Mediating Effects of Job Satisfaction between Nurses’ Perceptions of Patient Safety Culture and Their Safety Nursing Activities / 기본간호학회지

Purpose@#This study was conducted to identify the mediating effects of job satisfaction in the relationship between nurses’ perceptions of patient safety culture and safety nursing activities. @*Methods@#Data for this study were collected using a structured questionnaire from 219 nurses recruited through convenience sampling among nurses at the general wards of four small and medium-sized hospitals with fewer than 300 beds. The data collection period was between September 11 and 28, 2018. Data were analyzed using multiple regression and the Sobel test in SPSS 25.0 for Windows. @*Results@#The mean score was 3.14 out of 5 points for patient safety culture, 3.21 out of 5 points for job satisfaction, and 4.10 out of 5 points for safety nursing activities. Patient safety culture was significantly correlated with job satisfaction (r=.55, p<.001) and safety nursing activities (r=.48, p<.001). Job satisfaction was significantly correlated with safety nursing activities (r=.55, p<.001). Nurses' perceptions of patient safety culture (β=.48, p<.001) and job satisfaction (β=.42, p<.001) were identified as significant predictors of safety nursing activities. Job satisfaction had a partial mediating effect in the relationship between nurses’ perceptions of patient safety culture and safety nursing activities. These variables explained 35% of the variance in safety nursing activities. @*Conclusion@#Improving nurses’ perceptions of patient safety culture and job satisfaction, which had a partial mediating effect, can promote safety nursing activities.

Multilevel Analysis of Factors Associated with Perceived Good Health and Multimorbidity among Older Adults: Using the 2017 Community Health Survey

Purpose@#This study aimed to identify individual- and regional-level factors associated with perceived good health and multimorbidity among older adults. @*Methods@#Secondary analysis of the 2017 Korea Community Health Survey was conducted on a sample of 67,532 older adults. The individual level data set was combined with regional-level factors from the administrative data released on the Korea National Statistical Office website. Distribution of perceived good health and multimorbidity in 254 public health centers were calculated using sampling weights and presented as percentages. Multilevel logistic regression analyses were used to identify individual- and regional-level factors associated with perceived good health and multimorbidity. @*Results@#Overall, 21.1% of subjects perceived their health to be good, ranging from 9.3% to 39.4% by region. The prevalence of multimorbidity was 15.9%, and varied between 6.6% and 22.6% by region. At the individual level, perceived good health was associated with men, younger age, higher educational levels, higher income levels, and those married and living with a partner and maintaining a healthy lifestyle.At the regional level, higher rates of health center personnel among public officials and higher levels of financial independence were associated with perceived good health. Multimorbidity was associated with marital status and healthy lifestyle, and higher rates of health center personnel among public officials. @*Conclusion@#Regional factors such as health care personnel and local economy could affect population health. Our findings suggest the need to consider individual- and regional-level factors to promote good health among older adults and reduce the health gap by region.

Multilevel Analysis of Factors Associated with Perceived Good Health and Multimorbidity among Older Adults: Using the 2017 Community Health Survey

Purpose@#This study aimed to identify individual- and regional-level factors associated with perceived good health and multimorbidity among older adults. @*Methods@#Secondary analysis of the 2017 Korea Community Health Survey was conducted on a sample of 67,532 older adults. The individual level data set was combined with regional-level factors from the administrative data released on the Korea National Statistical Office website. Distribution of perceived good health and multimorbidity in 254 public health centers were calculated using sampling weights and presented as percentages. Multilevel logistic regression analyses were used to identify individual- and regional-level factors associated with perceived good health and multimorbidity. @*Results@#Overall, 21.1% of subjects perceived their health to be good, ranging from 9.3% to 39.4% by region. The prevalence of multimorbidity was 15.9%, and varied between 6.6% and 22.6% by region. At the individual level, perceived good health was associated with men, younger age, higher educational levels, higher income levels, and those married and living with a partner and maintaining a healthy lifestyle.At the regional level, higher rates of health center personnel among public officials and higher levels of financial independence were associated with perceived good health. Multimorbidity was associated with marital status and healthy lifestyle, and higher rates of health center personnel among public officials. @*Conclusion@#Regional factors such as health care personnel and local economy could affect population health. Our findings suggest the need to consider individual- and regional-level factors to promote good health among older adults and reduce the health gap by region.

