The influence of eHealth literacy, reproductive health knowledge, and self-esteem on health-promoting behaviors in early adult women: a cross-sectional survey

The purpose of this study was to investigate the influence of eHealth literacy, reproductivehealth knowledge, and self-esteem on early adult women’s health-promoting behaviors (HPB). Thisstudy was based on Pender’s health promotion model as a theoretical underpinning.Methods: Early adult women aged 18 to 35 years (n=165) were recruited by posting advertisements on social network sites for a student club and a faith-based community in Ansan, Korea. Willing individuals were invited to participate in the online survey from June 1 to June 30, 2022. Standardized instruments were used to measure HPB, eHealth literacy, reproductive health knowledge,and self-esteem. General characteristics included income level, perceived subjective health, and internet usage time. The collected data were analyzed using the independent t-test, one-way analysisof variance, Pearson correlation coefficients, and multiple regression.Results: The mean age of the respondents was 21.97±3.87 years. The total HPB score was 120.69,corresponding to a moderate level; and the total scores for eHealth literacy (30.24), knowledge ofreproductive health (23.04), and self-esteem (35.62) were higher than the midpoint. The model explained 53.3% of variance in HPB, and self-esteem (β=.48, p<.001) was the most influential factor.Other influential factors were, in descending order, higher economic level, higher subjective healthstatus, greater eHealth literacy, and less internet use time (<2 hours/day).Conclusion: In order to promote the health of early adult women, counseling or programs that positively improve self-esteem appear promising, and eHealth literacy should be considered as a way topromote HPB using information technology.

Validity and Reliability of the Korean Version of Assessment of Health Literacy in Breast and Cervical Cancer Screening

Purpose@#Health literacy is a significant determinant of health and health behaviors such as cancer screening. Despite its significance, there are limited instruments available to assess health literacy targeting Koreans. The purpose of this study was to test the psychometric properties of Korean translation of a validated health literacy instrument in cancer screening—Korean version of assessment of health literacy in breast and cervical cancer screening (K-AHL-C). @*Methods@#A total of 555 women aged 20~65 participated in the online survey study. Of 52 items addressing five domains included in the original version, we focused on 36 items addressing three key domains closely associated with cancer screening: familiarity, health navigation, and comprehension. @*Results@#During content validation, two items from the health navigation domain were removed, yielding 34 items. Using Rasch analysis and confirmatory factor analysis, we found the evidence of construct validity of K-AHL-C. The Korean version was also significantly correlated with measures of Functional Health Literacy scale, cancer prevention behaviors, and subjective health status, suggesting convergent validities respectively. Finally, K-AHL-C had acceptable reliability coefficients (α) ranging from 0.71 to 0.92 for each domain and the total scale. @*Conclusion@#These psychometric properties support the K-AHL-C is a valid and reliable instrument for measuring Koreans’ health literacy in cancer screening. Also it is expected to use the instrument to detect breast and cervical cancer early and improve the screening rate, and ultimately to contribute to the promotion of women's health and women's health nursing practice.

Risk Factors of the High-Risk Pregnancy and Association with Particulate Matter

Purpose@#High-risk pregnancy, resulting in major complications, such as abortion, gestational hypertension, and preterm labor, are on the rise, requiring intervention. Increased concentration of particulate matter that is 10 μg per cubic meter or less in diameter (PM10) due to increased air pollution and industrialization has recently been noted as a risk factor for health problems, and prior studies have reported that PM10 is related to abortion, gestational hypertension, and preterm labor. @*Methods@#This study used data from the Korean medical panel between 2008 and 2016 to identify 879 women with normal pregnancies and 301 women diagnosed with high-risk pregnancies. The association between high-risk pregnancy and PM10 was analyzed using the annual average regional concentration during the same period by the Korea Environment Corporation. @*Results@#At 35 years of age or older, the risk of abortion (p<0.001; 95% confidence interval [CI], 1.43–2.71) and preterm labor increased (p<0.05; 95% CI, 0.33–0.90). Married pregnant women were at a high risk of preterm labor (p<0.05; 95% CI, 0.25–0.98), and the prevalence of gestational hypertension was high in the metropolitan area (p<0.05; 95% CI, 12.09–25.93). On comparing the average annual concentration of particulate matter according to the level of atmospheric ventilation of the Korea Environment Corporation using a cutoff of ≤50 μg/m3, the probability of preterm labor was 2.2 times higher in groups exposed to particulate matter concentration of ≥50 μg/m3 (p<0.01; 95% CI, 1.49–3.25). @*Conclusion@#PM10 was related to preterm labor, and the risk of preterm labor was high if the average annual concentration of PM10 in the individual’s residential area exceeded 50 μg/m3.

