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Original Articles
Factors affecting cultural adaptation stress by gender among multicultural adolescents in Korea
Seungwoo Han
Res Community Public Health Nurs. 2023;34(4):320-331.   Published online December 29, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00276
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  • 17 Download
AbstractAbstract PDF
Purpose
This paper is a descriptive survey research to identify factors that affect acculturation stress in multicultural adolescents, and provide basic information that can be used to develop ways to improve their mental health.
Methods
This study used the data of the 2nd multicultural adolescents panel study provided on December 30, 2022 by the National Youth Policy Institute. The subjects of this study were 1,520 multicultural adolescents in the fourth grade of elementary school and the survey period was from July to November 2020. The dependent variable was acculturation stress, and the explanatory variables were as follows: mother’s and father’s country of origin, region size, home economic conditions, academic achievement, experience of discrimination, mother’s level of education, father’s level of education, and number of close friends. Data analysis involved calculation of descriptive statistics, analysis of differences in the level of acculturative stress and general characteristics between male and female adolescents, and multiple regression analysis.
Results
This study found that there are gender differences in significant influencing factors for acculturation stress among multicultural adolescents. For males, factors influencing acculturation stress were identified as regional size, mother's education level, parental support, and teacher support. For females, they were regional size, experience of discrimination, number of close friends, parental support, and self-esteem.
Conclusion
The results of this study suggest that psychiatric nurses should provide psychiatric nursing and counseling to multicultural adolescents in addition to clinical psychiatric nursing. Various mental health programs should be developed for multicultural adolescents, with a focus on counseling, education, and family therapy.
Factors Related to Smoking Relapse Within Six-Months of Smoking Cessation Among Inpatients
Ji Eun Bae, Chul-Woung Kim, Seung Eun Lee, Myungwha Jang
Res Community Public Health Nurs. 2023;34(4):307-319.   Published online December 29, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00213
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  • 19 Download
AbstractAbstract PDF
Purpose
The purpose of this study is to identify factors associated with smoking relapse within 6 months after quit attempts among inpatients of a university hospital.
Methods
The subjects of this study were 572 inpatients of the National University Hospitals in Daejeon & Sejong who had enrolled in the smoking cessation service provided by the Daejeon·Sejong Tobacco Control Center and attempted to quit smoking. The data used in the study were extracted from the Smoking Cessation Service Integrated Information System. The Kaplan-Meier method and Cox Proportional hazards model were used to identify variables associated with smoking relapse within 6 months.
Results
The smoking relapse rate within 6 months was 76.7%, and variables associated with relapse included the absence of supporters for quitting smoking (hazard ratio [HR]=1.42, 95% confidence interval [CI]=1.00-2.02), nicotine dependence (HR=1.09, 95% CI=1.03-1.15), the use of prescription medications (including varenicline or bupropion) (HR=3.99, 95% CI=1.83-8.71), and the number of consultations (HR=0.67, 95% CI= 0.63-0.70).
Conclusion
As a result of the study, the number of consultations showed the strongest correlation with abstinence within 6 months. This implies that it is necessary to increase the counseling participation rate of the subjects so that smoking cessation counseling can be continued after discharge, and it is also required to provide support education to guardians during hospitalization for effective smoking relapse prevention.
Relationships of Self-leadership, Working Environment, and Professionalism among School Health Teachers
Joohee Kim, Young Ko
Res Community Public Health Nurs. 2023;34(4):294-306.   Published online December 29, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00297
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AbstractAbstract PDF
Purpose
This study was conducted to examine the relationships of self-leadership, working environment, and professionalism, and to identify the factors that influence professionalism among school health teachers.
Methods
This study was a descriptive research study to identify the relationships of self-leadership, work environment, and professionalism among school health teachers. Data were collected from 198 people via an online survey using a structured questionnaire. The data were collected from February 7 to 24, 2023. The relationships of self-leadership, working environment, and professionalism were analyzed using multiple regression analysis.
Results
The score of self-leadership of school health teachers was 3.97 points out of 5, working environment was 3.28 points out of 5, and professionalism was 4.12 points out of 5. Professional accountability and competency development were influenced by behavioral strategies of self-leadership, cognitive strategies of self-leadership, and working environment. These variables explained 35.0% and 29.5% of professional accountability, respectively. Autonomy was influenced by age, cognitive strategy of self-leadership, and working environment, and these variables explained 19.2% of the variance of autonomy. Social recognition was influenced by behavioral strategy of self-leadership, and working environment, and these variables explained 28.0% of social recognition.