Historical Review of Modern Public Health Nursing / 農村醫學 地域保健

OBJECTIVES: The purpose of this study is to examine the modern history of public health(PH) and suggest a way forward for PH nursing(PHN). METHODS: This paper is a review article that derives results from literature review. RESULTS: In the period of beginning (up to 1944), PHN began as the PH Department was created in the Hygiene Bureau in 1908 and tasks about nurses were legislated. PHN was limited to infectious disease tasks and performed mostly by missionaries. In the period of foundation formation (1945 to 1961), the Republic of Korea was founded, and PH policies and tasks were defined with the establishment of the central government organization and the applicable laws. In the period of foundation establishment (1962 to 1979), the Regional PH Act was amended, and as a result, PH Centers(PHCs) spread across the country. In the period of foundation expansion (1980 to 1994), the PH referral system of PHCs, PH Units, and Primary Health Care Post was established. In the period of organization in each area (1995 to 2005), PH programs reflecting changes in disease structure and public needs for the quality of life. A regional health care plan was launched. In the period of funtion expansion (2006 to present day), Centers for support health living were established. CONCLUSIONS: In the future, PH nurses need to have a macroscopic perspective that views PH through the overall PH system, and to expand from the existing healthcare concept to the national and global healthcare one.

The Relationship among Family Support, Self-efficacy, Health Literacy, Perceived Health Status and Health-promoting Behavior in Married Immigrant Women

PURPOSE: The purpose of this study is to examine the association of family support, self-efficacy, health literacy and perceived health status with health-promoting behavior (HPB) in married immigrant women. METHODS: A cross-sectional based survey was conducted to collect data from married immigrant women living in Gyeongsang province. Questionnaires included Health promoting lifestyle profile II, General self-efficacy scale, Korean Health literacy assessment and perceived health status. RESULTS: 157 subjects participated in the study (mean age, 30.47±6.83). Their duration of living in Korea was 63.05±50.11 months. Of the participants, 59.2% were Vietnamese. The level of HPB, perceived health status, health literacy, support of family and self-efficacy were 2.58±0.42, 3.39±0.86, 25.12± 20.99, 3.83±0.70 and 3.61±0.53 respectively. Factors affecting the HPB of the participants were support from family (β =.45, p<.001) and self-efficacy (β=.16, p<.05). The explanatory power of these two variables was 34.2%. CONCLUSION: This study suggests that the factors influencing the HPB of married immigrant women include support from family and self-efficacy. A variety of programs should be provided for families so that they can support those women to help them increase their HPB. It is recommended that more various programs be provided to increase their self-efficacy.

Corrigendum: The Effects of a Cognitive Enhancement Group Training Program for Community-dwelling Elders

This erratum is being published to correct of Table 4.

Task Analysis of Managers in the Customized Visiting Health Services

PURPOSE: The aim of this study was to analyze the tasks of managers who were working in the Customized Visiting Health Services (CVHS) and to prioritize analyzed tasks according to performance frequency, perceived importance, and difficulty. METHODS: Job analysis method by Hartley (1999) was used for task analysis and performance frequency, perceived importance, and difficulty were used for prioritize as criteria. A total of 85 managers in the CVHS of public health centers nationwide were recruited through e-mail and mail survey. Using SPSS/WIN 15.0, descriptive statistics, such as frequency distribution, means, median, and standard deviation, were conducted to examine each subject's general characteristics, the frequency, importance, and difficulty of the tasks as well as to prioritize the each task. RESULTS: The job description of the managers revealed 12 duties, 35 tasks, and 104 task elements. Of the 85 managers, 84.8% were classified as nurses, 40.5% were home health care specialists, and 32.9% were social workers. Their coretasks were management of client cases, budget management, and management of work performance and quality assurance. CONCLUSION: Considering the analyzed managers' tasks and core tasks, we need to examine each manager's role precisely and provide various educational programs for improving overall manager competence.

