Research in Community and Public Health Nursing

Volume 11 (2); December 2000

Original Articles

A Model for Nursing Students' Stress: Mi Ra Lee, Mee Kyung Cho, Hyun Sook Chung; J Korean Acad Community Health Nurs. 2000;11(2):321-332. Published online December 31, 2000

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Abstract PDF: The purpose of this study was to test the hypothetical model designed to explain nursing students' perceived stress, coping levels, and stress outcomes. This hypothetical model was based on the Kim. Jung Hee(l987)' s stress model and stress-related literature. Exogenous variables were self-efficacy. hardiness. social support. and exercise. Endogenous variables were stress perception. coping levels. and stress outcomes. Empirical data for testing the hypothetical model consisted of 205 nursing students. SAS PC Program and LISREL 8.12a program were used for descriptive statistics and linear structural relationship(LISREL) modeling. The results were as follows. 1) The overall fit of the hypothetical model to the data was good(chi2=78.41(p=0.010), chi2/df=1.50. RMSEA=0.05, standardized RMR=0.05, GFI=0.95, AGFI=0.91, NNFI=0.90, NFI=0.94). 2) The results of statistical testing of the hypotheses were as follows. (1)As expected. self-efficacy had a significant effect on stress perception. But. hardiness. social support, and exercise did not have a significant effect on stress perception. Self-efficacy, hardiness. social support, and exercise explained 12% of the total variance of stress perception. (2) As expected, self-efficacy, hardiness, social support, exercise, and stress perception had a significant effect on coping behavior, Self-efficacy, hardiness, social support, exercise, and stress perception explained 53% of the total variance of coping behavior. (3) As expected, stress perception and coping behavior had a significant effect on stress outcomes. Stress perception and coping behavior explained 84% of the total variance of stress outcomes. In conclusion, the hypothetical model of this study was confirmed in explaining and predicting stress perception, coping levels, and stress outcomes in nursing students. And these findings suggest the need to develop nursing intervention to enhance self-efficacy, hardiness, social support, and exercise to decrease the harmful outcomes of stress.

A Structural Model for Health Promotion and Life Satisfaction of Life in College Students in Korea: Youn Lan Hong, Ga Eon Yi, Hyun Sook Park; J Korean Acad Community Health Nurs. 2000;11(2):333-346. Published online December 31, 2000

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Abstract PDF: The purpose of this study was designed to test and develope the structural model that explains health promoting behaviors among college students in Korea. The hypothetical model was constructed on the Pender's Health promotion Model(l996) and the inclusion of some influential factors for life satisfaction. The conceptual framework was built around eight constructs. Exogenous variables included in the model were self-esteem, perceived health status, self-efficacy, internal locus of control, chance locus of control. powerful other locus of control. Endogenous variables were health promotion behaviors and life satisfaction. The results are as follows; 1. The overall fit of the hypothetical model to the data was moderate < chi2=4.18(df=11. p=0.041), GFI= 0.99, AGFI= 0.76, RMR= 0.019, CFI= 0.99, CN= 248.50> 2. Path and variable of the model were modified by considering both its theoretical implication and statistical significance of parameter estimates. Compared to the hypothetical model. the revised model has become parsimonious and had a better fit to the data expected in a chi-square value < chi2=8.43(df= 16, p=0.21), GFI= 0.99, AGFI= 0.92., RMR= 0.024, CFI= 0.99, CN= 312.01> 3. Some of the predictive factors. especially self efficacy. self esteem. powerful others locus of control. perceived health status revealed the direct effects on health promoting behaviors. Of these variables. self-efficacy was the most signigicant factor. These predictive variables of health promoting behaviors explained 59% of total variances in the model. 4. Health promoting behaviors, self-esteem. and perceived health status revealed direct effect on the life satisfaction. Self-efficacy was identified as an important variable that contributed indirectly to improve life satisfaction by enhancing health promoting behaviors. These predictive variables of life satisfaction explained 42% of total variances in the model. In conclusion. the derived model in this study is considered appropriate in explaining and predicting health promoting models and life satisfaction among college students in Korea and could effectively be used as a reference model for further studies by suggesting a direction in health promoting nursing practices.

