptoms was significant. Step 4 showed the results of controlling for mediating factor (job satisfaction): job demand and insecurity were significantly associated with commitment to organization (p<0.001), the finding supports that others were fully mediated by each job satisfaction, and, the job demand and insecurity were partially mediated by job satisfaction. CONCLUSION: Results of this research indicated that job stress in customized home health care nurses was the principal variable affecting job satisfaction and commitment to organization. Appropriate stress management strategies based on assessment of job demand and job security for these nurses lead to development of improved commitment to organization.

Associations between Sleep Quality, Daytime Sleepiness, with Perceived Errors during Nursing Work among Hospital Nurses / 農村醫學 地域保健

OBJECTIVES: The objective of this study was to identify the influence of shift work on sleep quality, daytime sleepiness, and perceived errors during nursing work among hospital nurses. METHODS: The study subjects were 209 hospital nurses working in two general hospitals in South Korea. The data were collected through self-administered questionnaires in May 2013. Sleep quality was measured using Korea Pittsburgh Sleep Quality Index (PSQI-K), daytime sleepiness was measured using Epworth Sleepiness Scale (ESS), and perceived errors in past 6 months during nursing duty hours with the tool developed in this study. RESULTS: The sleep quality was significantly worse among rotating shift nurses when compared to fixed day duty nurses. However, the odds ratio (OR) of 1.92 [95% confidence interval(CI): 0.58-6.37] adjusted for sociodemographic variables, health behaviors, and working environment in logistic regression was not significant. There was no significant difference in the daytime sleepiness between rotating shift nurses and fixed day duty nurses in both simple and multivariable analyses. There were significantly more perceived errors in rotating shift nurses than fixed day duty nurses. However, the OR of 1.26 (95% CI: 0.38-4.21) adjusted for sociodemographic variables, health behaviors, working environment, sleep quality, and daytime sleepiness in logistic regression was not significant. Depression (OR=3.31, 95% CI: 1.11-9.84) and daytime sleepiness(OR=1.18, 95% CI: 1.07-1.30) were significantly associated with perceived errors in logistic regression. CONCLUSION: This study suggested shift work among hospital nurses had no independent influence of sleep quality, daytime sleepiness, and perceived errors. However, daytime sleepiness had independent influence of perceived errors. More studies are warranted to achieve more reliable conclusion.

Factors Affecting on Health Promoting Behaviors among Teachers with Middle-aged Women Experiencing Menopause / 한국직업건강간호학회지

PURPOSE: This study examined the relationships among menopausal symptom, self-efficacy, health promoting behaviors, and investigated factors affecting health promoting behaviors of teachers with middle-aged women experiencing menopause. METHODS: From September to October 2012, a convenience sample of 252 subjects aged 40 to 60 years was recruited from 8 elementary schools, 3 middle schools and 5 high schools. The data analysis was done by ANOVA and stepwise multiple regression. RESULTS: Menopausal symptom of subjects was slightly lower than general middle aged women and the average level of health promoting behaviors was similar to general middle aged women. Health promoting behaviors were differentiated by severity of menopausal symptom, not by menstruation state. Menopausal symptom was negatively related to health promoting behaviors. The most significant factor affecting health promoting behaviors was self efficacy (14.3%). The combination of self efficacy, menopausal symptom, and elementary school teachers accounted for 20.1% of health promoting behavior. CONCLUSION: When developing health promotion program for teachers with middle-aged women, such program should consider self-efficacy, menopausal symptom, and school type.

Effects of an Elder Health Promotion Program using the Strategy of Elder Health Leader Training in Senior Citizen Halls

PURPOSE: This study was conducted to develop and test the effects of an elder health promotion program and apply strategies for elder health leader training sessions with elders at senior citizen halls. METHODS: A nonequivalent control group pretest-posttest design was used. Participants were 49 elders at a senior citizen hall (intervention: 27, control: 22). The elder health promotion program consisted of health education and exercise. A professional leader led the program for 4 weeks, and then an elder health leader and research assistant led for 8 weeks (total 12 weeks). Scales for elder health promoting behaviors, perceived health status, life satisfaction and senior citizen hall capability were used and physical fitness levels were measured. Data were collected between April 21 and July 28, 2010 and analyzed using Chi-square, Fisher's exact test, t-test, and repeated measure ANOVA with SPSS/WIN 12.0. RESULTS: Health promoting behaviors, physical fitness, perceived health status, and senior citizen hall capacity were significantly better in the experimental group after the intervention compared to the control group. CONCLUSION: Study findings indicate that elder health promotion programs applying strategies of elder health leader training are effective and can be recommended as nursing interventions for health promotion of these elders.