The Effects of a Cognitive Enhancement Group Training Program for Community-dwelling Elders

PURPOSE: In this study a cognitive enhancement group training program of 10 sessions was provided for community-dwelling elders and the effects on cognitive function, depression and quality of life were tested. METHODS: A quasi-experimental study using a nonequivalent control group, pre-post design was used. The participants were 87 elders whose cognitive function was within the normal range. Of these elders, 45 were assigned to the experimental group and 42 to the control group. The intervention was conducted once a week for 10 weeks. Chi-square test, t-test, paired t-test, Wilcoxon rank sum test and Wilcoxon signed rank test were used to analyze the data. RESULTS: After the program, the cognitive function (t=-2.85, p=.006), depression (z=2.82, p=.005) and quality of life (t=2.79, p=.007) of the experimental group was significantly better than those of the control group. Especially, immediate recall (z=2.45, p=.014) and concentration (z=2.58, p=.010) in the subcategory of cognitive function were significantly better than that of the control group. CONCLUSION: The findings indicate that the cognitive enhancement group training program was effective in enhancing the cognitive function, depression and quality of life for elders and could therefore be considered as a positive program for emotional and cognitive support for community-dwelling elders.

A Survey on Health Management of during Pregnancy, Childbirth, and the Postpartum of Immigrant Women in a Multi-cultural Family / 여성건강간호학회지

PURPOSE: The purpose of this study was to investigate health management state during pregnancy, childbirth, and postpartum of immigrant women. METHODS: A descriptive research design was employed. Data were collected from 182 immigrant women who lived in four provinces and D city. Subjects were completed the following questionnaires: demographic, medical service use, pregnancy and childbirth, and health management during the ante-postpartum. RESULTS: The average age of subjects was 28.96 and 83 subjects (45.6%) were coming from Vietnam. 55 Subjects (30.2%) were within the low-income group with less than 4 million won per month. So, 62 subjects were uninsured women because of the expensive costs. Subjects mainly visited a health care center with their husband. On the using a health care center, subjects complained about communication difficulties and transportation problems. 42 Subjects were pregnant but 21.4% of pregnant subjects did not receive antenatal care. Subjects got information about pregnancy and childbirth through their husbands and husband's family. CONCLUSION: Nursing intervention to manage the pregnancy, childbirth, and the postpartum of immigrant women need to be developed and should include strategies to take care of themselves after delivery and provide knowledge and information about ante-postpartum.

The Effects of Hospice Care in Public Health Centers on Quality of Life of Terminal Cancer Patients and Care-giver Burden of Families / 農村醫學 地域保健

OBJECTIVES: This study aimed to find out the effects of hospice care in public health centers by evaluating the quality of life of terminal cancer patients and care-giver burden of their families. METHODS: From January to December 2007, 32 terminal cancer patients and their familes were selected as subjects for this study based on the research criteria. The data were collected using the questionnaire along with interviews. Instruments used for this study were C-QOL(Cancer-Quality of Life) that was developed by Lee(2007) and care-giver burden of families that was developed by Seo et al(1993). The data were analyzed using frequency, percentage and paired t-test. RESULTS: There was a statistically significant differences in the global overall quality of life between before and after receiving the comprehensive hospice care(t=18.997, p=.000). There was a statistically significant differences in the level of the quality of life of the hospice patients in physical aspects(t=21.196, p=.000), in emotional aspects(t=11.803, p=.000), in social aspects(t=24.310, p=.000) between before and after receiving the comprehensive hospice care. There was a statistically significant differences in care-giver burden of families between before and after receiving the comprehensive hospice care(t=36.468, p=.000). CONCLUSIONS: Hospice care in the public health center could be considered as an effective intervention to improve general quality of life of the terminally ill out patients and to decrease of care-giver burden of families with terminal cancer patients. It is recommended that hospice care in public health centers for the terminally ill out clients and their families should be increased.

