Research in Community and Public Health Nursing

Volume 12 (1); March 2001

Original Articles

Analysis on Nursing Diagnosis Classifications and Assessment Tools in Home Care: Ae Young So; J Korean Acad Community Health Nurs. 2001;12(1):3-21. Published online March 31, 2001

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Abstract PDF: Nursing Diagnosis classification is needed to define nursing phenomena and set up nursing plans. The purpose of this study is to develope common nursing diagnosis by comparing and analysing nursing diagnosis classification systems and assessment tools in home care. The target home care nursing diagnosis classifications and toos are HHCC, NANDA, OMAHA, MED_HC 2.2. OASOS-B1.
Results
of this study are as follows: - The number of components of nursing diagnosis classifications and tools is HHCC 4. NANDA 9. OMAHA 4. MDA_HC2.0 6. OASIS-B1 10. - The number of common nursing diagnosis in home care is summed up 51 which are physical health 17. social health 5. psychological health 11. health related behavior 13. environment 3.

Cost-Effectiveness Analysis of Home Health Care Program for Cerebrovascular Accident Patients: Kyung Ja June, Jeong Young Park; J Korean Acad Community Health Nurs. 2001;12(1):22-31. Published online March 31, 2001

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Abstract PDF: Purpose
of this study is to compare the cost effectiveness of home care services for the cerebrovascular accident patients by the type of institution. The method is the secondary analysis using the patients' charts. 107 subjects and 1,417 visits were sampled from each type of home care institution such as one hospital based home care center, one KNA home care center, one urban health center, one rural health center and one health care post.
Result
There were differences in the functional status of patients and the service contents and frequencies provided by the type of home care institution, The cost per visit for one unit of ADL by the hospital based home care was higher than by the community-based home care.
Conclusion
It was suggested that the referral system among the home care institutions would be developed to improve the cost-effectiveness.

Life of the Institutionalized Elderly: Ga Eon Lee; J Korean Acad Community Health Nurs. 2001;12(1):32-38. Published online March 31, 2001

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Abstract PDF: This study focused on the understanding the life of the elderly in the institution by phenomenological method. The participants were seven who were 4 men and 3 women living in the elderly institution in Taegu. The data were collected through the indepth interviews and participant observation from June 20. 1999 to January 10. 2000 and analyzed by phenomenological analytic method by Giorgi. The structure of the meaning were as follows: Unhappy life: irresponsibility, self-centered thought hardness Irresistible life: misfortune, unhealthiness, Reading their son's intention Bitter life: unfair treatment from their sons and daughters betrayed feeling for their being thrown away. Outside oriented life: a fear of other' attention wrong information about institutionalized life maladjustment Self-consolation life: comfortableness convenience. economic merit of low cost. Dissatisfied life: discomfort from communal living unkindness of the institution staffs depreciated social security system economic distress physical pain restrained feeling. Tenacity to their sons and daughters: longingness for their sons and daughters regretableness waiting. Regretable life: remorse for their past life agony guilty loneliness grief self-abandonment. self-depreciation other residents' death in common. Inharmonious life with other residents: complaint conflict ignorance selfishness Yearning life for opposite sex: sexual interest Preparing for their life: control over their body and mind consideration for others. A life with hope: blessing death forever healthfulness affiliation to their family. From the results of this study an education and consultation should be done as soon as possible to remove the negative recognition of the institutional life to the facility residents the family and the future consumers of elderly institution. to minimize the maladjustment to facility life of residents a new program and interventions for the new comer's are needed. The thesis with above results will widen the understandings of institutional residents and an important guidance for a better nursing care in elderly institutions of Korea.