Conclusion
To enhance the professionalism of school health teachers, it is necessary to cultivate self-leadership that can overcome difficulties in work and properly self-criticize. Improving the working environment would help enhance the professionalism of school health teachers.
A Multi-component Living Lab on Health Engagement for Advancing Self-care Agency among Migrant Workers in South Korea: A mixed methods study
Youlim Kim, Hyeonkyeong Lee, Sookyung Kim, Junghee Kim
Res Community Public Health Nurs. 2023;34(4):281-293.   Published online December 29, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00199
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  • 23 Download
AbstractAbstract PDFSupplementary Material
Purpose
Migrant workers battle to access health services and adapt to a new culture. Self-care agency can be essential for health self-management. This study examines the effects of a health engagement program to improve self-care agency using a living lab approach among migrant workers living in South Korea.
Methods
This study used a mixed-methods design, including a non-equivalent pre-post-test control group and three focus group interviews. Participants included 42 migrant workers from nine countries recruited via flyers, posters, and internet bulletins posted by a migrant community organization. During the 12 weeks, only the intervention group participants received four workshops addressing healthy physical activity, healthy dietary habits, effective cultural adaptation, stress management, and two outdoor cultural activities. They also participated in focus group interviews after the second, third, and fourth group activities and discussed the benefits of healthy behaviors and specific ways to implement them in real life.
Results
Participants in the intervention group showed an increase in self-care agency, health literacy, and acculturation after the 12- week intervention. Themes were derived based on the lessons from living lab activities, barriers to health behavior practices, and methods to overcome these.
Conclusion
This study demonstrated that multi-component intervention using a living lab effectively increased migrants’ participation in health promotion activities by strengthening health in their self-care agency. The qualitative and living lab approach effectively obtained comprehensive results on strategies to enhance healthy behavior engagement.
Development and Effectiveness of a Basic Epidemiological Investigation Simulation Program of Emerging Respiratory Infectious Diseases for Nursing Students: Application of Standardized Patients
Jiyun Park, Gye Jeong Yeom
Res Community Public Health Nurs. 2023;34(4):267-280.   Published online December 29, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00241
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AbstractAbstract PDF
Purpose
This study aimed to develop a simulation-based education program of emerging respiratory infectious diseases using standardized patients for nursing students, and to test the effects on basic epidemiological investigation performed while wearing Level D Personal Protective Equipment (PPE).
Methods
A total of 64 senior nursing students were recruited and assigned to either the experimental group (n=33) or a control group (n=31) in May 2022. This program was developed based on the analysis, design, development, implementation, and evaluation model. The analysis phase consisted of a literature review and target group survey. In addition, learning objectives and a structure were designed, and a scenario was developed with expert consulting. In the implementation phase, the program was conducted the course of 3 hours. The evaluation phase involved verification of the effects on clinical performance, self-efficacy, and anxiety related to basic epidemiological investigation, as well as an assessment of satisfaction with the program.
Results
There were significant differences between the experimental and control groups in clinical performance (Z=-2.15, p=.010) and anxiety related to basic epidemiological investigation (Z=-4.02, p<.001). However, there was no significant difference in self-efficacy related to basic epidemiological investigation.
Conclusion
The results indicate that this simulation-based education program was effective in improving clinical performance and reducing anxiety related to basic epidemiological investigation of nursing students. In addition, this program is expected to be widely used as an epidemiological investigation education for the initial prevention of infectious diseases.
Good subjective health status and health-related quality of life in people with chronic kidney disease: A secondary analysis using the Korea National Health and Nutritional Examination Survey in 2019 and 2020
Jena Lee, Yujin Suh
Res Community Public Health Nurs. 2023;34(4):255-266.   Published online December 29, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00262
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AbstractAbstract PDF
Purpose
This cross-sectional study aimed to describe subjective health status of people with chronic kidney disease (CKD), identify factors that affect good subjective health status and investigate the relationship between good subjective health status and health-related quality of life (HRQOL) in people with CKD.
Methods
This secondary analysis utilized data from the Korean National Health and Nutrition Examination Survey in 2019-2020. Participants (N=295) had an eGFR of ≤59 mL/min/1.73 m2. Descriptive and inferential statistics were used to analyze the data. Univariate and multivariate logistic regression analyses were performed to identify factors affecting good subjective health status and examine the association between good subjective health status and HRQOL.
