Effect of a transcultural nursing course on improving the cultural competency of nursing graduate students in Korea: a before-andafter study

PURPOSE: This study aimed to evaluate the impact of a transcultural nursing course on enhancing the cultural competency of graduate nursing students in Korea. We hypothesized that participants' cultural competency would significantly improve in areas such as communication, biocultural ecology and family, dietary habits, death rituals, spirituality, equity, and empowerment and intermediation after completing the course. Furthermore, we assessed the participants' overall satisfaction with the course. METHODS: A before-and-after study was conducted with graduate nursing students at Hallym University, Chuncheon, Korea, from March to June 2023. A transcultural nursing course was developed based on Giger & Haddad's transcultural nursing model and Purnell's theoretical model of cultural competence. Data was collected using a cultural competence scale for registered nurses developed by Kim and his colleagues. A total of 18 students participated, and the paired t-test was employed to compare pre-and post-intervention scores. RESULTS: The study revealed significant improvements in all 7 categories of cultural nursing competence (P<0.01). Specifically, the mean differences in scores (pre­post) ranged from 0.74 to 1.09 across the categories. Additionally, participants expressed high satisfaction with the course, with an average score of 4.72 out of a maximum of 5.0. CONCLUSION: The transcultural nursing course effectively enhanced the cultural competency of graduate nursing students. Such courses are imperative to ensure quality care for the increasing multicultural population in Korea.

Effects of anxiety, depression, social support, and physical health status on the health-related quality of life of pregnant women in post-pandemic Korea: a cross-sectional study.

PURPOSE: This study aimed to examine the effects of anxiety, depression, social support, and physical health status on the health-related quality of life of Korean pregnant women using Spilker's quality of life model. METHODS: This was a cross-sectional study with a correlational design. The participants included 166 pregnant women who were recruited via convenience sampling at two healthcare centers in South Korea. Questionnaires were collected from April 22 to May 29, 2023, in two cities in South Korea. The EuroQol-5D-3L, General Anxiety Disorder-7, Patient Health Questionnaire-2, Perceived Social Support through Others Scale-8, and EuroQol visual analog scale were used to assess the study variables. The t-test, Pearson correlation coefficients, and multiple regression tests were conducted using IBM SPSS ver. 26.0. RESULTS: Statistically significant correlations were identified between the health-related quality of life of pregnant women and anxiety (r=.29, p<.001), depression (r=.31, p<.001), social support (r=-.34, p<.001), and physical health status (r=-.44, p<. 001). Physical health status (ß=-.31, p<.001) and social support (ß=-.21, p=.003) had the greatest effect on health-related quality of life (F=15.50, p<.001), with an explanatory power of 26.0%. CONCLUSION: The health-related quality of life of pregnant women was affected by social support and physical health status. This study demonstrated that physical health and social support promotion can improve the health-related quality of life of pregnant women. Healthcare providers should consider integrating physical health into social support interventions for pregnant women in the post-pandemic era.

The effects of environmental prenatal program on environmental health perception and behavior using internet-based intervention in South Korea: A non-randomized controlled study.

PURPOSE: This study aimed to develop and examine the effects of an internet-based intervention program on environmental perception and behavior among Korean pregnant women based on revised protection motivation theory. METHOD: This study was a non-equivalent control group pre-post-test design. The experimental program consisted of prenatal education, reduction of fine dust, birth education, environmental health promotion, and postnatal management education using zoom video conferences. The face-to-face interventions were provided through regular prenatal classes at public health services for the control group. The total participant was 49 pregnant women: 25 in the experimental group and 24 in the control group. The program adaptation was conducted between April 2021 and November 2021 in Korea. The data were analyzed by ANCOVA and t-test to examine the effects using SPSS 26.0 program. RESULTS: After intervention of the program, environmental severity (F = 17.96, p < .001), response efficacy (F = 15.69, p < .001), and total environmental perception (F = 7.80, p = .008) were higher in the experimental group than in the control group. There were no significant differences in feasibility, accessibility, satisfaction, susceptibility, self-efficacy, barrier, personal environmental behavior, and community environmental behavior between the two groups. CONCLUSION: The internet-based educational program can be the alternative for the face-to-face prenatal class to promote environmental health perceptions during pregnancy in the pandemic situations.