Korean Undergraduate Students' Intention, Attitude, Perceived Control, and Social Pressure for Moderate Drinking Behavior: Hye Ra Yoo; J Korean Acad Community Health Nurs. 2000;11(2):347-357. Published online December 31, 2000

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Abstract PDF: The purspose of this study is to examine the undergraduate students' attitudes, salient beliefs, perceived self-control and intentions for moderate drinking behavior of their own. Two hundred and twenty five students in two universities in Seoul and Suwon participated in this study. Questionnaires developed by this investigator under the guidance of the theory of planned behavior were used to collect data, Descriptive statistics, t-test, ANOVA. Pearson correlation coefficients. and multiple regression were used to analyze the data. The majority of the students showed positive attitudes toward the moderate drinking behavior. Students perceived conflict messages. however. from their significant others about their moderate drinking behavior. While parents and other family members as sisters and brothers strongly supported the moderate drinking behavior of students, friends and school-mates did not. More than half of the students did not intend to reduce their alcohol consumption in the near future. Students' attitudes and perceived self-control were the predictor variables of the intention while subjective norms were not. Students who intended to reduce their alcohol consumption showed a more positive attitude, subjective norm, and higher perceived self-control scores than who did not. These students who were intent for moderate drinking behavior spent less money for drinking, had less opportunities to drink, and drank small amounts of alcohol Moderate Drinking Behavior programs focusing on students who were heavy drinkers, however, did not intend to reduce their alcohol consumption should be developed focused on their characters. Programs for students who intended to reduce their alcohol consumption also recommended to help the students' positive intention continued.

A Descriptive Study of The Way of Life and Health Status of Nursing Students: Myung Soon Kim, Yoo Hyang Cho, Moon Hee Jung, Hyun Li Kim; J Korean Acad Community Health Nurs. 2000;11(2):358-372. Published online December 31, 2000

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Abstract PDF: The purpose of this study was to describe the way of life (such as smoking habits, alcohol consumption, exercise, duration of sleep, eating habits etc.), physical. psychological and overall health complaints and to identify the relationship between the way of life and health complaints of the nursing students. Data was collected with the self-administered OMI( Okayama Medical Index Health Questionnaire, devised Cornell Medical Index) from 766 nursing students and was analyzed. For data analysis, descriptive statistics and an ANOVA with an SPSS/PC+ program were used. The results were as follows: 1. The mean age of subjects was 21.0557(2.7618) years old in their 1st, 2nd, 3rd and 4th year-classes of nursing departments and college students in 4 regions of Korea. 62.1% of subjects were of the proper body weight, 2.0% were overweight, and 28.3% were underweight. Most subjects did not have a past history of disease, but 1.8% of subjects had experienced a blood transfusion. 2. 28.3% of the subjects had averaged 7 hours of sleep, 98.5% were nonsmokers, 91.2% were nondrinkers, 74.7% of subjects had milk intake sometimes, 53.7% of the subjects had an average salt intake, 49.6% of the subjects usually had a green vegetable intake, 45.4% of the subjects sometimes had fatty food intake, 64.8% of the subjects had good taste, 29.5% of the subjects enjoyed physical exercise. 3. The highest percentages of "yes" among physical. psychological and overall health complaints were observed in the question 'Do you have gastric pain?'(60.2%), "Are you confused of disorderly?" (37.2%), "Physical body was burdensome and fatigued."(57.3%). 4. The total O.M.I. score ranged from 1 to 89 with an average of 22.91(SD=12.10). A statistically significant difference was observed for the physical. psychological complaints for alcohol consumption. and for the psychological complaints for salt and fatty food intake. These conclusions should provide grounds for future studies of strategies for health promoting lifestyle for nursing students and their health concerns. Further research is required to investigate the life environmental and psychological factors affecting the way of life for nursing students and their health status, to analyze the health behavior of nursing students related with their culture and consciousness. Also epidemiologic research methodology, such as prospective cohort study should be considered to explore the performing process of nursing student's health behavior related with the occurrence of diseases.