A Comparative Study on the Commitment of Home Health Care Nurses and Public Health Nurses: Soon Lae Kim, Sook Ja Yu, So Eun Choi, Sang Hee Lee; J Korean Acad Community Health Nurs. 2001;12(1):39-48. Published online March 31, 2001

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Abstract PDF: In order to confirm the level of professional commitment and organizational commitment of the home health care nurses and the public health nurses, this study was carried out by using the Commitment Inventory developed by Meyer and Allen and modified by Rhee and others. To compare the commitment level between two professionals, data was collected through self-administered questionnaires from the 61 home health care nurses and the 134 public health nurses working in 25 public health centers in Seoul. The results are as follows : 1. Commitment level of the Home Health Care Nurses(4.7+/-0.7) was significantly higher than that of the Public Health Nurses(4.4+/-0.7). The level of the professional commitment of the home health care nurses(5.0+/-0.9) was higher than that of the Public Health Nurses(4.5+/-0.8). The level of the organizational commitment of the of Home Health Care Nurses(4.5+/-0.7) was higher than that of the public health nurses(4.3+/-0.6). 2. The higher of affective professional commitment was shown in the home health care nurses, and the higher level of continuance professional commitment was shown in the public health nurses. The higher levels of normative professional commitment and affective organizational commitment were shown in the Home Health Care Nurses, and the higher level of continuance organizational commitment was shown in the home health care nurses. The higher level of normative organizational commitment was shown in the home health care nurses. 3. The level of professional commitment was statistically different in age and educational level. The level of affective professional commitment of the of home health nurses with higher-educated was higher than that of the lower-educated group. The level of organizational commitment of the Home Health Nurses in higher age was higher than that in lower age.

The Study on the Model Development and Analysis of 'Child Growth and Developmental Clinic': Focusing on the public health center: Kyung Ja Han, Kyung Sook Bang, Soon Nyoung Yun; J Korean Acad Community Health Nurs. 2001;12(1):49-59. Published online March 31, 2001

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Abstract PDF: PURPOSE
This study was intended to develop the framework of public health center based 'Child growth and developmental clinic' and analyze the efficiency of services. This was the part of Mother-Child Health Guidance Project by the Public Health Center in Seoul. The purposes of this project were to improve children's health and development with early detection of developmental delay by screening test, and to assist and guide the parent for child care and rearing, so that children can reach their maximum potential.
METHODS
Framework and standards for operation of 'Child growth and development clinic' were developed. We selected screening tool, developed parent education materials, and educated the personnel of public health center.
RESULTS
243 children were enrolled for developmental screening, and we detect the children with developmental delay and referred them for further evaluation. The proportion of developmental delayed children was approximately 2% of the enrolled children. Also, we analyzed the characteristics of enrolled children, and their parental needs and attitude on child rearing. Some problems in operation of developmental clinic were discussed.
CONCLUSION
Though we can found some limitations, we are confident that pubic health center can be charge of important role for improving child development for the majority. This study will be the basis of children's developmental clinic running by public health center.

A Study on Health and Public Health Center Utilization Behavior for lower Income Family in Korea: Ho Sihn Ryu, Mee Young Im, Ju Yull Lee; J Korean Acad Community Health Nurs. 2001;12(1):60-70. Published online March 31, 2001

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Abstract PDF: The purpose of this study was to analyze the relation between health behavior and public health center utilization among lower income families who earned half of the average Korean family income. The cross-sectional descriptive survey research we conducted was a nationwide randomization sampling among lower income families. The data was collected from July 12 to August 7, 1999 and the total sample was 5,819 household members (1,735 households). There were three major findings according to these studies. 1. In health behaviors, 26.5% of respondents had a health examination. Among them, 41.5% were in a poor condition of health. In health promotion behaviors, only 37.3% of respondents were doing activities for health maintenance or promotion. 2. In the results of the public health center utilization for the past year, 57.4% of respondents visited one or more times. In addition, 46.2% of respondents wanted to use a visiting nursing service. 3. In the results of multiple logistic regression, we found that less education, larger family size, and medicaid affects more utilization of public health center. In addition, older age, living without a spouse, less education, larger family size, lower family income, and public health center usage affects requests for the visiting nurse service.