Clinical Nurses' Resilience Skills for Surviving in a Hospital Setting: A Q-methodology Study

PURPOSE: Resilience relates to coping with stressful hospital environment. The purpose of this study was to identify the types of resilience skills of clinical nurses for surviving in a hospital setting. METHODS: The Q methodology was used as it helps analyze the participants' subjective perspective on each item. Participants were 32 registered nurses who sorted 38 selected Q statements that were then plotted on a normal distribution using a 9-point scale. The subjective perspectives on the resilience of clinical nurses were analyzed using the PC-QUANAL program. RESULTS: This study revealed four types of resilience in clinical nurses, accounting for 65.2% of the variance: Type I: Reality-harmonic type; Type II: Own will type; Type III: Professionalism-oriented type; and Type IV: Relation-oriented type. CONCLUSION: The present findings suggest the need to develop interventions for improving clinical nurses' resilience according to their types. Following further investigation of nurses' resilience, it may be necessary for organizations to develop several resilience strategies.

Linear programming method to construct equated item sets for the implementation of periodical computer-based testing for the Korean Medical Licensing Examination / 보건의료교육평가

PURPOSE: This study aimed to identify the best way of developing equivalent item sets and to propose a stable and effective management plan for periodical licensing examinations. METHODS: Five pre-equated item sets were developed based on the predicted correct answer rate of each item using linear programming. These pre-equated item sets were compared to the ones that were developed with a random item selection method based on the actual correct answer rate (ACAR) and difficulty from item response theory (IRT). The results with and without common items were also compared in the same way. ACAR and the IRT difficulty were used to determine whether there was a significant difference between the pre-equating conditions. RESULTS: There was a statistically significant difference in IRT difficulty among the results from different pre-equated conditions. The predicted correct answer rate was divided using 2 or 3 difficulty categories, and the ACAR and IRT difficulty parameters of the 5 item sets were equally constructed. Comparing the item set conditions with and without common items, including common items did not make a significant contribution to the equating of the 5 item sets. CONCLUSION: This study suggested that the linear programming method is applicable to construct equated-item sets that reflect each content area. The suggested best method to construct equated item sets is to divide the predicted correct answer rate using 2 or 3 difficulty categories, regardless of common items. If pre-equated item sets are required to construct a test based on the actual data, several methods should be considered by simulation studies to determine which is optimal before administering a real test.

Linear programming method to construct equated item sets for the implementation of periodical computer-based testing for the Korean Medical Licensing Examination / 보건의료교육평가

PURPOSE@#This study aimed to identify the best way of developing equivalent item sets and to propose a stable and effective managementplan for periodical licensing examinations.@*METHODS@#Five pre-equated item sets were developed based on the predicted correct answer rate of each item using linear programming. These pre-equated item sets were compared to the ones that were developed with a random item selection method based on the actual correct answer rate (ACAR) and difficulty from item response theory (IRT). The results with and without common items were also compared in the same way. ACAR and the IRT difficulty were used to determine whether there was a significant difference between the pre-equating conditions.@*RESULTS@#There was a statistically significant difference in IRT difficulty among the results from different pre-equated conditions. The predicted correct answer rate was divided using 2 or 3 difficulty categories, and the ACAR and IRT difficulty parameters of the 5 item sets were equally constructed. Comparing the item set conditions with and without common items, including common items did not make a significant contribution to the equating of the 5 item sets.@*CONCLUSION@#This study suggested that the linear programming method is applicable to construct equated-item sets that reflect each content area. The suggested best method to construct equated item sets is to divide the predicted correct answer rate using 2 or 3 difficulty categories, regardless of common items. If pre-equated item sets are required to construct a test based on the actual data, several methods should be considered by simulation studies to determine which is optimal before administering a real test.

