Research in Community and Public Health Nursing

Volume 11 (1); June 2000

Original Articles

Literature Review on Community Health Assessment based on the Concept of "Community as Client": Kyung Ja June, Young Sook Kwon, Jin Ju Oh, Eun Ok Park, Eun Young Kim, Hee Girl Kim; J Korean Acad Community Health Nurs. 2000;11(1):3-20. Published online June 30, 2000

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Abstract PDF: The purpose of this study was to compare the concept of community and community health, community health assessment tool, and community health nursing diagnosis based on the concept of "Community as Client". The method for this purpose was to search the articles and textbooks related to community assessment and review the contents by the researchers who were 5 community health nursing faculties and 1 doctoral candidate. The sources of articles were limited in Public Health Nursing and the Journal of Community Health Nursing. As the result, three types of conceptual model were classified: epideiological model. fuctional model. system model. System model by Newman and Helvie included more comprehensive concept of community health than others. Helvie model suggested the most specific indicators among them. The components of nursing diagnosis in the system model had the subjectives. problems and the related factors. It makes the nursing care plan related to the nursing diagnosis. But there was no nursing diagnosis system among the three model. It is needed to compare the nursing intervention based on the concept of "Community as Client". It will be helpful to the community health nursing practice to develop the nursing diagnosis system based on the system model. For the community health nursing education, it is suggested to try the case study by the using three types of model. Finally, it is needed to validate the community assessment tool in Korean setting.

A Study on Need Assessment in Health Promotion Programs for Developing Nursing Centers: Breast Self Examination: In Hyae Park, Hae Young Kang, Jeong Hee Lee, Hyun Sook Ryu; J Korean Acad Community Health Nurs. 2000;11(1):21-36. Published online June 30, 2000

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Abstract PDF: The purpose of this study was to assess the needs of breast self examination education (BSEE) programs for developing nursing centers. A first, we reviewed the literature of activity and management-related factors of nursing centers: and, second. we used a questionnaire to discover the degree of knowledge, attitude, and practice on breast cancer, as well as an individual's intention to participate BSEE program. 1. Reviewing the literatures of nursing center activities. Nursing centers which were administered by a professional nurse are an ideal site for faculty and student practices. With the use of nursing models of health. professional nurses in nursing centers diagnose and treat human responses to potential and actual health problems and offer holistic, client-centered health service. In nursing centers professional nursing services include health education, health promotion, and health-related research. A nursing center is comprised of the advisory and exacutive commitee; the advisory commitee serves consultants and links community needs to the nursing center, while the director of the exacutive commitee identifies the potential resources to generate funds, support, and facilitate the activities of staffs in a nursing center. Nursing centers mobilize various financal resources for reimbursement of services from college and insurance companies, collect minimum service fees from the client, and further collect fees for providing programs to community groups, this also includes membership fees, and donations. The services provided by nursing centers focus on services related to primary prevention, health maintenance & health promotion, direct nursing care for acute & chronic diseases, and holistic care for actual and potential health problems. The client satisfaction for the services was high. Students also showed positive reponses for their clinical experiences and independent working conditions. 2. The degree of knowledge, attitudes, and practices for breast cancer. and an individual's intention to participate in the BSEE program. The subjects of this study were 308 females in K-city in the Republic of Korea. Data were collected using a self-administered questionnaire. The mean age of the respondents was 35.0 years old. Those who already participated in the BSEE were 64.9%, and those who had support and encouragement to practice BSE from significant others were 25.1 %. Clients intent to participate in the BSEE were 37.0%. The mean score of knowledge(2.4 out of 5 points) and practices(1.8 out of 5 points) for breast cancer were quite low, but the mean score of attitudes was relatively positive04.5 out of 20 point) for breast cancer. Those who already had BSEE showed significantly high scores in knowledge(t=6.48, p<0.01), attitudes (t=10.54, p<0.01). and practices(t=57.07, p<0.001) for breast cancer than those who had not participated in the BSEE. In all age groups no intention to participate in the BSEE was higher than who the intention to participate. These findings suggest some strategies should be developed to increase the awareness of breast cancer's early detection.