A Study on the Utilization of the Volunteer Service in a Rural Community: Sung Sil Kim; J Korean Acad Community Health Nurs. 2000;11(2):373-388. Published online December 31, 2000

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Abstract PDF: The purpose of this study was to investigate the activities of woman volunteers. The sample consisted of 626 woman volunteers working in 18 districts in Kangwon province. The questionnaires consists of three parts: The first part of the questionnaire addresses demographic information. The second part of the questionnaire asks the feelings of subjects concerning volunteer activities (15 items). The third part of the questionnaire was to explore their perspectives of volunteer activities. An SAS was used for frequency. F-test, and a Pearson Correlation. The results of this study were as follows: 1. Most of the subjects were in their 40's(37.7%) and 10.7% were under age 20. About two thirds(69.8%) were housewives, the Buddhists were the highest religious groups (34.9%). Most of the subjects(36.7%) worked at Red-Cross. 2. Most of the subjects(56.8%) have nuclear families. 3. The subjects worked most frequently was at the Social Welfare Center, followed by homes, and welfare centers. 4. The most frequently used direct service was conversation(38.2%) followed by assistance with the eating process. 5. About thirty-nine percent of the subjects had less than one year of experience, and the majority of subjects had volunteer service once per week. 6. There was a significant relationship among age, number of family, duration of volunteer service, and experience. Integrated service will be needed to connect home health nursing with welfare service.

Perception of Importance and Performance in the Infection Control of Visiting Nursing Personnel in Public Health Centers: Kum Nam Kim, Jin Joo Oh; J Korean Acad Community Health Nurs. 2000;11(2):389-398. Published online December 31, 2000

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Abstract PDF: The work of visiting nursing personnel consists mostly of direct nursing and it is absolutely necessary that training of the nursing personnel for infection control be emphasized because most of patients are composed of elderly people with chronic diseases and malnutrition who are highly susceptible to infection. Accordingly. this study was designed to provide basic data for the development of an infection control program in public health centers as well as the promotion of perception and performance of infection control by analysing the perception of importance and performance in the infection control of visiting nursing personnel who carry out visiting nursing services. The subjects of this study consisted of a number of visiting nursing personnel working for 15 public health centers. 15 health-center branches. and 16 health clinics. The collection of data was grounded on a questionnaire method. The questionnaire breaks down to 8 questions about general characteristics and 108 questions in connection with the perception and performance of infection control. The results of this study are as follows: 1. 82 subjects (78.1%) responded that it is necessary to control infection. 79 subjects(75.3%) responded that education is necessary for infection control. 50 respondents (47.6%) answered in the affirmative in regard to the role of infection carriers. 2. The mean score for the perception of importance in infection control was 4.55 and that performance accounts for 4.03. this turns out to be very high. 3. In terms of the perception of importance per each field of infection control. medication. the management of contamination and sterilization, the control of environments and instruments. washing hands and individual hygiene as well as the prevention of cross-infection and the supervision of infection stand at 4.72. 4.64. 4.60. 4.58. 4.52 and 4.21 respectively. In terms of performance. the supervision of infection. the control of environments and instruments, individual hygiene and the prevention of cross infection. medication. washing hands, and the management of contamination and sterilization was 4.21. 4.12. 4.10. 4.03. 3.91 and 3.81 respectively. 4. In terms of the correlation between the perception of importance and the performance of infection control. the score stands high in all fields: this means the high perception of importance leads to high performance statistically (P< .05). 5. In terms of the perception of importance in general characteristics. there is no significant difference while the form of working places. working career and the career as visiting nursing personnel show a significant difference in terms of performance(P< .05). From the results. it is suggested that the visiting nursing personnel should be constantly educated with the aid of the development of infection control programs and that instructions and instruments for the management of infection should be worked out so as to enhance the performance of infection control on the part of nurses in applicable communities.