Patterns and Factors associated with Complementary and Alternative Medicine Use among Korean Postpartum Women

PURPOSE: This study was conducted to identify the pattern and factors associated with women's use of complementary and alternative medicine (CAM) during postpartum in Korea. METHODS: With a descriptive survey design, data of 423 postpartum women were collected via online and offline surveys. RESULTS: A total of 251 women (59.3%) reported CAM use during postpartum. Eating animal-based foods (65.3%), plant-based health foods (52.2%), and using oriental medicine (31.8%) were commonly used in postpartum women. The reason for using CAM were physical recovery (39.1%), breastfeeding (29.7%), weight loss (24.8%), prevention of postpartum complications (5.1%), and others (1.3%). People who recommended CAM use was mainly family (41.3%), and expense of using CAM was 751,188 Korea won. Most women discussed CAM use with doctor (44.9%), and 29.3% of women didn't even consult CAM use with health care providers. Most of (72.3%) women were satisfied with CAM use. Higher level of education and monthly income, being employed, primipara, normal range of gestational weight gain, no abortion experience, and no maternal complication were significantly associated with CAM use in postpartum women. CONCLUSION: Results of this study were somewhat different from those of western research. Findings offer baseline data of CAM use in postpartum women, and health care providers need to understand it when they care for them.

Validation of a Korean Version of Fertility Problem Inventory

PURPOSE: The Fertility Problem Inventory (FPI) is a screening instrument used to identify infertility-related stress. The purpose of this study was to assess the reliability and validity of the Korean version of the FPI. METHODS: Forward-backward translation of the FPI from English to Korean was conducted. The translated instrument was pilot-tested and administered to 259 women with infertility. Test-retest reliability was conducted and the internal consistency coefficient was determined. Validity was evaluated through content validity, construct validity with confirmatory factor analysis, discriminant validity, and convergent validity. RESULTS: The internal consistencywas satisfactory (Cronbach's alpha=.92, item-total correlations=.60-.92). The overall content validity index was 96.9%, signifying that the FPI had good content validity. The model fit indexes were acceptable (goodness of fit index=.92, adjusted goodness of fit index=.91, normal fit index=.95, comparative fit index=.93, and rootmean square error of approximation=.05), indicating good construct validity. The intercorrelations were significant, although low to moderate in size (.20-.59). The correlation between the FPI and depression ranged from .32 to .51 (p < .001), while the correlation between the FPI and the fertility-related quality of life ranged from -.35 to -.58 (p < .001). CONCLUSION: The Korean version of the FPI has high reliability, and good content, construct, discriminant, and convergent validity. A validated Korean version of the FPI may help nurses identify infertility-related stress and administer appropriate nursing interventions to Korean women with infertility.

A Structural Model for Quality of Life of Infertile Women

PURPOSE: The purpose of this study was to test a model for quality of life among infertile women. This model was based primarily on the concept of the Fertility Quality of Life by Boivin et al. (2011) and the Infertility Resilience Model by Rindenour (2009). METHODS: Fifteen measurable variables were used to estimate quality of life. They included endogenous variables such as fertility quality of life and resilience, and exogenous variables such as infertility related stress, depression, marital adjustment, and family support. Data sets (n=203) used for analysis were collected in a general hospital which had, on average, 400 assisted reproductive technologies per month. RESULTS: The assessment of the modified model indicated acceptable fit, with chi2/d.f=2.07, GFI=.90, AGFI=.89, NFI=.89, CFI=.91, RMSEA=.07. Depression, infertility related stress, marital adjustment, resilience, and family support had direct influences on quality of life. CONCLUSION: The results of this study should contribute to the development of nursing intervention programs to enhance quality of life using factors that affect fertiQol (fertility quality of life) of infertile women.