Customized Home Visiting Nurses' Experiences in Telephone Visiting

PURPOSE: The purpose of this study was to explore and understand customized home visiting nurses' experiences in telephone visiting. METHODS: Qualitative data were collected from several discussions of 4 focus groups consisting of 20 customized home visiting nurses. All interviews were recorded and transcribed according to thematic content analysis processes. RESULTS: The five main themes on customized home visiting nurses' experiences of telephone visiting were 'greeting', 'counseling', 'using strategies', 'maintaining attitude for enhancing relations' and 'enduring difficulties'. The category of 'counseling' was composed of confirming, educating, supporting, adjusting, and indicating. And, the category of 'using strategies' included complimenting, scolding, persuading, compensating, and ignoring. CONCLUSION: Developing a standardized manual on telephone visiting is needed to guide an effective counseling. In order for a customized home visiting nurse to be a good telephone counselor, training of motivational interviewing is recommended.

An Analysis of Articles for Health Promotion Behaviors of Korean Middle-Aged

PURPOSE: This study has a purpose to suggest research and intervention directions for health promoting behaviors (HPB) of the Korean middle-aged in the future. METHODS: Forty four articles on HPB of the Korean middle-aged were reviewed and analyzed. The articles analyzed are theses written for a doctoral or master's degree and published between 1995 and 2007. RESULTS: 1. As for the major characteristics of the subject groups, most of them were between 40 and 60 years old (61.4%), were females (79.5%), and resided in cities (84.1%). 2. The dependent variables adopted were physiological, psychological and cognitive factors (self-efficacy, knowledge of health management, etc.), HPB and factors related to Health Promoting Lifestyle Profile (HPLP). 3. The average scores of HPLP were 1.57~3.08 on a 4-point scale. The highest score was observed in self-actualization, and the lowest score in exercise. 4. Self-efficacy, perceived health status and income had significant correlations with HPB. 5. In regression analysis, self-efficacy, self-esteem and perceived health status were the most powerful predictors. CONCLUSION: It is necessary to develop intervention tools for more diverse HPB of the Korean middle-aged. The interventions are recommended to focus on increasing exercise and to use strategies for improving self-efficacy and self-esteem.

A Study on the Relationship between Breastfeeding Empowerment and Self-confidence in the Maternal Role of Breastfeeding Mothers / 여성건강간호학회지

PURPOSE: This study was conducted to evaluate the relationship between breastfeeding empowerment and self-confidence in the maternal role of breastfeeding mothers. METHOD: Breastfeeding empowerment was measured on a scale of 5 developed by Kim & Park(2004), while self-confidence was measured on a scale of 4 by Lederman et al.(1981). Data was collected during a Breastfeeding Infant Contest held in September 2006 and 2007 in Changwon-si, Gyeongsangnam-do. The subjects were 278 breastfeeding mothers. The collected data was processed with the SPSS win 12.0 version. RESULT: Breastfeeding empowerment scored 4.21 on average (5.0 full score). The score showed a statistical difference only in breast milk quantity and breastfeeding knowledge. On the otherhand selfconfidence in the maternal role showed a statistical difference only in breastfeeding frequency and knowledge. Self-confidence in the maternal role showed a statistically significant relationship with breastfeeding skill(gamma=0.50), with breastfeeding will(gamma=0.45), with adherence to exclusive breastfeeding(gamma=0.35) and with group empowerment(gamma=0.39). CONCLUSION: The positive relationship between breastfeeding empowerment and self-confidence in the maternal role implies that breastfeeding empowerment may be utilized to promote self-confidence in the mother's role.