The Factors Influencing on Health Promotion Behavior in Low-Income Vulnerable Elementary Students

PURPOSE: The goal of this study was to find out factors influencing the health promotion behavior of low-income vulnerable 4th, 5th and 6th-grade elementary school students. The specific goals were: first, to find out difference in health knowledge, self-esteem and health promotion behavior according to general characteristics; second, to investigate the correlations among health knowledge, self-esteem and health promotion; and, third, to analyze factors influencing health promotion behavior. METHODS: The subjects of this study were 137 low-income vulnerable 4th, 5th and 6th-grade elementary school children who were participating after-school programs in Seoul. RESULTS: Statistically significant differences were observed in health knowledge, self-esteem and health promotion behavior between girls and boys. In the sub categories, differences were observed in personal hygiene and health responsibility, stress management and personal relationship. The correlation of health promotion behavior with self-esteem and health knowledge was statistically significant. Regression analysis revealed that the influencing factor is self-esteem with the other variables under control. CONCLUSION: Health promotion education requires low-income vulnerable elementary children to increase their self-esteem. We recommend that it should be one of the most effective ways to split boys and girls to educate them in disparate classrooms.

Job Stress and Health Status of Circulation Enterprise Workers

PURPOSE: The purpose of this study was to measure the level of job stress and health status and find out factors affecting the health status among circulation enterprise workers. METHOD: This study was a cross-sectional descriptive study. The subjects were 128 workers whose mean age was 33.2 years. Korean occupational stress questionnaire Short Form was used to measure job stress. Todai Heath Index that was made by Aoki in 1977 and translated by Kim(1997) was used to measure the health status. RESULTS: The total job stress scores of men and woman fell in the lower 50% of Korean workers. Job autonomy and interpersonal conflicts as a subcategories fell in upper level 50% in both men and women and job insecurity fell in the upper level 50% in women. The mean score of health status was 51.47, indicating slightly higher frequency of complains of health symptoms. There was no significant correlation between total job stress and total health status. Finally, factors influencing the health status were organizational system and age. CONCLUSION: Based on the results of this study, it is necessary to develop comprehensive stress management programs including interventions of personal and organizational levels for promoting workers' health.

Subjective Health Status, Religiosity and Fear of Death of the Elderly in Rural Communities

PURPOSE: This study was performed to investigate the level of subjective health status, religiosity and the fear of death of the elderly and to identify the relationships among them. METHODS: This study was a cross-sectional descriptive study using a questionnaire. Fear of Death Scale that was made by Loo & Shea (1996) and translated and revised by Kim(2003) was used to measure the fear of death. The data was analyzed using SPSS. RESULTS: The subject was 128 community dwelling elders who had a religion. Of the respondents, 50% felt 'not healthy', and 69.5% was moderately religious. The mean score of FODS was 3.18 (out of 5). The mean score of each subcategory of FODS was as follows: Death anxiety about the death of self was 3.00. Death anxiety about the dying of self was 3.18. Death anxiety about the death of others was 3.31 and death anxiety about the dying of others was 3.23. There was a statistically significance correlation between the level of religiosity and FODS (F=3.29, p=.040). CONCLUSION: Health professionals may make efforts to learn about healthy attitudes toward death and aid for the elderly and to comfort them. Death education programs are needed for the elderly.

Health Education Needs of Mothers who are Caring for Children with Disabilities / 아동간호학회지

PURPOSE: The purpose of this study was to investigate the health education needs of mothers who are nurturing children with disabilities. METHOD: A descriptive study was done and the participants were 108 mothers of children with disabilities such being mentally challenged, developmentally delayed or having a disability involving brain damage. The questionnaire was a health education need assessment with 11 categories(58 items) developed by Han et al. The data were analyzed using SPSS program. RESULTS: The mean score for health education needs of the mothers of children with disabilities was 3.83 (SD=0.58) out of a maximum 5. The health education need for acquisition of knowledge and information had the highest score (4.40+/-0.54) followed by health education needs for cognitive development and learning (4.31+/-0.64), interpersonal relationships (4.04+/-0.65) and behavior and emotion (4.04+/-0.79). There were significant differences between the children's sex (t=2.08, p=.04), birth order (t=2.17, p=.03), grade of disability (F=3.32, p=.02) and sex education suitable to the child's in age. CONCLUSION: The health education needs of mothers of children who are disabled were very high and varied. Therefore, it was important to develop comprehensive education programs which include this content and provide opportunities for mothers of children with disabilities to receive this education.