Impact of Prepregnancy Body Mass Index on Pregnancy Outcome in Women with a Singleton Conceived by Assisted Reproductive Technology and Spontaneously Conceived Pregnancy: A Case-control Study

PURPOSE: To compare and confirm the impact of prepregnancy body mass index on pregnancy outcome in women with a singleton conceived by assisted reproductive technology and spontaneously conceived pregnancy. METHODS: A sample of 165 and 247 pregnant women with and without assisted reproductive technology were retrospectively recruited from electronic medical charts of C hospital. RESULTS: There were significant differences between the two groups for maternal age, paternal age, length of marriage, prepregnancy body mass index, parity, spontaneous abortion experience, and preterm delivery. A prepregnancy body mass index of > or =25 was associated with higher risk for maternal and neonatal complication in the assisted reproductive technology group. CONCLUSION: The results indicate that a higher prepregnancy body mass index is associated with increased risks for adverse pregnancy outcomes for women using assisted reproductive technology. So these women need appropriate care to compensate for the risk.

Music Therapy on Anxiety, Stress and Maternal-fetal Attachment in Pregnant Women During Transvaginal Ultrasound

PURPOSE: The purpose of this study was to examine the effects of music therapy on anxiety, stress and maternal-fetal attachment in pregnant women during a transvaginal ultrasound. METHODS: This study was a nonequivalent control group nonsynchronized design. Pregnant women (n = 232) were assigned to experimental (n = 117) and control (n = 116) groups respectively. The data were collected from August 2 to 27, 2010. The experimental group received general prenatal care and single 30-minute session of music therapy, while the control group received only general prenatal care. Anxiety, stress, and maternal-fetal attachment was assessed using three self-report measures by State scale of the State-Trait Anxiety Inventory (1976), Pregnant women's stress scale of Ahn (1984) and Cranley's (1981) maternal-fetal attachment scale. RESULTS: The music therapy group showed statistically significant decrease in anxiety compared to control group but no significant difference was identified in stress and maternal-fetal attachment. CONCLUSIONS: The finding provides evidence for use of nursing intervention in prenatal care unit to reduce pregnant women's anxiety. Further research is necessary to test the benefits of music therapy with different frequency and duration.

Effects of Laughter Therapy on Postpartum Fatigue and Stress Responses of Postpartum Women

PURPOSE: The purpose of this study was to examine the effects of laughter therapy on postpartum fatigue and stress respon-ses of postpartum women. METHODS: The research design was a nonequivalent control group non-synchronized design. The participants were 67 postpartum women who agreed to participate in this study, selected by convenience sampling: (experiment group-33 and control group-34). The data were collected from August 5 to September 30, 2010. The experimental group received laughter therapy from a laughter therapy expert for 60 min, twice a week for 2 weeks, a total of 4 sessions. To evaluate the effects of laughter therapy, postpartum fatigue by self-report questionnaire and cortisol concentration in breast milk were measured. The data were analyzed using the SPSS WIN 13.0 Program. RESULTS: The first hypothesis that "the degree of postpartum fatigue in the experimental group participating in laughter therapy would be lower than that of the control group" was accepted. These findings indicate that laughter therapy has a positive effect on decreasing postpartum fatigue. CONCLUSION: The finding provides evidence for use of complementary and alternative nursing in Sanhujori facilities and obstetric units to reduce postpartum women's fatigue.