A Study on the Recognition of Client Home Visit Nursing Care Services in Public Health Centers: Young Sun Min, Yeoun Kang Chung, Seung Eui Han; J Korean Acad Community Health Nurs. 2000;11(2):399-410. Published online December 31, 2000

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Abstract PDF: In this, analyzing the type of subjectivity in which people would have about home visit nursing services originating from public health care centers. I tried to research more effective ways to improve home visit nursing care services. and later. for the development of home visit nursing care. to supply basic data. The method for this study was the Q-method. created by William Stephenson. and was adequate for the study of subjectivity. For this study. through the deep interview. literature inquiry, and the discussion course. 206 Q-statement sentences were abstracted. and based on them, after Q-sample-selection. I then collected the Q-categorized-result from 32 subjects from Mar. 10. 2000 to Mar. 25. 2000. Through the statistic a analysis of PC-Qunal program. the subjectivity species were categorized and analyzed. The study results show that there are 3 sorts of recognition types. and they are analyzed in the following; The first type: the positively receiving type shows that they feel thankful and a trusting feeling about home visit nursing. The second type: the negatively mistrusting type shows that they had doubtful attitudes about the specialty of home visit nursing: they wanted medicine or nutrition remedies rather than health education and concerning the their own health care, they prefered the hospitals or clinics. The third type: the conditional receiving type shows that even though they had a positive receiving attitude about home visit nursing wanting to consult with the home visit nurses about the difficult problem which could not easily be settled, hoping that the home visit nurses could visit them more often, in their actual lives. they strongly indicated their attitudes concerning money as more important than home visits. The subjects in these 3 types commonly had a good feeling about the kindness of the home visit nurses: the first and third types also had a positive recognition about home visit nursing; however. in aspects of the evaluation and receiving attitudes, they showed a big difference. When all the above results are integrated. in the case of the first type the home visit nursing service, which satisfied the demand for health care of the medically weak people. should be continuously supplied. Additionally in case of the second type (negatively mistrust). continuous education and support should be supplied with enough interest to lead their concerns about their own health care as well as lead medical spending in a productive and effective direction in order to change their impressions. Through this study. I learned that the recognition of the objectives of home visit nursing services can be categorized in to 3 types and could be analyzed. Thus I wish that this study helps to present basic data which contributes to the development of the home visit nursing field.

Emergency Care Conditions where the Nurse is posted in the 119 Relief Squad: Young Im Kim, Hye Sun Jung, Chang Hyun Lee, Gum Sook Kim, Jung Young Park; J Korean Acad Community Health Nurs. 2000;11(2):411-422. Published online December 31, 2000

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Abstract PDF: The purpose of this study is to identify the difference of emergency care conditions where the nurse is posted in the 119 relief squard or not. The data composed a total of 777 cases of emergency activity of one police stand in Seoul during March, June. September and December in 1998. The results of this study were as follows: 1. The age of the subjects was 20-60 age 54.3%, over 60 age 35.4% with an average age of 50.2. Among them men were 55.0%, the unemployed were 60.8%. The place of the occurrence of an accident was the house, 49.7% and the cause as illness was 59.6%. 2. The main symtom was pain the 36.2% the main consciousness state was alert 76.9%: The state of the patients as chronic was 59.6%. 3. The consulting hospital of the 119 relief squad as a third medical center was 79.9%. The distance to the medical center as less than 5 km was 77.2%, and an average transfer distance was 5.38 km. The cases of doctor guided emergency care was 0.9%, the cases that had posted nurses in 119 relief squads was 48.6%. 4. The case of the best emergency care operation was difficulty in breathing, 62.1% and the second was unconsciousness, 46.1 %. The more serious the consciousness state, the higher the rate of emergency care operation. There wasn't any difference in emergency care operation concerning transfer distance. 5. The cases that had the posted nurses was 19.1%, the cases of no nurse was 11.7% among the cases of emergency care operation during transfering; the cases that had posted nurses had the higher emergency care operation. (p<0.05). Airway maintenance was 14.8% in cases that had the posted nurses, while in the cases of no nurse, 10.9%; and oxygen inspiration was 16.0% in cases that had the posted nurses while in the cases of no nurse 7.6% (p<0.01); spinal fixation was 6.6% in cases that had the posted nurses while in the cases of no nurse 4.6%(p<0.05). With these results, we can conclude that the cases that had the posted nurse showed higher emergency care operation.