Experience of Adolescents Smoking Cessation: Use of Focus Group interview / 아동간호학회지

PURPOSE: The purpose of this study was to identify the experience of smoking cessation in middle and high school students who smoked or were ex-smokers. METHOD: Data were collected through focus group interviews with 3 groups (15 students), and were analyzed according to the analytic method of Morgan (1998) and Krueger (1998). RESULTS: Six categories were identified. They included reasons to quit smoking, efforts to maintain smoking cessation, lures to start smoking again, improved self-esteem after overcome temptations, frustration following repeated failures in attempts to quit smoking and suggestions to help maintain smoking cessation. Through these results, it was found that reasons for quitting smoking were different from those of adults, strategies to maintain smoking cessation were limited and repeated failure in attempts to quit smoking led students to give up attempting to quit smoking. CONCLUSION: A high percentage of adolescent smokers want to quit but are unsuccessful in doing so. Considering the results of our analysis, smoking cessation programs and strategies should be carefully developed to be more effective in help adolescents quit smoking and maintain smoking cessation.

Knowledge, Attitude and Practice of Home Visitors in Public Health Centers toward Wife Abuse

PURPOSE: This study investigated knowledge and attitude of home visitors in public health centers toward wife abuse and the actual status of how they were detecting wife abuse and providing interventions. METHOD: Data were collected using questionnaires from October 2003 to December 2004. The subjects were 403 home visitors at Public Health Centers around Korea. The data were analyzed using SPSS program. RESULTS: The correction rate of knowledge related to wife abuse was 51.9%. The mean score of attitude toward wife abuse was 3.09 (SD=.40) out of 4, showing that their attitude is right. There was a significant difference in attitude according to age (F=3.27, p=.008). One hundred twenty six visitors (31.3%) detected wife abuses and each visitor confirmed 2.3 cases on the average. Forty eight respondents (38.1%) answered that they had provided interventions. CONCLUSION: This result implies that health visitors have difficulties in detecting wife abuse, and even for identified cases, the rate of providing interventions was low. It was because health visitors' educational experience in wife abuse is insufficient and they do not regard this work as their duty. These findings suggest the necessity for developing nursing in-service programs teaching health visitors their duties and knowledge related to wife abuse.

Grounded Theory Approach to Health Care of Older Adults at a Doctorless Farm Village / 간호학회지

PURPOSE: The purpose of this study was to explore how older adults kept their health good at a doctorless farm village. METHOD: Data was collected through in-depth interviews with 32 participants who were over 65 years old and analyzed in terms of Strauss and Corbin`s (1990) grounded theory methodology. RESULT: The Core Category of health care of older adults was identified as "enduring physical changes by themselves". The process of this could be divided into 4 stages : the stage of bearing, the stage of managing daily living activities, the stage of passively collecting information and the stage of minimally utilizing health care services. Older adults accepted the aging process positively but health sources limitation passively, so they managed daily living activities and used natural food for health. In addition, they collected information related to health care and used health care services minimally. CONCLUSION: We found that participants managed their health passively because of negative attitudes toward active health behaviors of older adults by themselves and the difficulty of access to health care services. Therefore, various community health services for older adults need to be developed to empower older adults in the community.