The Needs of Sexuality Education in High School Students: Jin Kyung Lee, Eun Ju Kim, Young Hee Yom; J Korean Acad Community Health Nurs. 2001;12(1):71-80. Published online March 31, 2001

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Abstract PDF: In an attempt to measure the needs of sexuality education according to sex, grade, type of school, this study was carried out. For this study, the questionnaires were given to 600 students of 4 high-schools in Seoul from March to April, 1999. Students never being received sexuality education were 32.5%. Even though in students being received sex education, the answer of being very instructive was only 2.2%. The needs of sexuality education in boy-student was high in sexual behavior and relationship domain as compared with the girl-student, especially high in masturbation and sexual dysfunction. In girl-student, the needs of sexuality education were high in abortion, sexual damage. In third-grade, the needs of sexuality education were high in personal skill domain as compared with the first and second-grade. And the second-grade's needs were high in sexual behavior domain. In academic school students, the needs of sexuality education were high in sexual behavior and sexual health domain as compared with vocational school. In conclusion, a variety of systematic sex education programs suitable for each characteristic of adolescence should be in need of being developed to the base on the sex educational needs of the students.

A Survey on Health Promoting Behavior and its Related Factors for High School Students: Young Hee Mun; J Korean Acad Community Health Nurs. 2001;12(1):81-91. Published online March 31, 2001

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Abstract PDF: In order to identify the health promoting behavior and its related factors for high school students a survey was performed from 4th to 8th of December 2000. Population were selected by stratified random sampling method and total 355 students replied to the self-administered questionnaire survey. Data analysis was done by descriptive statistics t-test ANOVA, Pearson's Correlation stepwise multiple regression. The results were as follows: 1. The average score of health promoting behavior practices was 2.23(SD=.41) points by the 4 point scale, which was lower than that of adults. In the subcategories the highest degree of performance was self-actualization (mean=2.68 SD=.68) and the lowest degree was health responsibilty(mean=1.33 SD=.41) 2. According to gender(t=2.70 P=.00) school type (t=2.53 p=.01)father's educational level (f=4.16 p=.00) sleeping hours (F=3.80 p=.02) and number of hours at school (F=4.44 ,p=.01) there were a statistically significant differences in modifying factors of health promoting behavior. 3. Health promoting behavior showed significant positive correlations with self-efficacy(gamma=.461 p=.000) internal health locus of control (gamma=.284 p=.000) perceived health status(gamma-163. p=.002) 4. The combination of self-efficacy internal health locus of control school type and gender explained 30% of the variance on health promoting behavior. Therefore the finding of research can serve as the basis for developing health promoting programs which enhance self-efficacy and performed in school and community.

Middle School Students' Perceptions of Sexual Violence: Young Hee Yom, Yang So Yoon, Kyu Eun Lee, Hyun Sook Chung; J Korean Acad Community Health Nurs. 2001;12(1):92-104. Published online March 31, 2001

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Abstract PDF: The purpose of this study was to analyze the experience of sexual violence and sexual violence education. The data were collected from June 19 to July 14. 2000 using the questionnaire. The Subjects of this study consisted of 736 middle school students in six provincess(Seoul, Incheon, Daegu, Kyunggi, Kangwon, Kyungbuk). Data were analyzed using percentage mean standard deviation. ANOVA and Duncan test. The results were as follows: 1. About sixty-two percent of the subjects was educated for sexual violence. 2. About twenty-five percent of the subjects experienced sexual harassment 12.1% of the subjects experienced serious sexual contact. and 2.0% of the subjects was raped. 3. The mean score of misconception related sexual violence was 2.86+/-0.47. 4. The mean score of misconception related sexual violence showed significant differences in experience of education(t=-3.83 p<.0001) in delayed time of education (F=6.33 p<.0001) and in reading of pornomagazine (F=2.03 p<.05). 5. The mean score of misconception related sexual violence showed significant differences in experience of sexual harassment (t=-1.92 p<.05) and in experience of serious sexual contact (t=-2.41 p<.01). 6. There was a significant difference in misconception related sexual violence between boy and girl(t=5.79 p<.0001). According to the above results realistic and future-directed sexual violence education materials should be developed for middled school students. This information will provide useful data to promote a more systemic desirable and sexual violence education.