Results
Among all participants, 61.4% had good subjective health status, and the HRQOL index was 0.88 in people with CKD. Household income, activity limitation, stress, and the number of comorbidities in people with CKD were associated with good subjective health status. People with better subjective health status were more likely to be satisfied with self-care, usual activities, and pain/discomfort in HRQOL.
Conclusion
Good subjective health status is associated with better HRQOL. Therefore, subjective health status should be assessed early, and a nursing intervention program should be developed considering factors that can improve subjective health status in people with CKD.
Experience Related to Acceptance of Illness among People with Early-Stage Dementia: A Phenomenological Study
Jaewon Park
Res Community Public Health Nurs. 2023;34(4):241-254.   Published online December 29, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00157
  • 950 View
  • 35 Download
AbstractAbstract PDF
Purpose
This study aims to describe the structure of the experience related to acceptance of illness among people with early-stage dementia (PWED).
Methods
Participants were six people who had Alzheimer’s disease or vascular dementia. Their clinical dementia rating scores were 0.5 or 1. Data were collected from individual in-depth interviews. The collected qualitative data were analyzed based on Giorgi’s descriptive phenomenological method.
Results
The five constituents and eight sub-constituents were derived from the experience related to acceptance of illness among PWED; ‘Facing the changed me’, ‘Facing changes in roles and relationships with others’, ‘Conflict between recognizing and denying dementia in daily life’, ‘Perceiving the limits and accepting dementia’, and ‘Reconstructing daily life for the prolongation of the current health status’.
Conclusion
This study contributes to the expansion of the in-depth understanding of the experience related to acceptance of illness among PWED. The results of the study will be helpful as basic data for community health nurses to develop interventions to improve acceptance of illness of PWED.
A Structural Equation Model on Health Status in Delivery Workers: Based on the Theory of Salutogenesis
Min Ji Kim, Eun Suk Choi
Res Community Public Health Nurs. 2023;34(3):228-239.   Published online September 27, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00171
  • 859 View
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AbstractAbstract PDF
Purpose
This study aimed to develop and test a structural equation model on health status of delivery workers. The conceptual model was based on the theory of salutogenesis.
Methods
Data were collected from 262 delivery workers working in D and K cities from August 2 to August 27, 2021. The structural equation model was used to assess the relationships among the variables. The model comprised three exogenous variables (working environment, social support, health promotion activities) and two endogenous variables (sense of coherence, health status). The data were analyzed using SPSS 23.0 and AMOS 22.0.
Results
The hypothetical model showed a good fit to the data: χ2/df=2.38, TLI=.91, CFI=.93, SRMR=.08, RMSEA=.07. Out of 10 research hypotheses, 10 were supported, and explained 62.3% of the variance in the health status of delivery workers. The model confirmed that sense of coherence was the most important factor. Health status is directly affected by working environment, social support, and health promotion activities. Health status is indirectly affected by working environment, social support, and health promotion activities through mediation of sense of coherence.
Conclusion
The theory of salutogenesis is adequate to use for developing health promotion programs for delivery workers. There is a need to develop a customized program to increase health status of delivery workers by enhancing sense of coherence.
The Effect of Dual Sensory Impairment on Cognitive Function Decline in the Elderly: The Moderating Effect of Social Support
Soo Jee Yang, Ju Young Yoon
Res Community Public Health Nurs. 2023;34(3):217-227.   Published online September 27, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00255
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AbstractAbstract PDF
Purpose
This study verified that the dual sensory impairment (DSI) in the elderly is associated with cognitive impairment (CI) and confirmed how change in cognitive function varies depending on the social support (SS).
Methods
For a study sample of Korean older people, data from the Korean Longitudinal Study of Ageing (KLoSA) from the 7th (2018) to the 8th (2020), were included in this cross-sectional descriptive study. Among people who responded in both 2018 and 2020, a total of 2,069 people of those who are 65 years of age or older, and have living children and normal cognitive function, were analyzed. X2 -test, t-test and logistic regression analyses were utilized.
Results
First, the number of elderly with visual impairment (VI), hearing impairment, and DSI increased on 8th data compared with 7th data. In addition, 22.9% of the 2,069 people showed a decrease in cognitive function. Second, compared to the elderly with normal sensory function, the cognitive function of the elderly with only VI was found to be more degraded, and the cognitive function of the elderly with DSI was found to be much more degraded. In addition, among SS, only participation in social gatherings was found to show significant change in cognitive function of the elderly with DSI. Third, the interaction effect of participating in social gatherings was not significant in the CI of the elderly with DSI.