Phenomenological Study on Experience of Preterm Labor / 여성건강간호학회지

PURPOSE: The purposes of this phenomenological study were to explore the experience of preterm labor. METHODS: The participants were 7 women admitted to two obstetric hospitals in Kyunggi-do Province with preterm labor. Data was collected with MP3 records through individual in-depth interviews and participated observation. The data was analyzed by Giorgi(1985) method. RESULTS: The results were divided into six categories as follows: 1) Inappropriate coping: unexpected event, overwork, lack of insight of preterm labor, 2) Burn out: multiple role, burden, role conflict. 3) Restrictions of lifestyle: uncomfortable hospital environment, wearisomeness, limitations of personal hygiene, 4) Physical discomfort: headache, flush, tremor, palpitations, 5) Psychological distress : concerns about fetus health status, fear of possible preterm delivery, lack of information, financial worries, 6) A transition to new lifestyle: share of household chores, communication with self-help group, careful lifestyle. CONCLUSION: The findings of this study will offer a better understanding of women's preterm labor experiences and suggest clues to nurses on how to improve the care they provide.

Effects of Koryo Hand Therapy on Menopausal Symptoms and FSH, LH, and Estradiol in Climacteric Women

PURPOSE: The purpose of this study was to examine the effects of Koryo Hand Therapy (KHT) on menopausal symptoms and hormone levels (Follicle Stimulating Hormone [FSH], Luteinizing Hormone [LH], and estradiol [E2]) in climacteric women. METHODS: The research design was a nonequivalent control group pretest-posttest design. Data were collected from November 28, 2005 to February 28, 2006. The 45 participants were assigned to either the experimental group (23) or control group (22). KHT was applied three times a week, for a total of 8 weeks to the women in the experimental group. RESULTS: There was a statistically significant decrease in menopausal symptoms (F=42.49, p=.000), FSH level (F=26.98, p=.000) and LH level (F=5.31, p=.026) between the experimental and control groups. There was an increase of the estradiol level in the experimental group but the difference between the two groups was not statistically significant. CONCLUSION: KHT can be applied as a supportive nursing intervention to climacteric women. KHT is expected to be a complementary alternative intervention for health management of the climacteric women.

A Study on the Life Adjustment of Widowed Elderly Women in Korea: A Q-Methodological Approach / 간호학회지

PURPOSE: The purpose of this study was to analyze the types of life adjustment of widowed elderly women in Korea. METHODS: The research design was a Q-Methodological Approach. Thirty selected Q-statements from 32 subjects were classified into a shape of normal distribution using a 7 point scale. The collected data was analyzed using a QUANL PC program. RESULTS: Three types of life adjustment were identified. Type I is the independent type: overcome the reality. Type II is the abandonment type: deny the reality. Type III is the accommodation type: accept the reality. CONCLUSION: The results of the study indicate that different approaches to the quality of life for widowed elderly women in Korea are recommended based on the three types of life adjustment.

Effects of Kangaroo Care on Anxiety, Maternal Role Confidence, and Maternal Infant Attachment of Mothers who Delivered Preterm Infants / 간호학회지

PURPOSE: The purpose of this study was to examine the effects of Kangaroo Care(KC) on anxiety, maternal role confidence, and maternal infant attachment of mothers who delivered preterm infants. METHODS: The research design was a nonequivalent control group pretest-posttest. Data was collected from September 1. 2006 to June 20. 2007. The participants were 22 mothers in the experimental group and 21 in the control group. KC was applied three times per day, for a total of ten times in 4 days to the experimental group. RESULTS: The degree of anxiety was statistically significantly different between the two groups but maternal role confidence and maternal infant attachment was statistically insignificant. CONCLUSION: This data suggests that KC was effective for mothers anxiety relief but it was not effective for maternal role confidence and maternal infant attachment of mothers. The implications for nursing practice and directions for future research need to be discussed.