Literature Review on Adolescent Runaways: Woon Sook Jung, Shin Ae Park; J Korean Acad Community Health Nurs. 2001;12(1):105-114. Published online March 31, 2001

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Abstract PDF: It was orginally thought that runaway adolescents needed to improve their ability to cope with personal problems based on their own understanding of them. As a result we exchanged theoretical background on the matter as follows: 1. Generally adolescency is a transitional period from childhood to adulthood and characterized by a dramatic conversion period with unique phenomena relative to other periods. Futhermore it is the key transitional moment in the development of an adult personality. 2. Runaway adolescents are defined as "adolescents who leave impulsively or intentionally their homes without permission of their parents for at least 24 hours." 3. The reason for this behavior are generally regarded as complex interdependent and dynamic including a cast-away factor seducing factors and other action-provoking factors. There is also another view to explain the adolescent run-away as a combination of personal domestic academic peer or socal factors. 4. We found that adolescent runaways have different attitudes dependent on the reasons and procedures of runaways lifestyles of adolescents and results of their runaway experience. In conclusion runaway adolescents are in a very important period in their development and growth of bodies and minds but are in a great crisis for various complex reasons. Therefore we propose that nursing should provide effective nursing interventions to improve the ability of the runaway adolescents address these problems by themselves.

The Effects of Smoking Cessation School Program on Smoking Behavior in Adolescent Smokers: Mi Ra Song, Soon Lae Kim; J Korean Acad Community Health Nurs. 2001;12(1):115-124. Published online March 31, 2001

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Abstract PDF: This study was designed to investigate the effects of a smoking cessation school program on attitudes towards smoking cessation the subjective norm perceived behavioral controls the intent to cease smoking and smoking behavior. Also included was the goals of the program itself. Study subjects were 80 adolescent smokers who at least attended the smoking cessation school program without absence had smoked one cigarette at the time of the first study before the program and attended the first second and third studies (The study was conducted from September 26 to December 21 1999. a period of 59 days). Data collection was performed using the TPB questionnaire which was developed by Jee Yon-Ock (1994) The survey included questions covering the intended areas of study mentioned above. The first data was collected during the first day of the five day program. The second survey was conducted immediately after the last day of the program and the last survey was four weeks late. Data was analyzed with a SAS/PC program including N, %, a paired t-test. The results were as follows: 1. After the program the scores representing attitude towards smoking cessation (before program: 14.5 after program: 16.8) and perceived behavioral control (before program: 1.2 after program: 2.1) rose significantly but the scores for attitudes towards the subjective norm and the intent to cease smoking were not notably different. 2. After the program the frequency of daily smoking fell significantly (before program: 5.7 cigarettes after program: 3.2 cigarettes). In conclusion the five day smoking cessation school program increased attitude perceived behavioral control and decreased smoking behavior but did not influence subjective norm smoking cessation intention. Thus further study is required to better evaluate the effects of the program and th improve any shortcomings.

A Study about the Factors Affecting Hearing loss in Adolescent's use of Personal Cassette Players(PCPs): Kyung Hee Lim, Kyung Min Park, Myung Hwa Park; J Korean Acad Community Health Nurs. 2001;12(1):125-141. Published online March 31, 2001