Conclusion
VI and DSI effected cognitive function, but participation in social gatherings such as SS has not significant interaction effect on CI of the elderly with DSI.
Effects of Fatigue and Emotional Labor on Sleep Quality among Apartment Security Guards
Chul-Gyu Kim, Sujeong Jeong, Young Mi Ryu, Seungmi Park, Kyoungmi Moon, Yunjung Kwon, Sun-A Park, Hye Ok Park
Res Community Public Health Nurs. 2023;34(3):205-216.   Published online September 27, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00220
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AbstractAbstract PDF
Purpose
This study aimed to identify the effects of fatigue and emotional labor on the quality of sleep among apartment security guards.
Methods
A total of 196 apartment security guards working in 10 different regions participated in the study between July and October 2022, completing questionnaire assessing fatigue (physical imbalance, exhaustion, mental fatigue, and nervous system disfunction), emotional labor, and sleep quality. Data were analyzed using descriptive statistics, independent t-test, Mann-Whitney U test, ANOVA including Scheffe’s post hoc, and regression analysis.
Results
183(93.4%) participants were poor sleeper. Regression analysis of the factors influencing sleep quality yielded a significant model (F= 21.56, p<.001) with an explanatory power of 25.0% in the order of fatigue(exhaustion) (β=.28, p<.001), emotional labor (β=.27, p<.001), and subjective economic status (β=.15, p=.017).
Conclusion
It is essential to develop nursing educational programs that reduce exhaustion and emotional labor for improving the quality of sleep.
Gender Differences in Older Adults’ Muscle Strength and Depressive Symptoms: A Relationship Mediated Through Perceived Stress
Gyeong A Kang, Jihye Shin, Ju Young Yoon
Res Community Public Health Nurs. 2023;34(3):196-204.   Published online September 27, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00164
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AbstractAbstract PDF
Purpose
Preventing the effects of physical vulnerability is a practical approach to improving older adults’ depressive symptoms. This study aims to examine the relationship between gender differences related to muscle strength and depressive symptoms mediated by perceived stress.
Methods
In this cross-sectional study, data from 2,705 older adults (65 years old or older) from the Korea National Health and Nutrition Examination Survey VII 2016 and 2018 were analyzed. The moderated mediation model was developed; the outcome, independent, mediation, and moderated mediation variables in the literature-based research model were depressive symptoms, muscle strength, perceived stress, and gender, respectively.
Results
Perceived stress had a mediating effect on the relationship between muscle strength and depressive symptoms. The indirect effect of muscle strength on depressive symptoms mediated by perceived stress was β = -.02 (95% CI:-0.03~-0.01). The moderated mediation model demonstrated that the interaction term of handgrip strength and gender negatively affected perceived stress, which indicated that gender moderated the mediating model of perceived stress on the association of muscle strength and depressive symptoms (β = -.01, p <.05). The conditional indirect effect model was insignificant in the male group (β = -.00, 95% CI:-0.01~0.01) but significant in the female group (β = -.01, 95% CI: -0.02~0.00). Conclusions: Perceived stress mediated the relationship between muscle strength and depressive symptoms. However, the effect differed by gender. A stress-mediated depressive symptoms intervention program for older adults should be developed to consider women’s needs.
Factors Affecting the Performance of Infection Control of Multi-drug Resistant Organisms in Intensive Care Unit Nurses of General Hospitals based on the Theory of Planned Behavior: The Mediating Effect of Intention
Nam-Sook Kim, So-Eun Choi
Res Community Public Health Nurs. 2023;34(3):183-195.   Published online September 27, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00150
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AbstractAbstract PDF
Purpose
The purpose of this study is to analyze the factors that affect the performance of infection control of multidrug-resistant organisms (MDROs) by nurses in intensive care units (ICU) in general hospitals.
Methods
Participants were 105 ICU nurses from 6 general hospitals. The questions for the survey performed were based on the theory of planned behavior, such as attitude towards infection control of MDROs, subjective norms, perceived behavioral control, intention, and performance.
Results
In the relationship between subjective norms towards infection control of MDROs and performance, intention showed a significant complete mediating effect; and in the relationship between perceived behavioral control and performance, intention showed a partial mediating effect. The attitude towards infection control of MDROs was excluded from the mediating effect verification because there was no significant correlation between intention and performance.
Conclusion
The results of this study suggest that department atmosphere and perceived behavior control promotion programs should be developed to enhance subjective norms in order to promote the performance of infection control of MDROs.