Effects of Koryo Hand Therapy on Menopausal Symptoms and Blood Lipid Levels in Middle-aged Women / 여성건강간호학회지

OBJECTIVES: The purpose of this study was to examine the effects of Koryo Hand Therapy(KHT) on menopausal symptoms and lipid levels in middle-aged women. METHODS: The design of this study was a nonequivalent control-group pretest-posttest design. There were 32 subjects, 40-60 years of age, and assigned to two group. There were 16 members in the experimental group and 16 members in the control group. KHT was applied three times a week, for a total of 8weeks to the experimental group. The instruments used in this study to measure the effects of KHT were the menopausal symptoms scale and clinical laboratory testing(Blood Lipid Levels). Data was analyzed by Fisher's Exact Test, Mann-Whitney U-test, and ANCOVA, using SPSS/Win PC 13.0. RESULTS: There was a statistically significant decrease in the menopausal symptoms, and levels of the total cholesterol and LDL cholesterol in the experimental group compared to the control group. CONCLUSIONS: KHT was effective in decreasing menopausal symptoms in middle-aged women. Therefore KHT is recommended as a nursing intervention strategy for middle-aged women.

The Effect of P6 Acupressure for Symptom Control in Pregnant Women Having Hyperemesis Gravidarum / 간호학회지

PURPOSE: The purpose of this study was to determine the effects of Nei-Guan(P6) acupressure on nausea and vomiting in pregnant women having hyperemesis gravidarum. METHOD: The research design was a randomized control-group pretest-posttest repeated measure design with counter balancing. For the experimental treatment, P6 acupressure was carried out for ten minutes. Data was collected from April 1. 2003 to April 30. 2004. The participants were 66 patients admitted with hyperemesis gravidarum. They were divided into three groups, a P6 acupressure group, placebo point group and a control group. RESULT: Hyperemesis gravidarum patients who received P6 acupressure during admission experienced much less nausea and vomiting than the placebo acupressure and control group(F=8.259, p=.001). CONCLUSION: Nei-Guan(P6) acupressure is considered an effective intervention for reducing nausea and vomiting in pregnant women having hyperemesis gravidarum. Further more Nei-Guan(P6) acupressure maybe used as an independent nursing intervention method for pregnant women with severe nausea and vomiting.

Development of a Problem-based Learning Package for RN-BSN Students: Based on the Cases of Women during Pregnancy, Childbirth and Postpartum / 여성건강간호학회지

PURPOSE: The purpose of this study is to present a procedure for developing a PBL package and to provide the example of its application. METHOD: In this study, the PBL package was proposed based on the integrated curricular under maternity nursing. The PBL package model proposed by Little was applied to this study. RESULT: The procedure for developing the PBL package includes course objectives, learning objectives, concept mapping, situation scenario, tutor guide, and evaluation method. Clinical scenarios used in 3 PBL packages were composed of a pregnant women, a childbirth women, and a postpartum women. The Eight detailed steps are given in this study. CONCLUSION: Through these findings, the steps might be easier and more useful for nurse professionals to begin using the PBL package in maternity nursing. In addition, the steps will actively contribute to imply the PBL in nursing education.

Degree of Hysterectomy Patients' Educational Needs and Nurses' Educational Performance on Sexual Health Education / 여성건강간호학회지

PURPOSE: This study was to serve the sexual health education of the hysterectomy patients and to get the basic data of the nursing intervention on sexual health education. Sexual health education for the patients is an independent function as well as a professional responsibility of nurses. METHOD: The subjects were composed of 108 post-op patients who had undergone doing a hysterectomy 5 to 10 days previously and 101 nurses at OBGY hospitals. For data analysis, the study executed a frequency, mean, standard deviation, t-test, ANOVA, Duncan Multiple Range test and Spearman's rho correlation coefficient, in accordance with the purpose of the study using SPSS Win 10.0. RESULT: Mean score of the needs degree of sexual health education was 3.30 point. The need for education was highest in the sexual health promotion with education related to sexual interaction the lowest. Mean score of the nurses' teaching performance degree of sexual health education was 1.80 point. The nurses' teaching performance was highest in the sexual health promotion. There exist significant correlations between the degree of patients' educational needs and the degree of nurses' teaching performance on physiosexual (rho=-.667, p .05). CONCLUSION: The degree of sexual health education needs of hysterectomy patients was very high. Therefore, continuous nursing education program should be developed and provided for the promotion of the performance of sexual health education as the nursing professional role.