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Abstract PDF: The purpose of this study was to investigate the factors affecting hearing loss in adolescent's use of PCPs, and to give the basic data for adolescent's hearing conservation program development and prevention education against their hearing loss. This study was a descriptive research about three factors affecting hearing loss ; the knowledge and attitude about noise, the perception of hearing loss and the hearing threshold. The subjects of this study were 383 students in two general high schools and two vocational high schools in Teagu. They have been using PCPs but with no current or past ear disease. This study was carried out from Sep. 1, 2000 to Oct. 24, 2000. The instrument used for the knowledge and attitude about noise was a questionnaire developed by Rhee, Kyung Yong and Yi, Kwan Hyung(1996). The instrument used for the perception of hearing loss was a Smith Hearing Screening Questionnaire. A Belton Model 112 Audiometer, air-conduction hearing test instrument, was used for the hearing threshold. Data was analysed by a SPSS/Win 10.0 program with frequency, percentage, t-test, ANOVA and pearson correlation. The results of this study were as follows ; 1. The average of concern about hearing scored the highest 3.66+/-0.70. The average of perceived susceptibility scored 2.64+/-0.85 and the average of knowledge about noise scored 2.13+/-0.56. The average of total knowledge and attitude about noise scored 2.82+/-0.46. The average of discomfort of hearing loss(2.51+/-0.81) scored higher than that fear of hearing loss(1.35+/-0.53). The average of total perception of hearing loss scored 1.93+/-0.59. The hearing threshold of the subjects scored the highest at 500Hz(Lt. 23.21+/-6.62, Rt. 23.39 +/-7.02) and scored higher in order of 1000Hz, 2000Hz, 4000Hz and 8000Hz. 2. The knowledge and attitude about noise and the perception of hearing loss were both affected only by one important characteristic, which was general and vocational high schools. The knowledge and attitude about noise raked (t=5.258, p=0.000), and perception of hearing loss raked(t=2.241, p=0.026). However, several other important characteristics also impacted significantly on the knowledge and attitudes about noise. They included grade(t=1.987, p=0.048), father's education(F=2.745, p=0.043), marks(F=3.157, p=0.044), drinking(t=2.307, p=0.022) and smoking(t=2.587, p=0.010). The left hearing threshold differed significantly by sex at 1000Hz(t=5.175, p<0.001) and 8000Hz (t=3.334, p<0.01). According to general and vocational high schools(p<0.001), at 500Hz (t=-5.056), 1000Hz (t=-5.253), 2000Hz (t=-4.905), 4000Hz (t=-4.704) and 8000Hz (t=-5.204) significant differences were also shown. Marks were significant at 1000Hz (F=3.824, p<0.05) and drinking was found to be significant at 500Hz(t=2.203, p<0.05). The right hearing threshold differed significantly by sex at 1000Hz(t=5.557, p<0.001), 4000Hz(t=2.234, p<0.05) and 8000Hz (t=2.730, p<0.01). According to general and vocational high schools(p<0.001) at 500Hz (t=-4.730), 1000Hz(t=-6.271), 2000Hz (t=-4.573), 4000Hz(t=-3.554) and 8000Hz (t=-3.405) significant differences were also shown. Grades impacted at 500Hz(t=2.201, p<0.05) and 4000Hz(t=2.511, p<0.05), while marks were significant at 1000Hz(F=4.115, p<0.05) and drinking was significant at 500Hz(t=2.333, p<0.05). 3. The left hearing threshold in accordance with use of PCPs differed significantly at 2000Hz(F=2.996, p=0.031) according to volume level and at 8000Hz(F=2.197, p=0.022) according to durationxhours per day. The right hearing threshold differed significantly at 1000Hz(F=3.075, p=0.028) according to volume level and at 8000Hz(F=2.925, p=0.034) according to duration. 4. The knowledge and attitudes about noise showed a light positive correlation with the perception of hearing loss. A positive correlation was shown, as stated previously in all Hz, between the left hearing threshold and the right hearing threshold, especially the highest correlation at 2000Hz(r=0.761, p=0.000). This study has shown that the factors related to adolescent's use of PCPs are important as they impact significantly an adolescent's hearing. These results then indicate that in future, when designing a hearing conservation program and prevention education this data should be considered.

Factors Related to Visual Health Promotion Behavior of Elementary School Aged Children: Jung Sook Kim, Jin Joo Oh; J Korean Acad Community Health Nurs. 2001;12(1):142-149. Published online March 31, 2001

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Abstract PDF: The health education for elementary school students is a very important factor in the development of adult health practices. Particularly, eyesight is difficult to recover if lost. Therefore, prevention is better than cure. This study was conducted to investigate the factors that affect the visual health behavior of elementary school students and to furnish basic materials and directions for the promotion of elementary school health. The investigation was carried out for 4 days from 9. 18. 2000 to 9. 21. 2000 for 199 children in 3 elementary schools. A questionnaire was composed of 3 questions about general property, 20 questions about visual health behavior, 7 questions about visual self-efficacy, 5 questions about visual motivation, 16 questions about self-conception, 20 questions about the health locus of control. The data was analysed by an SAS program for t-test, ANOVA, correlation, and multiple regression tests. The results are as follows. 1. The visual health behavior of elementary school children was good (average 52.53). 2. For visual health behavior, school, year, and sex were influential factors, economic levels were not. 3. Visual health behavior had a significant correlation with visual self-efficacy, visual health motives and self-conception, but not with the locus of control. 4. In the multiple regression test, visual self-efficacy and self-conception were significant prediction factors -- the suitability of the regression model was 30.8%. Suggestions from the results are as follows: First, school year and sex had a significant influence on visual health behavior; therefore, it is necessary to consider these two factors when education programs are developed. Second, this study was carried out for students in a partial area only. Therefore, repeated studies for a large sample are necessary for the future.