A Study on the Demand and Utilization of Volunteers in Health Centers: Eun Sook Choi; J Korean Acad Community Health Nurs. 2000;11(1):37-66. Published online June 30, 2000

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Abstract PDF: Volunteers activities in Health Centers are strategically important for the efficient utilization of human resource and local people's health promotion in community. With these backgrounds. this study is conducted to examine significant factors in relation to demand and utilization of volunteers in Health Centers. and the factors are the characteristics of Health Centers. volunteer management factors and external environment factors. Subjects in this study were 245 Health Centers all chosen. Data were collected from April. 12. 1999 to May. 31. 1999. and the data for analyses were ones of 116 respondents. Then, the data coded and submitted to Fisher's exact test. NPAR1WAY ANOVA, Correlation analysis. multiple regression analysis, multiple logistic regression analysis with SAS program. The key results from this study can be epitomized as follows: 1. 43.1% of responding health centers answered that they "utilize volunteers". The average number of volunteers who were engaged in responding health centers was 43, out of which 7 were men and 36 were women. As for the adequacy of the number of the volunteers. 55.1% responded "not enough" and 30.6% responded "adequate". The more the number of volunteers needed. the more the number of utilizing volunteers is. When asked about their views concerning the utilization of volunteers in Health Centers. 88.7% of all respondents answered in the affirmative. The accountable factor for the utilization of volunteers was the present utilization of volunteers. 2. Concerning the reasons for using volunteers. "to induce local people's participation in health services" was the highest comprising 76% of the responding health centers. 3. Most of volunteers were housewives and independent enterprisers. The most type of volunteer activities was "just simple labor". 4. As for the action duration of volunteers. 69.4% answered "under 6 months". The factor was significant difference with the action duration of volunteers was "to provide social meeting" in the middle of rewards for volunteers. 5. Asked about the problem in utilizing volunteers. 53.2% answered "the difficulty of recruitment and education for volunteers". and 42.6% answered "lack of budget and manpower needed for the utilization of volunteers." 6. Concerning the evaluation of the performance by volunteers. 88% answered "satisfactory". With regards to the reason for that. 29.3% answered "volunteers can provide various kinds of services." 7. 88.7% of responding health centers answered that they will continuously or newly utilize volunteers in the future. 8. The main health program services which expect utilization of volunteers were visiting health services(63.2%). old people's health services (25.3%). These were not significant difference with any explanatory variable. 9. The average number of volunteer needed in responding health centers was 38. The more the average number of utilizing volunteers. the more the number of volunteers needed is. The more the degree of financial independence. the more the number of volunteers needed is. In conclusions. Health centers are necessary to promote their role of recruitment. education and training for volunteers. the development of volunteer activities programs.

Development of a Database System for Efficient Community Health Management : Focus on the Home Visiting Care of Family as a Unit by the Health Centers: In Hee Choi; J Korean Acad Community Health Nurs. 2000;11(1):67-79. Published online June 30, 2000

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Abstract PDF: In recent years, the recipients of the services of the health centers in Korea have been shifted from individual sick persons to families as a unit. As a result, the home visiting care records which are all filled out manually, will be increased. Since there is virtually no increase in the number of community health nurses, the CHNs are required to work more efficiently. One of the ways to make the CHNs' work more efficient is to reduce recording time by using a computer. However, a computer system that can manage the families as a unit has not yet been developed. In response to this need, we developed a database system that can be utilized in home visiting care service. The family assessment data is collected. diagnosed. and evaluated according to the family diagnosis classification. The system for family diagnosis consists of seven areas. Those areas are family structure. maintenance of the family system, interaction and interchange. support. coping and adaptation, health management. and housing environment. The areas of the family diagnosis consists of 99 items in all. We expect the following from this system. First. the CHNs will be able to identify family problems more easily. Second. the community's health level can be confirmed by the statistics the system produces. Thirdly, the CHNs' nursing services will be cost effective via reduced recording time. Finally, the family problems of the sick individuals which have been neglected under the health system oriented on individual persons can be effectively managed.