The Related Factors of Attitude toward Childbirth among Female Students in Junior, Senior High School, and University / 農村醫學 地域保健

OBJECTIVES: The purpose of this study was to obtain basal information to establish a proper birth-encouraging policy in the future through the survey of the attitude towards childbirth and its related factors among female students in junior, senior high school, and university. METHODS: A survey was performed for 2 weeks in June, 2006, for a total of 688 female students which included 185 ones in a girls' junior high school and 242 ones in a girls' senior high school in Sacheon, and 261 ones in two universities in Jinju. The selfadministered questionnaires developed by the authors included the socio-demographic characteristics, the attitude towards childbirth, the preference of a son for their future child, the belief on relative importance of family or work after marriage, the seriousness perception of low birth rate in Korea, frequencies of education in school about low birth rate. The attitude was measured by an answer to the question of 'To what degree do you think you are going to have a child(or children)?' RESULTS: The proportion of positive attitude towards their future childbirth was 76.2% in junior high school, 63.9% in high school, and 82.8% in university students (p<0.01). In the logistic regression analysis, the significant factors related with positive attitude towards future childbirth were school grade, preference of a son for their future children, and belief on relative importance of family or work after marriage. CONCLUSIONS: It suggests that the related factors with positive attitude towards future childbirth need to be considered to make a proper birth policy.

The Effects of Health Promotion Program on Stress and Menopausal Symptoms in Menopausal Women / 성인간호학회지

PURPOSE: The purpose of this study was to investigate the effects of health promotion program on physiological stress, perceived stress and menopausal symptoms in menopausal women. METHODS: This study followed a nonequivalent control group pretest-post test design. The subjects consisted of 57 middle-aged women(30 in the experimental group and 27 in the control group) who were recruited from the community health center in J city. The subjects in the experimental group participated in a health promotion program for 8 weeks, which was composed of yoga and teaching for 1 session per week. RESULTS: The health promotion program showed a statistical difference in blood pressure, pulse rate and perceived stress. However, there was not a statistical difference in serum cortisol, or menopausal symptoms. CONCLUSION: This health promotion program was partially effective for reducing stress and it was not effective for reducing menopausal symptoms in menopausal women. It is necessary to conduct a future study using a different time period, measurement time, and target population.

A Study on Role Conflict and Job Satisfaction of Neurosurgery Clinical Nurse Specialist / 성인간호학회지

PURPOSE: The purpose of this study was to describe role conflict and job satisfaction of Neurosurgery Clinical Nurse Specialist(NCNS) and to identify associated factors. METHOD: The target populations was 77 NCNSs from 30 general hospitals. Data were collected with self-administered questionnaires and analyzed using t-test and ANOVA. RESULTS: The overall mean scores of role conflict and job satisfaction were 3.60(+/-0.54) and 3.04(+/-0.46) respectively. Significant variables affecting role conflict were the working period as NCNS, the number of colleague NCNSs in working hospital, and assignment of prescription rights. The significant variable affecting job satisfaction was assignment of prescription rights. There was no statistically significant correlation between job and role conflict. CONCLUSION: The variable effecting both role conflict and job satisfaction was the extent of prescription rights. In order to improve the quality of patient care and to protect Neurosurgery Nurse Clinical Specialist, the enactment of law on prescription practice is needed.

A Study on the Correlation Among Total Serum Cholesterol Level, Blood Pressure, Body Mass Index, and Lifestyle / 성인간호학회지

PURPOSE: The purpose of this study was to examine the relationship among the levels of total serum cholesterol level, blood pressure, body mass index, and lifestyle. METHOD: This study was designed as a descriptive correlation study. Subjects were 972 adults participated voluntarily living in GyeongNam. The height, weight, blood pressure and fasting serum cholesterol were measured. Body mass index was caculated. Information on general characteristics (age, gender, education, job, family history) and life style(cigarette, alchol, sleeping time, regular exercise, meal pattern, peppery, salty, sweetness, vegetable diet, meat diet) were collected using a questionnaire by interviewing method. RESULT: The mean value of total serum cholesterol was 197+/-36.4mg/dl(mean; 189.4+/-36.7, women; 202.1 +/-35.1). By simple analysis, the serum total cholesterol according to general characteristics features was statistically significant in age(F= 6.765, p=000) and gender (t=5.372, p=.000). Total serum cholesterol levels increased significantly with increasing BMI. The serum total cholesterol according to life style features was statistically significant in cigarette(chi2 =12.12, p=.016), exercise(chi2=6.335, p=.042), salty taste(chi2=18.801, p=016), vegetable diet(chi2=19.488, p=012). The most affecting factor which total serum cholesterol factor was BMI(beta=.151, p=.000). CONCLUSION: The significant risk factors relating to serum total cholesterol were age, gender, BMI, smoking, and exercise. Therefore, for the reduction of serum total cholesterol level, it is recommended that nursing intervention for the prevention of obesity, change of life style should be implemented.