Effect of Pro-Environmental Prenatal Education Program on Pregnant Women's Environmental Health Awareness and Behaviors based on the Protection Motivation Theory.

This study aimed to verify whether a pro-environmental prenatal education program has an effect on pregnant women's environmental health awareness and behaviors in Korea. This quasi-experimental study employed a nonequivalent control group and nonsynchronized design based on the protection motivation theory as a theoretical framework. In total, 96 pregnant women had their data collected and analyzed in Korea (40 in the experimental group; and 56 in the control group). Data collection through self-reported questionnaire was conducted between September 2017 and August 2018. The program consisted of lectures and group activities aimed at educating participants on environmental awareness and behaviors. The data were analyzed using t-test, chi square test, and ANCOVA using SPSS 24.0 program. After the intervention, the experimental group showed significantly higher sensitivity (54.78 ± 9.47 and 49.75 ± 5.42; F = 15.13, P < .001), susceptibility (26.30 ± 5.18 and 24.28 ± 4.53; F = 53.94, P < .001), response efficacy (27.40 ± 3.40 and 25.18 ± 4.23; F = 39.42, P < .001), self-efficacy (22.43 ± 4.15 and 21.35 ± 4.25; F = 41.13, P < .001), individual environmental behavior (58.59 ± 12.25 and 51.93 ± 12.64; F = 172.75, P < .001), and communal environmental behavior (18.45 ± 9.68 and 13.13 ± 8.24; F = 126.26, P < .001) than the control group. The developed pro-environmental prenatal education program contained content on the environment and pregnancy, environmental toxin, effects of endocrine disruptors, airborne pollutants, water pollutant, soil pollutant, radio-electronic exposure, and pro-environmental health behaviors during pregnancy. Pregnant women who participated in the pro-environmental prenatal education program had positive changes in environmental health perceptions and behaviors. As environmental hazards continue to increase, pregnant women should receive effective motivational education on eco-environmental protection to increase their sensitivity to environmental risk factors and to encourage active environmental health behaviors.

The Effects of Group Art Therapy on the Primary Family Caregivers of Hospitalized Patients with Brain Injuries in South Korea.

This study examined the effects of group art therapy on depression, burden, and self-efficacy in primary family caregivers of patients with brain injuries. This was a quasi-experimental, nonequivalent control group and a pre- and post-test design. This study was carried out in one national rehabilitation hospital targeting 41 primary family caregivers of patients with brain injuries. Group art therapy intervention was carried out three days per week comprising 12 sessions over four consecutive weeks. The experimental group (n = 20) received group art therapy, whereas the control group (n = 21) did not. We used a time difference method to minimize the risk of contaminating the control group by sampling sequentially. For depression, although there was a significant difference after the intervention (t = 3.296, p = 0.004), the mean difference score was not statistically significant between the experimental group and the control group (t = 0.861, p = 0.395). The experimental group showed a significantly greater decrease in burden (t = 2.462, p = 0.020) and significantly greater improvement in self-efficacy (t = -6.270, p < 0.001) than the control group. Group art therapy may be an effective nursing intervention for primary family caregivers of patients with brain injuries.

Impact of the COVID-19 pandemic on women's health nursing clinical practicums in the spring 2020 semester in Korea: a nationwide survey study.

Purpose: This study investigated the impact of coronavirus disease 2019 (COVID-19) on women's health nursing clinical practicums in undergraduate nursing schools in Korea during the spring 2020 semester. Methods: A cross-sectional online survey on clinical practicum teaching experiences in the spring 2020 semester was distributed to members of the Korean Society of Women Health Nursing (KSWHN) who taught undergraduate nursing. One faculty member from each of 203 institutions was requested to respond and there were no duplicate participants. Seventy-nine participants (38.9%) responded and 74 responses were analyzed. Descriptive statistics were presented for all survey items. Results: Fifty-two faculty members (70.3%) belonged to universities and 22 (29.7%) taught at colleges. Thirty-eight (51.4%) answered that their institutions had affiliated teaching hospitals. More than half (52.7%) conducted hospital-based clinical practicums either entirely (n=20) or partially (n=19), whereas the rest of them (47.3%) conducted clinical practicums at school or home via online teaching. The typical teaching methods for offline or online education were case conferences, tests or quizzes, scenario studies, nursing skill practicums, (virtual) nursing simulations, and simulated patient education. Most of faculties (93.2%) supported the development of an educational platform to share educational materials and resources, such as case scenarios. Conclusion: Nursing faculty members utilized various teaching methods to enhance clinical skills and mitigate limited clinical exposure during the early stage of the COVID-19 pandemic. The KSWHN should move forward to develop an education platform and modalities for members who face many challenges related to the accessibility and quality of nursing education contents.