The Effects of Excercise Program on Cognitive Perception, Health Promotion Activity and Life Satisfaction of Elderly in Senior Citizen's Center: Eun Young Kim, Kyung Ja June; J Korean Acad Community Health Nurs. 2000;11(1):80-89. Published online June 30, 2000

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Abstract PDF: This study was designed to investigate effects on cognitive perception. health promotion activity and life satisfaction of elderly. The participants for this study were 292 in senior citizen's center in S-city. The participants were categorized by two groups. one have taken exercise regularly. at least more than one a week for 6 months, the other have not. The measurement tools were the Perceived Benefit Scale developed by Walker, et al. and translated by Kim. Hee Ja(1994), the Life Satisfaction Index developed by Neugarten. etc. and translated by Lee. Ga Ok(1994) and Self efficacy Scale developed by Kim. Hee Ja (1994). The data were collected by personal interviews. which were taken from January 11 to 16. 1999, and analyzed by SAS 6.12. The major results of this study were as follows; 1. Scores of self-efficacy were higher regular exercise group than irregular group. 2. Regular exercise group have taken exercise such as jogging, climbing and the other hands irregular group have not. 3. When the participants were categorized by smoking, other health promotion behavior (weight control. diet), both scores of life satisfaction index were higher smoking group than non-smoking group, other health promotion behavior than non-health promotion behavior. 4. There was no significant difference between the two groups in terms of perceived benefit, life satisfaction. From these findings, regular exercise program will be able to provide elderly with opportunity to change positively their lives in cognitive perception. health promotion activity.

Current State of Occupational Health in Small-Scale-Enterprises of Korea: Soon Nyung Yun, Young Im Kim, Hye Sun Jung, Soon Lae Kim, Kyung Hae Yoo, Young Sook Song, Hwa Joong Kim; J Korean Acad Community Health Nurs. 2000;11(1):90-104. Published online June 30, 2000

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Abstract PDF: This study was carried out to investigate the current state of occupational health management and characteristics of employees working in small-scale-enterprises (SSE) employing less than 50 workers. Samples were chosen among the two thousands employees working in 838 factories where located in Youngdungpo-Ku, Seoul, Korea. The study results were as followed: 1. Most factories investigated in the study were manufactures (68.6%) which were established in 5 to 10 years ago (29.2%), employing less than 5 workers (72.9%) and registered in accident compensation insurance (23.0%). 2. Health screening was undertaken in 24.9% workplaces for periodic health examination and in 1.5% for special health examination. Environmental monitoring was done in 3.3% factories. Very few factories displayed Material Substance Data Sheet (MSDS) in 3.1% among the total factories. 3. Workplaces usually had their own toilets in 75.9% and washing basin in 58.6% as types of sociowelfare facilities. 4. Employees responded in the study were mostly in the range of age from 30 to 39 in 34.7%. male in 84.8%. the married in 70.3%. manual workers in 42.0%. mostly working regularly 51 hours per a week in 48.2% and earned 710.000 Won to 1.000.000 Won per month in 35.0%. Medical utilization for employees were covered by factories sponsored medical insurance in 12.7% and by provincial sponsored medical insurance in 83.4%. 5. Two point six percents of employees were suffered by diseases. The health complaints indicated were mainly digestive problems in 46.7% and hypertension in 24.4%. 6. Employees wore personal protective equipments for work such as gloves in 48.1%. safety shoes in 30.5%. ear plug in 5.5% and mask in 6.9%. Based on the results of study, we recommend that various types of occupational health management should be developed according to workplace working condition of each factory. In addition to the development of occupational health strategies. we think that it is more important to monitor and to allocate how effectively they operate each other on the basis of longitudinal continuity. Besides, we would like to insist that these all management effort should be focused on prevention of disease and occupational health education of employees.