The Home Care Need and the Burden of a Primary Family Care Giver with Senile Dementia Patients: Young Ju Son, Ki Seon Kang, Soo Jin Kim; J Korean Acad Community Health Nurs. 2000;11(2):423-440. Published online December 31, 2000

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Abstract PDF: This research was conducted to identify the following: the home care needs of patients with dementia and the burden on the primary family care giver: to provide basic data required to develop nursing intervention for the care giver: and to suggest recommendations for medical institutions and social services that could reduce the burden on the families of people suffering from dementia. Subjects of this research were 53 patients of the two Public Health Centers of Cheju Province who are suffering from dementia and their families. The instrument used in the research was Kuen. Jung Don (1994)' s assessment tool of burden in the primary family care giver who has parents with senile dementia and Yoo. Young Mi(1998)'s assessment tool of home care need. modified by the researcher in the questionnaire by a Likert rating scale. The period of data collection was from February 8. 2000 to March 10. 2000. Collected data was analyzed by SPSS, using mean, standard deviation. ANOVA, t-test and Pearson correlation coefficient. The result of this research was that there was not a significant correlation between the burden on the care giver and the level of dementia, its duration, the patient's ability to perform daily tasks, the period of care giving. and the use of social services, although the lower the patient's ability to perform daily tasks. and the worse the care giver's own health situation, the higher the burden on the primary family care giver. The following suggestions are made based on the results of this research. 1. More than half of the subjects don't use social facilities and services. More publicity and referral efforts are needed about medical institutions. nursing institutions and other facilities that specialize in services for dementia sufferers and their families. 2. Nursing services should include intensive education for the primary care giver in the most important aspects of home care. 3. Further research should be done, and should include data from all parts of Cheju Province.

A Study on Urinary Incontinence of Elderly Communities: Young Hee Ju, Jung Soon Kim; J Korean Acad Community Health Nurs. 2000;11(2):441-452. Published online December 31, 2000

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Abstract PDF: The purpose of this study was to identify the prevalence of urinary incontinence and its relating factors elderly communities. Subjects of this survey consisted of 877 elderly women and men in one Kun. Korea, who were over 60 years old. The design for this study was descriptive: the subjects were interviewed by well trained investigators from July 9. 1999 to July 20. 1999. During that survey period, the subjects were interviewed with a structured questionnaire. The data were analyzed by frequency, percentage, chi2-test. T-test using an SAS program. The results of the study were the following: 1. The prevalence rate of urinary incontinence was 20.1%. of the total. The types of urinary incontinence were mixed incontinence 44.3%. stress incontinence 38.1%. and urge type incontinence 17.6%. 2. The relating factors of urinary incontinence were as follows: 1) 33.5% of UI(urinary incontinence) subjects reported urine loss once a month. twice or three times a week 23.3%. one or two times a day 17.0% 2) 38.1% of elderly reported only 1 to 2 drops. 1 t-spoon 36.9%. 1 T-spoon 15.9% 3) The volume of urine loss registered by changing underwear was 63.1 %. no necessity of changing underwear was 22.1 %. or using some type of pads was 13.1%. 4) 62.5% of UI subjects never discussed their UI problem with other people. 73.9% of the total had never experienced any treatment for their UI problem. The reasons for not receiving medical cure were their typical conception about urinary incontinence taking UI as a normal part of aging 76.2% and due to their bad financial situation 9.2%. 3. Women had more prevalence of UI than men (p=0.01), and it was found that the worse the subjective health state. the higher the prevalence of UI (p=0.001). However. there was no statistical difference in daily frequency of UI (p>0.05). The more nocturnal incontinence (p=0.001), the more intermittent stream experience (p=0.01), the more retention experience (p=0.01), and the more incomplete the emptying experience (p=0.001), the higher the prevalence of UI. 4. UI groups had lower ADL scores than non UI groups(p=0.01). The level of depression in the group of urinary incontinence was significantly higher than that of non incontinence group (p=0.0001). As shown above, the elderly people suffering from UI haven't been treated properly: their subjective health state and their ADL competence was lower, and their depression level was higher than non UI groups. Therefore, the development of a proper urinary incontinence management program are required so that they can lead more healthy lives. Also continual case studies for the elderly people with UI are necessary.