Comparison of the number of live births, maternal age at childbirth, and weight of live births between Korean women and immigrant women in 2018.

Purpose: This study compared maternal age at childbirth, the number of live births, and the weight of live births between Korean women and immigrant women using statistical data from the Republic of Korea for the period of 2008-2018. Methods: The analysis was conducted using data from the Microdata Integrated Service of Statistics Korea (https://mdis.kostat.go.kr/index.do). Results: Korean women and immigrant women showed a higher age at childbirth in 2018 than in 2008. The percentage of newborns of Korean women with a birth weight of less than 2.5 kg increased slightly for 3 consecutive years from 2016 to 2018, whereas for immigrant women, this percentage increased in 2017 compared to 2016 and then decreased again in 2018. Very low birth weight (less than 1.5 kg) became more common among immigrant women from 2016 to 2018. Birth at a gestational age of fewer than 37 weeks increased both among Korean and immigrant women from 2016 to 2018. In both groups, the percentage of women who had their first child within their first 2 years of marriage decreased from 2008 to 2018. Conclusion: Immigrant women had higher birth rates than Korean women, while both groups showed an increasing trend in preterm birth. Greater attention should be paid to the pregnancy and birth needs of immigrant women, and steps are needed to ensure health equity and access in order to prevent preterm births. It is also necessary to identify factors that affect preterm birth and birth of very low birth weight infants among immigrant women in the future.

Pro-environmental health behaviour and educational needs among pregnant women: A cross-sectional survey.

AIM: To investigate pro-environmental health perceptions, behaviour and educational needs among pregnant women in Korea. BACKGROUND: Based on concerns about the effects of environmental hazards and pollution on their babies and themselves, pregnant women behave in ways that protect their health. The framework of this study was based on Rogers' protection motivation theory. DESIGN: Cross-sectional survey using questionnaires. METHOD: The sample comprised 358 pregnant women recruited from July - August 2018 in South Korea. Participants were recruited from prenatal classes at two healthcare centres and patients receiving prenatal check-ups at two women's hospitals. RESULTS: Perceived educational needs were ranked in the following order: particulate matter (23.7%), electromagnetic waves (11.7%), instant food (food additives) (9.0%) and environmental hormones (8.3%). Age (ß = 0.17, p = .001), perceived severity (ß = 0.19, p = .001) and response efficacy (ß = 0.28, p < .001) affected pro-environmental behaviour, which explained 23.0% of the variance. CONCLUSION: Educational programs are necessary for mitigating environmental risks during pregnancy. Pregnant women engage in pro-environmental behaviour influenced by pro-environmental perceptions, especially perceptions of severity regarding environmental diseases and the efficacy of health behavioural responses. Nursing professionals can use these results to promote pro-environmental health in pregnant women. IMPACT: This study demonstrated that pregnant women need environmental health programs in prenatal education. Pro-environmental perceptions regarding the severity of the environmental diseases and behavioural efficacy preceded the formation of environmental health behaviours. Nurses should support pregnant women's environmental health through educational interventions including air, electromagnetic, food pollution and endocrine disruptors.

Artificial intelligence, machine learning, and deep learning in women's health nursing.