The Relationships of Blood Pressure with Dietary Habit and Level of Physical Fitness of Middle-aged Male Workers by Age: Kyung Min Park, Jeong Sook Park; J Korean Acad Community Health Nurs. 2000;11(1):105-116. Published online June 30, 2000

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Abstract PDF: The purpose of this study is to evaluate the relationship of blood pressure with dietary habit and level of physical fitness of middle-aged male workers by age. The study subjects included 511 male employees who have worked at a company in C City, whose age was more than 40 years old. Between April 10 and May 30. 1998, all of the study subjects measured physical fitness (Balance, strength, power, agility, flexibility and endurance) and blood pressure. A questionnair was administered for dietary habit and socio-demographic characteristics. The average age (SD) of the study subjects was 46.61(3.98) years. The study subjects were classified by age into 3 groups; 40-44 aged group(34.6%), 45-49 aged group(41.3%), and 50-54 aged group (24.1%). The score of dietary habit of 40-44 aged group was 69.77+/-5.82 that of 45-49 aged group was 69.77+/-5.83, and that of 50-54 aged group was 71.85+/-6.82(p=0.005). But age of health physical fitness tend to weaken in the age of 40-44. Systolic(p=.011) and Diastolic blood pressure (p=.011) were significantly increased with age increment. Diastolic blood pressure and dietary habit of 45-49 aged group showed the significant negative-correlation(r=.280. P<0.05). and Diastolic blood pressure and age of health physical fitness of 40-44 aged group showed the significant positive-correlation(r=.182. P<0.05). On the basis of the results of this study. I hope occupational nurses should play an active role to improve dietary habit and physical fitness for prevention of hypertension with increase of age in middle-aged male workers.

Health Problems of Female workers in Small Workplace: Young Im Kim, Soon Nyung Yun, Jeong Myung Choi, Chun Mi Kim, Hye Sun Jung; J Korean Acad Community Health Nurs. 2000;11(1):117-126. Published online June 30, 2000

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Abstract PDF: For basic data to develop health management program of female workers. this study was intended to characterize factors affecting health problems of women at workplace which has less than 50 workers by Cornell Medical Index(CMI). 195 items of CMI questionnaire were simplified to 57 items which were composed of 35 items concerning physical health problems and 22 items concerning mental health problems. The data was collected during 6 months from July 10 to December 30 and analyzed with frequency, percentage, t-test and ANOVA. The 107 female workers included in this study was characterized to be mainly twenties(64.5%), single(69.2%) and working at production position(89.7%). The most frequent physical problem was fatigability and the next, neurological system and cardiovascular system. Main mental complaints were inadquacy. anger and tension. When the health problems were reviewed according to its general characteristics, anger in young age, adaptiveness in single and respiratory complaints in self-recognized unhealthy group were prevalent. According to life styles. the prevalent complaints were musculoskeletal one in alcoholic group and cardiovascular one in group who are sleeping just for four to five hours. The appropriateness of each items of CMI should be evaluated to reveal the reasons why meaningful results could not come from many items of this questionnaire. The repeated study should be carried out to figure out the health problems and its related factors of female workers at small scale workplace. Also, exercise program and abstinence from drinking and smoking should be carried out for female worker's health.

A Study on Health Behaviors and Problems of Female Retail Workers: Souk Young Kim, Soon Nyung Yun; J Korean Acad Community Health Nurs. 2000;11(1):127-145. Published online June 30, 2000