A Study on Disturbing Behaviors of Demented Elderly Staying at Home: Young Sil Kang; J Korean Acad Community Health Nurs. 2000;11(2):453-469. Published online December 31, 2000

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Abstract PDF: This study has a purpose to provide information to help develop nursing intervention for demented elderly staying at home. For this purpose I analysed the relationship of patients' disturbing behaviors with their demographic and social characteristics, premorbid personality, and present environmental characteristics through questionnaire survey on their family members. The survey was performed through direct interview, telephone contact. and mail in the regions of Pusan and Gyeongnam. Among family members contacted. 112 ones made an appropriate response to the survey. The statistical package SAS was utilized for descriptive statistics, correlation coefficients, stepwise multiple regression, and cluster analysis. The results of the study were as follows: 1) Demographic and social characteristics of the patients surveyed are female 81.3%, average age 81.4 years, lack of schooling 83.0%, spouse dead 73.2%, having no other disease 58.9%, average duration of dementia 3.8 years, no medical treatment for dementia 84.8%, good married life 40.2%, and primary care given by daughter-in-law 49.1%. 2) Aggressive Psychomotor Behavior(APB) was observed in a way statistically meaningful in case that primary care was given by daughter-in-law, while Nonaggressive Psychomotor Behavior(NPB) was in case of good married life and primary care given by other than daughter-in-law and spouse. Verbally aggressive behavior (VAB) was observed in groups of female, spouse dead, bad married life, and daughter-in-law's primary care. As for Passive Behavior(PB), it was observed in case that patients had educational background of not less high than middle school and that they were having medical treatment. Functionally Impaired Behavior(FIB) was observed in age group of 60-69 and more than 90, in patients' group having no other disease, and in case that the duration of dementia was not less than 5 years. 3) Premobid Neuroticism(N) showed positive correlation with APB and VAB, while Openness (O) did negative correlation with PB. Agreeableness (A) was proved to have positive correlation with PA and FIB, but to have negative correlation with APB and VAB. In addition, Conscientiousness(C) showed negative correlation with APB and VAB. 4) The worse the psychosocial environment was, the more NPB and VAB were observed. 5) APB was explained 24% by C and primary care-giver, while NPB was explained 28% by psychosocial environment, having other disease or not, and married life. VAB was explained 40% by A. sex, and married life. On the other hand PB was explained 33% by O, A. N, and having medical treatment or not. But any significant factor was not found to explain FIB. 6) A cluster analysis was performed on disturbing behaviors of demented elderly staying at home. It enabled to regroup the demented elderly in 5 patterns: high scored in NPB, high scored in FIB. high scored in NPB and VAB, moderately scored in most disturbing behaviors, and low scored in all areas. In conclusion, disturbing behaviors of demented elderly not only reflect their premorbid personality in the past, but also are affected by their present psychosocial environment. Therefore, it is necessary to encourage and respond them with understanding their disturbing behaviors in relation to their past premorbid personality. In addition, it is important to provide them better psychosocial environment in order to reduce their disturbing behaviors.