A Cross Sectional Study on Elementary Students' Access to Computer Online Pornography: Jung Nam Kim, Hae Ja Woo; J Korean Acad Community Health Nurs. 2001;12(1):150-167. Published online March 31, 2001

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Abstract PDF: This cross sectional study was done to find out the situation of computer online pornography access by 4th to 6th grade elementary school students. The subjects of this study were three elementary schools in Andong which were selected randomly and 120 students randomly selected from 4 th to 6th grade for a total of 360 students. The questionnaire was composed with the help of a community health nursing professor and through the reference review. The collected data were analysed by a PC SPAA 10.0 according to school grade and sex and chi2-test was implemented to learn what percent of students have computers and softwear which prohibit the viewing of online pornography access motivation and time content viewed attitude after accessing the contents and opinions about somputer online pornography. The results of this study were as follows: 1. A total of 86.1% of students had computers at home. Most students placed computers in their own room. 78.9% of students had computer online communication experience. Higher grade students tended to have more experience of communications on the internet (P<0.001) Most students used computers more than one hour a day(P<0.05). They used computers according to the following priorities: game studying listening to music communications chatting. 2. Regarding the frequency of going computer online more than seven times per week male students showed a higher frequency than female students (P<0.05) Male students used computers more than one hour a day and female students less than half an hour (P<0.001) Male students mostly used computers to play computer games. On the other hand female students used the computer to study listen to music and chat (P<0.001) 3. Regarding software installation to prevent access of computer online pornography a total of 19.4% of students responded they installed one but 80.6% didn't have any 20.3% of students had accessed pornography 46.6% of students responded they first get to know to the computer online pornography through friends. 4. The reasons for accessing computer online pornography were ranked as follows: curiostiy interest to release stress and sex drive (p<0.05) Obscene contents were found in computer games pictures and video among these pictures were the most common. 5. Regarding students' attitude toward online pornography most students responded that they took much pleasure in the contents(P<0.05). 6. Regarding th question 'Does online pornography degarde morals and cause a sex crime' most students responded as 'no'. They also responded positively to the suggestion that the contents would be effective in preventing sex crimes and to release stress 74.7% of students responded that males'n access of the contents as proper but females' access as immoral. Regarding social efforts to protect students from this harmful environment most replied that those efforts were unnecessary (P<0.001).

A Study on Health Promoting Behavior and Disease Preventive Behavior of a Community Residents: Koje area: Keum Ee Kim, Mee Young Im; J Korean Acad Community Health Nurs. 2001;12(1):168-174. Published online March 31, 2001

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Abstract PDF: This study was conducted to investigate the disease preventive behavior and health promoting behavior of a community residents. The subjects were selected by convenient sampling and the total number was 300(Female, 170, Male, 130). The data were collected by face to face interviews during the period of Sep. 15-30, 1999. The measurement tool for this study was the rating score for disease preventive behavior and health promoting behavior. The instrument was developed by the researcher based on the tool of Korea Institute for Health and Social Affairs. The data were analyzed by percentage, mean, t-test, ANOVA, chi2 test by Windows SPSS/PC program(v7.5). The results were as follows: 1. In the comparison of disease preventive behavior rates between male and female, there was a statistically significant difference in physical examination, measuring the blood pressure and vaccination for B type hepatitis. In the comparison of disease preventive behavior rates among the age, there was a statistically significant difference in physical examination, measuring the blood pressure. 2. The rating score for the health promoting behavior of the men subjects was lower than that of the women subjects. In the comparison of health promoting behavior scores between male and female, there was a statistically significant difference in smoking, drinking, regular exercise, breakfast eating, vegetable consumption and teeth brushing. In the comparison of promoting Behavior scores among the age, there were significant difference. there was a statistically significant difference in smoking, sleeping, seat belt use, breakfast eating and salty eating.

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