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Abstract PDF: The objectives of this study are to identify health behaviors and health problems. and the relations between health behaviors and health problems of female workers in the retail business. The number of subjects were 200 female workers of 6 department stores in Seoul and Kyonggi area, whose jobs last more than 6 months as retail employees. The data was collected during 2 months from July 1 to August 30, 1998. The Cornell Medical Index Health Questionnaire(CMI) was used to measure their health problems, while health behaViorn were investigated in terms of 'smoking', 'alcohol', exercise', 'diet', and 'sleeping'. The data were analyzed with frequency. percentage, t-test, ANOVA test, and chi2-test by SPSS PC+ program. The results of this study are as follows: 1. Out of health problems. Digestive symptoms occupied the highest percent number. nervous ones the second and cardiovascular ones the third among physical health problems of retail female workers. The most frequent mental health problem was 'adequacy' and the next, 'tension' and 'anger'. 2. Health problems according to general characteristics of subjects were shown that the younger or the unmarried complained more than the older or the married, especially in the items of 'eye and ear', 'respiratory system', 'cardiovascular system', 'digestive tract', 'nervous system', 'adequacy', and 'depression'. The longer working duration they have had, the more they complained of 'respiratory system' and 'adequacy'. The lower academic careers complained of 'nervous' than the higher ones with statistical significance. 3. The analysis of daily health clinic notes showed that respiratory complaints were the highest percent, successively followed by digestive tract, nervous one, external injury, musculoskeletal system, urinary-reproductive system and others. 4. The level of their health practice was generally low in smoking, diet habit and alcohol intake, exercise, sleeping, very low especially in smoking, diet, alcohol intake, and exercise among them all. 5. Present smokers and ones with past experience complained of physical and mental health problems of 'respiratory system', 'digestive tract', 'skin', 'nervous', 'urinary-reproductive system', 'fatigability', adequacy', 'depression', 'anxiety', 'anger' and 'tension', than non smokers, with statistical difference. Workers without having breakfast and with irregular diet had more complaints on 'digestive tract', 'adequacy' and 'tension', than those who had regular dietary habit. The less the subjects slept, the more they complained of eye and ear, cardiovascular system. The subjects who drank alcohol complained more digestive problem. However, whether they exercise or not did not affect physical and mental health problems in a significant manner. 6. The subjects' age and marital status were statistically significant relating to health behaviors, as the younger or unmarried recorded a low level of health practice in smoking, drinking, dietary habit. Based on the results, the suggestions are made as follows: 1. Health education program on smoking, alcohol intake, diet habit is needed to improve health problems and health behavior of female retail workers. 2. The unmarried workers of late teen and twenties, who are transitional period from teenagers to adulthood are important targets for health promotion program especially for maternal health. 3. Better working environment with sufficient time and facilities for workers to relax is required to promote female sales workers' health. 4. Further research is required to identify the relation between workers' visual fatigue and intense lights for the display of goods.

A Study on the Powerlessness of Elderly Adults in Nursing Homes: Jung Soon Kim, Mi Sook Kim; J Korean Acad Community Health Nurs. 2000;11(1):146-157. Published online June 30, 2000

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Abstract PDF: The purpose of this study is to provide basic data necessary for the establishment of a nursing intervention program to relieve the powerlessness of elderly adults in nursing homes by investigating the degree of such powerlessness and factors affecting it. For the study, 353 elderly adults from S. A. D. J and Y free nursing homes located in Pusan were sampled as the subjects. The data were collected through direct interviews using a questionnaire survey and recorded by observation for a month from September 1. 1999. Data were analyzed using the statistical package SAS. The main results were as follows; 1. The mean score of the degree of perceived powerlessness of the subject were 30.4 point out of 64 point. 2. The level of powerlessness showed significant differences among the subjects in terms of educational background and monthly allowance both of which belong to socio-demographic characteristics. 3. Concerning the level of powerlessness based on health conditions. it showed significant differences in terms of the situation of common activity and the subjective perception of health condition. 4. Based on social support. the level of powerlessness was found significantly different in terms of close friends. 5. According to social activity. the level of powerlessness showed a significant difference in religious and leisure activities. In conclusion, it would be more effective in reducing powerlessness in elderly adults and in dealing with chronic diseases and physical discomfort. if we operated programs through which elderly adults can make friends and develop a nursing intervention program focusing on a variety of leisure activities.