Health Promotion Lifestyle Profiles of the Korean Elderly in Japan: Ae Hwa Jaung, Kyung Min Park, Mi Kyung Ryu; J Korean Acad Community Health Nurs. 2000;11(2):470-485. Published online December 31, 2000

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Abstract PDF: The purpose of this study was to investigate health promotion lifestyle profiles of the Korean elderly in Japan. The subjects of this study were 202 elders in Aichi prefecture. The method of this study questionnaires interviews, and a self-administered questionnaire from the 1st to the 20th of April in 2000. This study tool was based on Walker et al. (1987)'s Health Promotion lifestyle Profiles (HPLP). Analysis of the data used an SPSS/pc+ WIN 9.0 program. Data analyses were conducted by using frequency, percentage, t-test, ANOVA. Pearson correlation, Kendal tau and Stepwise Multiple Regression. The results were as follows: 1. The average score of Health Promotion Lifestyle Profiles of Korean elderly in Japan was 2.72(SD=0.40). On the sub-scale of Health Promotion Lifestyle Profiles: nutrition(M=3. 06), self-actualization(M=2.99), interpersonal support (M=2.81), stress management (M=2.68) revealed higher scores, whereas the scores of health responsibility(M=2.52), and exercise(M=1.92) were lower. 2. Health Promotion Lifestyle Profiles were significantly different by age (F=11. 02, p=.000), religion(F=2.96, p=.033), occupation(F=6.91, p=.000), living family status(F=13.07, p=.000), living family number(F=11.74, p=.000), monthly pocket money(F=18.79, p=.000), the source of pocket money (F=7.18, p=.000), and the length of residence(F=9.79, p=.000). 3. Health Promotion Lifestyle Profiles was significantly predicted by monthly pocket money(r2 change=0. 188, p=.000), sex(r2 change=0.066, p=.000), the length of residence(r2 change=0.059, p=.000), the source of pocket money(r2 change=0.036, p=.000), age (r2 change=0.018, p=.000). These variables showed a positive correlation with health promotion lifestyle profiles of the Korean elderly in Japan. These variables explained 36.7% of the variance of Health Promotion Lifestyle Profiles. On the basis of the above findings, Health Promotion Lifestyle Profiles programs for Korean elderly in Japan needs be to developed with Japanese social-culture perspectives and needs to develop an intervention method to improve Health Promotion Lifestyle Profiles. It is also suggested that further research is required.

The Middle-aged's Health Problems and Health Behavior in an Urban Area: Soon Nyoung Yun, Jeong Hee Kim; J Korean Acad Community Health Nurs. 2000;11(2):486-498. Published online December 31, 2000

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Abstract PDF: The purpose of this study is to identify health problems and health behaviors of the middle-aged residing in urban areas and to plan and implement health promotion programs based on their health needs. The subjects' age ranged from 30-64 years in 1.040 middle-aged residing in an area of Kangbook-ku in Seoul. The data were collected from September 1998 to February 1999 with structured questionnaire using face-to-face or telephone interviews. The data were analyzed by SPSS-PC+ and identified by chi2 test and ANOVA. The results were as follows: 1. 35.4% of the males and 27.8% of the female responded that they were healthy regarding their perceived health status. In the order of chronic illness prevalence in the case of males was hypertension, diabetes, and digestive disorders and. in the case of females, was digestive disorders, hypertension, arthritis, anemia, and diabetes. 2. Male and female's smoking rates were 7.3% and 3.6% each and marked the highest rate of 30 to 40 years: drinking behavior was 66.9% in males and 32.2% in females. 3. The younger males had the worse dietary habits and had the lowest frequency of regular exercise. The older the females were, the more their weight increased. According to the results, health promotion programs by sex are recommended, especially in the target population of 30 to 40 years. and focused on the strategies for promoting self-care and actual health practice: it is strongly suggested that health promotion programs for adolescent and school-aged children before middle aged health behavior begins.