Review Article
Factors Related to Diabetes Self-Care among Immigrants in the United States: A Scoping Review
Jung Eun Kim
Res Community Public Health Nurs. 2023;34(2):171-182.   Published online June 30, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00094
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AbstractAbstract PDF
Purpose
The purpose of this scoping review was to explore related factors in diabetes self-care among immigrants in the U.S. Diabetes is one of the fastest-growing chronic illnesses, but little is known about factors in self-care among minority immigrants in the U.S.
Methods
The Arksey and O’Malley (2005) methodological framework guided this review, which examined 16 articles, including qualitative, quantitative, and mixed-methods designs. PRISMA guidelines were used with five Databases. Search terms included: immigrants in the U.S., type 2 diabetes, self-care, and self-management.
Results
Factors related to diabetes self-care among immigrants were identified: (1) changed dietary lifestyle, (2) low economic and health insurance, (3) social support and resources, (4) low English proficiency, (5) psychological contexts, and (6) gender roles.
Conclusion
Given the culturally unique related factors in diabetes self-care among immigrants, healthcare professionals must be knowledgeable and responsive to the ethnic minority immigrants’ needs to promote effective diabetes self-care.
Original Articles
Assessment of Metabolic Syndrome Risk Based on Body Size Phenotype in Korean Adults: Analysis of Community-based Cohort Data
Ji Young Kim, Youngran Yang
Res Community Public Health Nurs. 2023;34(2):158-170.   Published online June 30, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00101
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AbstractAbstract PDF
Purpose
Body size phenotypes can be regarded as an indicator of cardiovascular incidence risk factors. The aim of this study was to investigate the incidence of metabolic syndrome among metabolically healthy adults according to body size phenotype using Korean Genome & Epidemiology Study [KoGES]-community based cohort from 2001-2002 to 2014.
Methods
A prospective population-based cohort including 5,068 adults aged 40-69 years free from metabolic syndrome was included and divided into three phenotypes: metabolically healthy normal weight (MHNW), metabolically healthy overweight (MHOW), and metabolically healthy obesity (MHO). The time dependent Cox’s proportional hazards regression model was used to estimate the incidence of the metabolic syndrome after a follow-up 14 years.
Results
In the demographic, health related variables-adjusted model (Model 3), the hazard ratio of the metabolic syndrome was 1.92 (CI 1.54-2.40) for MHOW, 2.88 (CI 2.32-3.58) for MHO among males, 1.89 (CI 1.51-2.37) for MHOW, 2.34 (CI 1.88-2.90) for MHO for females compared to MHNW, respectively.
Conclusion
In conclusion, MHOW and MHO in both males and females increased the risk of metabolic syndrome compared to MHNW. Obesity management should be considered even in the absence of metabolic syndrome. Programs and resources should be provided for prevention of cardiovascular diseases and better quality of life.
What Determines the Health-related Quality of Life of Vietnamese Migrant Workers in Korea?
Jihyon Pahn, Heesuk Kim, Youngran Yang
Res Community Public Health Nurs. 2023;34(2):147-157.   Published online June 30, 2023
DOI: https://doi.org/10.12799/rcphn.2023.00066
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AbstractAbstract PDF
Purpose
Over time, the number of migrant workers in Korea has shown a steady increase. Notably, among all migrant workers, those from Vietnam constitute the third largest group in Korea. The main objective of this study was to investigate the factors that influence the health-related quality of life of Vietnamese migrant workers. The study aimed to provide essential data for the development of customized nursing intervention programs and policy preparation in the future.
Methods
A total of 220 Vietnamese migrant workers aged between 18 and 64, who were employed in Korea through the Employment Permit System and had been residing in the country for more than 91 days, participated in this study.
Results
The study results revealed that physical activity (β=.19, p=.002), hope (β=.50, p <. 001), cohabitation with colleagues (β=.16, p =.003), and sleep hour (β=.11, p =. 031) had a statistically significant impact on health-related quality of life. The findings showed that higher levels of physical activity and hope were positively associated with higher health-related quality of life. Moreover, cohabiting with colleagues and sleeping for more than six hours were also significantly related to higher health-related quality of life.
Conclusion
Given these findings, it is imperative to develop programs that encourage physical activity and enhance the health-related quality of life of migrant workers from Vietnam. Policymakers and employers should also consider providing adequate living conditions that facilitate cohabitation with colleagues and sufficient time for sleep to improve the health and well-being of migrant workers.

RCPHN : Research in Community and Public Health Nursing