The Relationship Among Self-Efficacy, Social Support and Depression of The Poor Elderly: Nam Ho Song, Sun Mi Kim; J Korean Acad Community Health Nurs. 2000;11(1):158-171. Published online June 30, 2000

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Abstract PDF: The elderly population will increase from 5.8% in 1996 to 12.5% in 2020. The related problems of health will also become a very important issue in the future. Therefore. it is important to address the problems of geriatic nursing and geriatic health. The purpose of this study was to examine the relationship among self-efficacy, social support and depression of the poor elderly. The subjects of this study were 42 poor elderly in Tae Jeon city. The data were analyzed by the SPSSWIN computer program and include AONVA. Pearson Correlation, frequency analysis. The Cronbach Alpha of self-efficacy tools was .8297, social support tools was .9187 and depression tools was .8887. The data were collected through personal interviews using a questionnaire from September 27 to October 23. 1999. The conclusion of this study are summarized as follows: 1. There were mean scores for self-efficacy at for social support 86.00+/-18.43 and for depression 60.31+/-15.61. 2. There was a significant positive correlation between self-efficacy and social support(r= .361. p<.05) in the poor elderly. There was a significant negative correlation between social support and depression(r= -.640, p<,01), self-efficacy and depression(r= -.182) in the poor elderly. 3. In a significant test in the general characters of the subjects and in the higher social support level. we obtained the following results: living with partner is. have son is. living family members is. the higher economic level is. 4. In a significant test in the general characters of the subjects and in the lower depression level, we can obtained the following results: The old man is. living with partner is. living family members is. the higher economic level is, the higher health level is.

A Study on Health as Expanding Consciousness of Korean Elderly People with Chronic Illnesses in the Community: Hae Young Kang; J Korean Acad Community Health Nurs. 2000;11(1):172-183. Published online June 30, 2000

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Abstract PDF: This paper explores the process of pattern recognition reflected in Newman's praxis methodology by three Korean elderly people with chronic illnesses. Four core themes demonstrated from the life pattern of participants that discouragement/frustration, regret, deep grudge/pent up feeling and renunciation/resignation were prevalent. None of the participants had experienced the turning point central to the process of expanding consciousness. It was concluded that it requires longer a research period with repeated in-depth interviews to explore the transformation in the process of recognizing a pattern of life.

A Study on Influencing Factors in Health Promoting Lifestyles of Female College Student: Mal Soon Kang, Chung Nam Kim; J Korean Acad Community Health Nurs. 2000;11(1):184-198. Published online June 30, 2000

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Abstract PDF: This descriptive correlational study was conducted to identify the variables related to a health promoting lifestyle in college female students. Participants were 232 female college student living in chinju city who selected by convenience sampling method. The data were collected by self-reported questionnaires from May to December. 1999. The data were analyzed by using descriptive statistics. pearson correlation coefficient. t-test. ANOVA. Duncan verification and stepwise multiple regression with an SAS program. The result to this study were as follows; 1) The average score of a health promoting lifestyle performance was 97.19, the average score of each item was 2.37. among the each items. self-actualization was obtained the most high score(31.10) and stress management was obtained the low score(14.74). 2) The result of compare health promoting lifestyle performance with related variables was follows; (1) In intervention factor, school lifestyle level showed significant positive correlations with teaching relationship level. (2) In Analysis of relationship of health definition. self-efficacy, perceived health status. and perceived benefit & barriers of health that is recognition-perception factors. health promoting lifestyle performance showed significant positive correlations with health definition (r=.2948. p=.001) and self-efficacy (r=.4587. p=.001). (3) A health promoting lifestyle showed significant positive correlations with school lifestyle(9.9%), family support (12.8%), and relationship with teacher (14.6%). This result indicate that; 1) need to development the health promoting model that suitable to our situation. 2) need to development the health promoting model that include family member and application and test to women. 3) need to development of the health promotion program and health education to women. 4) need to study for find out variables that have a influence to stress management. exercise. nutrition. and health promoting performance with low score in test.