Artificial intelligence (AI), which includes machine learning and deep learning has been introduced to nursing care in recent years. The present study reviews the following topics: the concepts of AI, machine learning, and deep learning; examples of AI-based nursing research; the necessity of education on AI in nursing schools; and the areas of nursing care where AI is useful. AI refers to an intelligent system consisting not of a human, but a machine. Machine learning refers to computers' ability to learn without being explicitly programmed. Deep learning is a subset of machine learning that uses artificial neural networks consisting of multiple hidden layers. It is suggested that the educational curriculum should include big data, the concept of AI, algorithms and models of machine learning, the model of deep learning, and coding practice. The standard curriculum should be organized by the nursing society. An example of an area of nursing care where AI is useful is prenatal nursing interventions based on pregnant women's nursing records and AI-based prediction of the risk of delivery according to pregnant women's age. Nurses should be able to cope with the rapidly developing environment of nursing care influenced by AI and should understand how to apply AI in their field. It is time for Korean nurses to take steps to become familiar with AI in their research, education, and practice.

Comparison of Needs for Pregnancy and Postpartum Adaptation of Chinese Immigrant Women and Vietnamese Immigrant Women in South Korea.

PURPOSE: To identify needs for pregnancy and postpartum adaptation of Chinese immigrant women and Vietnamese immigrant women in South Korea. METHODS: A descriptive research design was employed. Data were collected from 244 Chinese immigrant women and Vietnamese immigrant women from 3 provinces, 20 health care centers, and multi-cultural family support centers. Data were analyzed with descriptive statistics, t-test and ANOVA. RESULTS: An average score for needs perceived by Chinese immigrant women was significantly higher than that perceived by Vietnamese immigrant women. There were significantly differences in physical and emotional adaptation after childbirth, nutrition during pregnancy, cross cultural understanding and personal respect, and adaptation daily activity during pregnancy between the 2 groups. The highest score of needs in Chinese immigrant women was for nutrition during pregnancy and that in Vietnamese immigrant women was for baby rearing and family support. CONCLUSION: Based on needs of pregnancy and postpartum adaption, nursing intervention program in consideration of cultural characteristics of Chinese immigrant women and Vietnam immigrant women need to be developed for their pregnancy and postpartum health care.

A Survey on the Educational Needs and Competence of Nurses in Maternal Fetal Intensive Care Unit.

PURPOSE: Maternal Fetal Intensive Care Unit (MFICU), which provides intensive care to high-risk mothers with increasing maternal age and high-risk newborns, has become a new field of nursing work in South Korea. The present study was conducted to identify the educational needs and self-assessing clinical competence of nurses in MFICU. METHODS: The education needs and competencies of MFICU nurses were measured through prepared questionnaires by researchers based on the previous studies on job analysis of nurses in MFICU. Data were collected from January 2019 to March 2019. The study involved 168 nurses working in MFICUs at 12 hospitals nationwide as study subjects. The data were analyzed using the SPSS WIN 23.0 program. RESULTS: The education needs of nurses in MFICU had an average of 4.21 points (±0.50) and their nursing competence was average 3.38 points (±0.60). The items reported as high education needs but low competency by nurses in MFICU were as following: 'postpartum hemorrhage and shock,' 'cardiopulmonary resuscitation (CPR) for neonate,' 'CPR during pregnancy,' 'disseminated intravascular coagulation,' 'sepsis,' and 'mechanical ventilation during pregnancy.' CONCLUSION: Based on these results, it is proposed that a comprehensive education program for nurses in MFICU should be developed by considering low capabilities among MFICU nurses as a priority factor.

Effects of a cultural nursing course to enhance the cultural competence of nursing students in Korea.

PURPOSE: With Korea's recent rapid change into a multicultural society, cultural competence is being emphasized as a core nursing competency. This study investigated the effects of a cultural nursing course that aimed to enhance the cultural competence of nursing students in Korea. METHODS: This was a single-group pre- and post-comparison study. The subjects were 69 nursing students at Dongyang University who attended a cultural nursing course in 2015, of whom 62 students responded to the survey. The 13-week cultural nursing course was held for 2 hours a week. The methods of the course included small group activities, discussions and presentations, experiential learning, reflective activities, and lectures. Nursing students' cultural competence was measured pre- and post-course with the Cultural Competence Scale for Korean Nurses, which contains 33 items scored on a 7-point Likert scale. RESULTS: After completing the cultural nursing course, students' total cultural competence scores increased, as did their scores in each category (cultural awareness, cultural knowledge, cultural sensitivity, and cultural skills) (P<0.001). There was no significant difference in cultural competence by gender (P<0.001). CONCLUSION: This cultural nursing course was found to be effective in enhancing the cultural competence of nursing students. Therefore, the educational program developed in this study can be extended to other university-level nursing programs in Korea.