The Evaluation of a Program to Promote Healthy Joints in Older Adults Residing in the Community / 기본간호학회지

PURPOSE: This study was conducted from March to August, 2003 to evaluate the process and outcomes of a program to promote healthy joints in older adults residing in the community. METHOD: A quasi experimental research design (one group pretest-posttest design) was used in this study. The participants were 26 older adults (but 74 older adults also participated in a program immediately after the study program). Program had 4 sessions (8 hours) once a week. Data were collected before the program, immediately after and 4 weeks after the program was completed and were analyzed with paired t-test. RESULTS: The level of a satisfaction, interest and understanding of the program were high. Significant differences were found in the health state, the flexibility of neck and shoulder joints and joint exercise habits between the scores before the program started and 4 weeks after it finished. CONCLUSION: This results suggest that the joint health promotion program for older adults in the community developed this study is effective. So this program can be recommended as an effective nursing intervention for joint health promotion in older adults living in the community.

A Study on Health Status of Joints in Elderly People / 기본간호학회지

PURPOSE: The purpose of this study was to describe the subjective health status of joints, flexibility of joints, muscle strength and state of joint exercise in elderly people living in the community. METHOD: The participants were 74 elderly people in a health program of the Gerontological Health Research Center at G University. The data were collected from March to July, 2003. The instrument for the study included items on general characteristics (5 items), subjective health status of joints (10 items), flexibility of joints and strength of muscle (8 items), and state of joint exercise (7 items). RESULTS: The score for subjective health status of joints was 3.70 (range 1-5). Knee and waist joints were in the worst state. Neck extension and flexion were 17.38+/-1.80 and .60+/-1.08(cm) respectively. Trunk extension and flexion were 68.24+/-4.47 and 58.00+/-4.91(cm) respectively. Flexibility of the Rt./Lt. shoulder joints was 14.63+/-12.51/18.82+/-13.80(cm). Muscle strength of the Rt./Lt. leg was 30.47+/-19.68/29.67+/-21.22 (sec.). Shoulder joints were more flexible for men and people in their sixties compared to women and people in their seventies. Hand grip was stronger for men compared to women. The score for state of joint exercise was 2.83(range 1-4). The state of handgrip correlated with the state of joint exercise [r=.423 (Rt.)/r=.273(Lt.)]. CONCLUSION: To prevent falls and disorders in neuromuscular function, it is important to develop systemic joint exercise programs for elderly people.

The Evaluation of a Health Promotion Program for the Community resident Older Adults / 간호학회지

PURPOSE: This study was conducted to evaluate the process & outcome of a Health promotion program(Growing Younger & More Active) for the community resident older adults from March to December, 2001. METHOD: A quasi experimental research(one group pretest-posttest design) was used in this study. The subjects were 82 older adults(but 40 older adults 4 weeks after the program). Program had 5 sessions(10 hours) once a week. Data were collected before the program, immediately after & 4 weeks after the program and were analyzed with paired t-test. RESULT: The levels of Satisfaction, Interest & Understanding of the Program were high. Significant differences were found in health knowledge, health promoting behaviors, perceived health status and life satisfaction between before program and immediately after program as well as between before program and 4 weeks after program, but no significant differences in Health attitude. Self efficacy has significant difference only between before program and immediately after program , but no significant differences between before program and 4 weeks after the program. CONCLUSION: This results suggest that a Health promotion program for the community resident older adults developed this study is effective. So this program can be recommended as an effective nursing intervention for the health promotion of the older adults living in community.