A Study on the Effect of Physician Characteristics on the Cesarean Section Rate: Eun Hee Cho; J Korean Acad Community Health Nurs. 2000;11(2):499-512. Published online December 31, 2000

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Abstract PDF: The number of deliveries by cesarean section has increased internationally. However, The cesarean section rate is different by country to country. It is because each country has different social and cultural background and. practices its unique delivery policies. Hence, it is very important to understand the uniqueness that one country faces related with the cesarean section. In Korea, there have been many researches on the clinical. maternal. hospital and community factors and so on. However, few studies have attempted to reveal the physician factors in Korea because it is difficult to approach hospital records. So, in this study, the physician factors that influence the increase of cesarean section rate in Korea was investigated, and preliminary research agenda for policy establishment to keep the cesarean section rate from excessive increase was provided. In this study, all 2744 cesarean section deliveries performed by 36 physicians at the hospital was considered. and detailed delivery records of 12 months selected randomly from January 1996 to August 1998 was reviewed retrospectively. Chi-square analysis is used to examine the homogeneity of distribution of maternal, fetal, and clinical factors. In addition, multiple regression analysis is used to examine the effect of physician characteristics on the cesarean section rate. Physician characteristics as independent variable and the cesarean section rate as dependent variable was put in this analysis. Follows are the results of this study. 1) Total cesarean section rate is 34.8%. primary cesarean section rate is 12.5 % and repeated cesarean section rate is 22.3 %. Among the indications for the primary cesarean section, 15.6 % is for breech presentation. 40.2 % is for dystocia. 7.6 % is for fetal distress. and 36.6 % is for others. 2) There is positive correlation between physician's age and the cesarean section rate (p<0.001). And statistically significant correlation is found between the physician's educational attainment and the cesarean section rate (p<0.001). A physician with Ph.D degree has lower cesarean section rate than a physician with B.A only and M.A. degree (p<0.001). However. physician's gender, location of graduated university. position at the hospital, and the religious belief were not shown statistically significant relations with the cesarean section rate. 3) Among all cesarean sections in this study, only 15.4 % is performed during weekend. While 18.2 % is performed on monday only. This suggests that physicians may not prefer weekend operation of cesarean section. In addition, 86.1 % among all cesarean section operations is performed from 6 a.m. to 6 p.m. So the cesarean section rate could be related with a day of the week and a time of the day. From this results. there is a possibility that the physicians' personal comfort may influence the cesarean section rate.

The Study on Medication Management in Small-to-Medium Sized Workplaces and the Level of Awareness about "Separation of Prescribing and Dispending": Young Im Kim, Ju Ok Jee, Soon Nyung Yun, Hye Sun Jung, Sook Ja Choi, Jung Ok Lee, Hyun Jung Lee; J Korean Acad Community Health Nurs. 2000;11(2):513-525. Published online December 31, 2000

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Abstract PDF: This study was to investigate medication management and the level of awareness about separation of prescribing and dispending at small-to-medium sized workplaces which have less than 300 employees in Korea. The data were collected by questionnaires from May to June in 2000. The number of subjects were 127 workplaces and 130 employees. The SAS PC Program was used for the descriptive statistics. The results are as follows; 1. The over the counter(OTC) drug was provided sufficiently(91.1%). but medication management was not performed systematically. 2. On drug-providing rate and drug-using rate, the latter was high in the workplace and Health care management's nurses consume all of the over the counter drug provided. 3. When the separation of prescribing and dispending starts, employees shall be medically examined, treated and prescribed by physicians and drugs shall be dispended by pharmacists. It is necessary to make it possible to visit health care institutions whenever they want to. (eg. lunch time or after work) They should change their drug-dependent behaviour. We should focus on strengthening Health Promotion Program to prevent disease by making habitual of health promotion behaviour.

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