Army Soldiers' Knowledge of, Attitude Towards, and Preventive Behavior Towards Tuberculosis in Korea.

OBJECTIVES: The aim of this study was to gather information about Korean Army soldiers' attitude towards tuberculosis to enable the development of an informed educational program and potential intervention plans. METHODS: There were 500 male soldiers serving in the Korean Army who responded to questionnaires regarding knowledge of, attitudes towards, and preventive behavior towards tuberculosis. The questionnaires were collected between September 10 until October 1, 2014. Participants' characteristic that influenced differences in knowledge, attitudes, and preventive behavior towards tuberculosis were compared by t test. Variables that influenced preventive behavior were identified by multiple regression analysis. RESULTS: The mean scores assessing knowledge of, attitude, and preventive behavior towards tuberculosis were 11.64 (± 4.03) out of 20 points, 3.21 (± 0.38) out of 4 points, and 2.88 (± 0.42) out of 4 points, respectively. Non-smokers were more knowledgeable about tuberculosis than smokers. Participants who had family or friends with tuberculosis had better knowledge and a more productive attitude to tuberculosis. Participants who were educated or obtained information about tuberculosis, received better scores in all areas of knowledge, attitude and preventive behavior compared to other participants. Non-smoking, family or friends who have had tuberculosis, obtaining information about tuberculosis, and positive attitudes towards treatment and preventive education had an explanatory power of 24.6% with regard to preventive behavior against tuberculosis. CONCLUSION: More relatable, systemized education should be provided regularly to improve soldiers' knowledge of, attitudes towards, and prevention against tuberculosis in the Republic of Korea Army.

[Development of an Instrument to Assess the Quality of Childbirth Care from the Mother's Perspective].

PURPOSE: This study aimed to develop an instrument to assess the quality of childbirth care from the perspective of a mother after delivery. METHODS: The instrument was developed from a literature review, interviews, and item validation. Thirty-eight items were compiled for the instrument. The data for validity and reliability testing were collected using a questionnaire survey conducted on 270 women who had undergone normal vaginal delivery in Korea and analyzed with descriptive statistics, exploratory factor analysis, and reliability coefficients. RESULTS: The exploratory factor analysis reduced the number of items in the instrument to 28 items that were factored into four subscales: family-centered care, personal care, emotional empowerment, and information provision. With respect to convergence validation, there was positive correlation between this instrument and birth satisfaction scale (r=.34, p<.001). The internal consistency reliability was acceptable (Cronbach's alpha =.96). CONCLUSION: This instrument could be used as a measure of the quality of nursing care for women who have a normal vaginal delivery.

Development of Korean Menstrual Symptom Scale for University Students.

PURPOSE: To develop Korean Menstrual Symptom Scale (KMSS) for university students and test its reliability and validity. METHODS: The scale was developed by intensive literature review, development of preliminary items, verification of content validity, development of secondary items, verification of construct validity, and extraction of final items. Thirty-nine items were constructed. Data for validity and reliability testing were collected with a questionnaire survey from 391 university students. Data were analyzed with descriptive statistics, factor analysis, and reliability coefficients (Cronbach's α) with the SPSS program. RESULTS: There were 37 final items which were sorted into six factors: 'negative affection (8 items)', 'change of activity level (7 items)', 'physical symptom (9 items)', 'mood change (9 items)', 'change in concentration level (4 items)', and 'body water retention (5 items)'. The cumulative percent of variance was 63.3%. Regarding the reliability of the scale, its Cronbach's α was 0.96. Cronbach's α values for these factors ranged from 0.75 to 0.91. CONCLUSION: The KMSS demonstrated acceptable validity and reliability. Repeated research is needed to measure menstrual symptom experienced by women of variable ages.

Factors influencing beliefs about intimate partner violence among adults in South Korea.