Elderly Women's Health Care Experience at Doctorless Farm Villages / 여성건강간호학회지

PURPOSE: This study investigated elderly women's health care at doctorless farm villages based on information-about the perception and management of their health. METHOD: Grounded theory method as mapped out by Strauss and Corbin-was used to record and transcribe open-ended interviews. The data from these interviews were analyzed. RESULT: We found 18 categories and 28 sub-categories. In data analysis, the core phenomenon was named "movement in pain". Causal condition as essential prerequisites were aging symptoms, bad state of health, comfortable life to live alone, longevity, deficiency of health care resources, and sub-categories of the phenomena revealed acceptance of discomfort, enduring pain, continuity of movability. Elderly women's health-related activities included enduring as it is, movement consciously, applying resources, difficult in using health medical institutions. Family support, economic level, disease condition, support system of community were influenced to their health-related activities. Consequently, the results indicated that they wanted to accept given life, expected easy death, held out remaining life. CONCLUSION: This study revealed that the most important factor of elderly women's health care was "movement in pain". On the basis of this study, we needed to develop diverse nursing implementation plans for maintaining and improving' movability without pain'.

The Experience of Occupational Health Care Providers in the Government-funded Subsidized Occupational Health Program for Small Scale Industries: Use of Focus Group Interview / 대한산업의학회지

OBJECTIVE:This study was conducted to provide the fundamental information to prepare better strategies based on the experiences of occupational health care providers who are involved in the Government-funded subsidized occupational health programs for small scale industries. METHODS:The focus group methodology was used in this study.The data was collected using focus group interviews and analyzed in the framework of the Grounded theory method as mapped by Strauss and Corbin(1990). The subjects enrolled in this study included 20 occupational health care providers in the Government-funded subsidized occupational health program for the SSI;6 doctors and 14 nurses. RESULTS: We identified 69 concepts,28 sub-categories and 5 categories(Table 2).The categories were the Program's Goals, Various Services,Difficulties in Implement Services, Program Evaluation,and Suggestions for Alternative Plans. CONCLUSIONS: This program showed that autonomous health management ability has not changed although the possibility for small scale industries to start the health management arose by acknowledging the importance of the health management in the work-place. A successful program should provided a practical service that is planned by the characteristics and the requirements of the workers,a better service than the standard, more visiting times,and a trusting relationship among workers. The occupational health agency's quality and the health manager's specialty needs to be improved and the health manager's authority should be consolidated. An actively cooperative triangular relation among the Labor Department/KOSHA, service organizations, and the workplace is required.In addition,alternative plans were suggested.These included various programs for planning an autonomous service suitable for the quality of the workplaces,a model set-up suitable for the quality of the workplaces,and a role model set-up for the health manager.

Analysis of Needs for Sexual Education in Primary School Children / 아동간호학회지

The purpose of this study was to analyze and identify the higher-grade primary school children's needs for sexual education. We got the data with open question from 481 children from March to July 1999. We analyzed them according to the framework suggested by the Sex Information and Education Council of USA. The framework involves the six domains such as human development, relationship, personal skills, sexual behavior, sexual health, and society & culture. In the analysis of need for sexual education according to domain, need for human development was highest (79.2 %), after that followed society & culture (8.3 %), sexual health (5.8%), sexual behavior (3.6%), and relationships (3.1%). There was no need for personal skills. By topics, there were needs for puberty (38.0%), reproduction (32.5%), gender roles (6.0%), body image (4.9%), sexual abuse (2.4%) and reproductive health (2.4%). Girls and boys all mostly wanted to know human development 41.0 % and 38.2 % each. Society & culture (3.4 %), sexual behaviour (2.7%), sexual health (2.6%), relationship (2.4%) were domains selected by boys. Girls wanted to know society & culture (4.9%) and 'sexual health (3.2%). Comparing by grade, fourth, fifth and sixth grade children are commonly interested in development, society & culture. Fourth grade children scarcely show attention on the relationship, sexual behaviour and sexual health; meanwhile sixth grade children would like to know sexual behaviour and sexual health. When their grade became higher, they would like to know more precise, concrete and deep information. We suggest that the textbook/guidebook for sexual health for the higher-grade primary school children should be developed considering the sex and grade.