The Reliability and Validity of the Health-Related Hardiness Scale in a Sample of Korean Nursing Students: Mi Ra Lee; J Korean Acad Community Health Nurs. 2000;11(1):199-208. Published online June 30, 2000

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Abstract PDF: The purpose of this study is to test the psychometric properties of the Korean version of the Health-Related Hardiness Scale(HRHS) in a sample of Korean nursing students. The korean version of HRHS was administered to 234 nursing students including 135 college students and 99 university students. The Korean version of HRHS was measured on a 6 Likert scale, assessing three factors of HRHS : control, commitment, and challenge. Internal consistency was used to test the instrument's reliability. The internal consistency of the scale was measured using a coefficient alpha. The coefficient alpha was .69(control), .49(commitment). and .69(challenge). Item analysis and confirmatory factor analysis (CFA) were used to test the instrument's construct validity. The item analysis identified that there were 13 items. which were lower than the .25 item-total correlation. CFA revealed that the scale's fadoral validity was not proper by showing unfit indices(RMSEA .07. stand, RMR .09. GFI .71). According to the findings of this study, the reliability and construct validity of the Korean version of HRHS is not satisfactory in the sample of nursing students. As a result. the researcher modified the scale through item analysis and repetitive CFA process, and proposed the revised 25-item Korean version of HRHS for nursing students. The revised scale's reliability(control .74, commitment .73. challenge .77) and factorial validity were within acceptable levels. The item analysis identified that there was no item, which is lower than the .25 item-total correlation. CFA revealed that the scale's factoral validity was proper by showing fit indices(RMSEA .08 stand. RMR .08. GFI .80).

The Knowledge, Attitude and Behavior on Smoking in Elementary School Students: Kwang Ok Lee, Hye Young Choi; J Korean Acad Community Health Nurs. 2000;11(1):209-221. Published online June 30, 2000

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Abstract PDF: I began the study to identify the issues related to knowledge. attitude and behavior regarding smoking by sixth graders. which will ultimately lead to the development of a smoking prevention program that will not only help deter school-age children from smoking, but also make them aware of the more desirable behaviors and techniques for healthier life. The results are as follows: 1. Smoking Behavior: Of the focus group. 4.15% are current smokers and 18.23% are ever smokers. 2. Correlation between smoking knowledge and ever smoking: Ever smoking sample(11.10+/-3.66) is less knowledge able than the never-smoking sample(12.17+/-3.95), (t=3.23. p=.001). 3. Correlation between smoking attitude and ever smoking: Ever smoking sample(28.12+/-8.51) was less desirable than the never-smoking sample(12.17+/-3.95). (t=8.24, p=.000). 4. Correlation between smoking Knowledge and smoking attitude: knowledge about smoking and attitude toward smoking are quantitatively correlated in such way that the more knowledgeable the child is about smoking. the more desirable the attitude toward smoking is(r=.17. p=.000). 5. Correlation between socio-anthropological characteristics and ever smoking: family . atmosphere(chi2=16.49. p=.001), school life (chi2=l1.58, p=.003), grades in school(chi2=11.89. p=.003), gender(chi2=8.97. p=.003). friends' gathering place(chi2=13.19. p=.02), marital status of parents(p* =.03). and family's financial status(chi2=6.71. p=.035). In addition, Correlation between somking-environmental characteristics and ever smoking: number of friends who smoke(chi2=76.01. p=.001). information source for smoking(chi2=48.03. p=.001), whether or not siblings smoke(chi2=26.07, p=.001), whether or not female relatives smoke (chi2=15.65. p=.001), whether or not father smokes (chi2=12.10. p=.007), errands to buy cigarettes for someone(chi2=9.18. p=.010), and whether or not male relatives smoke (chi2=8.82. p=.35). 6. Results of the logistic analysis performed to identify the factors correlated to ever smoking show that: one point decrease in attitude score translates to 25.39 times' increase in ever smoking one person decrease in the number of friends who smoke translates to 0.66 times' decrease in ever smoking: the group where the father has quit smoking has 1.40 times more ever smoking than the group where the father does not smoke at all: and likewise, the group where the father currently smokes has 1.40 times more ever smoking than the group where the father has quit smoking. 7. The overall cause-and-effect relationship between the ever smoking and the related factors: attitude toward smoking caused ever smoking by -.43, smoking by friends, by .12, marital status of arents, by .05, school life. by .04, gender, by -.03, and smoking by father, by -.02. Knowledge about smoking (t=-1.67) did not cause significant effects on ever smoking.

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