OBJECTIVES: This study aimed to identify factors influencing beliefs about intimate partner violence among Korean adults. DESIGN AND SAMPLE: This is a cross-sectional descriptive study that analyzed data from 466 adults. MEASURES: Beliefs about intimate partner violence were measured using a self-report questionnaire with a total of 28 items consisting of four subscales: perpetrator's justification for beating women, blaming women for violence against them, perpetrator's responsibility for violence, and giving help to victims. RESULTS: Men and women had significantly different beliefs about intimate partner violence (t = -7.19, p < .001). Some characteristics were identified that led to unhealthy beliefs about intimate partner violence. Four variables-gender, age, educational level, and witnessing parental violence-had an explanatory power of 20% with regard to beliefs about IPV (F = 10.50, p = .000). CONCLUSIONS: In South Korea, men, older individuals, and those with less formal education or who have witnessed parental violence need education to foster healthier beliefs about intimate partner violence. Nurses can play a vital role in efforts to decrease intimate partner violence.

A Concept Analysis of Cultural Nursing Competence.

PURPOSE: The aim of this study was to conduct a concept analysis of cultural nursing competence. METHODS: Cultural nursing competence was analyzed using Rodgers' evolutionary concept development method. A literature search using the keywords "cultural nursing competence", "intercultural nursing competence", "cultural nursing", "cultural health nursing", and "cultural competence" was conducted in PubMed, CINAHL, ERIC, and RISS on material published before 2015. Database and bibliographic searches yielded 35 records. RESULTS: Cultural nursing competence comprised cognitive, affective, and behavioral domains. The critical attributes of the concept were sensitivity, equality, and activity. The analysis identified the following dimensions: awareness, openness, and coherence. The consequences of cultural nursing competence were personal satisfaction and social justice. The definition contained competence on both an individual and social level. CONCLUSION: Cultural competency enhances quality of care by narrowing health disparities and increasing client satisfaction. The concept analysis of cultural nursing competence may offer an acceptable framework which can be used to develop psychometric tools of this concept and provide guidelines in nursing practice.

Advanced Aged Women's Needs for Pregnancy and Childbirth Care.

PURPOSE: Advanced aged pregnancy may be related with health problems so that more aggressive health care is necessary for these women. This study aimed to provide the basic data for developing nursing intervention programs to enhance the health of pregnant women and their new-born babies and by identifying the advanced aged women's need for pregnancy and childbirth. METHODS: It is the cross-sectional descriptive study to identify the advanced aged women's need on pregnancy and childbirth. Subjects were pregnant women 35 years or older and postpartum women. Total number of subjects was 95. Measurement tool is self-reporting survey that consisted of 67 items with four-point Likert scale, which was completed during October to November 2014. RESULTS: Average score was 3.44 out of maximum 4 on the care need on pregnancy and childbirth. Average scores according to category were as follows: baby rearing and parental role, 3.55; preconception care, 3.49; delivery care, 3.47; postpartum care 3.42; and prenatal pregnancy, 3.39. The degree of needs on pregnancy and childbirth was different according to delivery experience (t=-2.49, p=.014). CONCLUSION: Prenatal and postpartum nursing interventions were completed regardless of pregnant women's age until now; however, new nursing intervention programs are necessary to prevent the risk of advanced aged pregnancy, to provide the preconception care, and to increase the infant care and family support.

Development and Evaluation of Multilingual Education Materials to Promote Immigrant Women's Adaptation to Pregnancy.

PURPOSE: This study was done to develop and evaluate multilingual education materials to promote health and adaptation to pregnancy for immigrant women in Korea. METHODS: This study had three procedures: First, contents of the education materials were developed according to pregnant women's needs, literature reviews, and group discussion. Details in contents were constructed based on Roy's adaptation model; Second, validity verification and translation of education materials were accomplished; Third, evaluation of the education materials was done through a survey of immigrant women. RESULTS: The education materials were developed in six languages (Korean, English, Chinese, Vietnamese, Filipino, and Cambodian). The title is "Healthy mother, happy family: eight-step guide to a healthy pregnancy". It was composed of an eight-step guide to healthy pregnancy, self-examination check list, websites for childbirth education and information, and guidelines on education materials in a brochure. In the evaluation, the average response score for the questionnaire items was high (3.23 on a four-point Likert scale). The average score for Cambodian immigrants was the highest of all immigrant women. CONCLUSION: Multilingual education materials developed in this research will help community health nurses to manage pregnancies for immigrant women and will be useful for health education for these women.