Research in Community and Public Health Nursing

Volume 13 (1); March 2002

Original Articles

Effect of a Smoking Cessation Program on the Stop-smoking Rate and Nicotine Dependency for the Adult Smoker: Hyun Ok Kim; J Korean Acad Community Health Nurs. 2002;13(1):5-16. Published online March 31, 2002

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Abstract PDF: PURPOSE
This study was to compare the stop-smoking rate and nicotine dependency for an adult smoker after implementing the smoking cessation program.
METHOD
Fourty-six adult smokers participated. Self report questionnaire and telephone interview were conducted at the pretest, 6 months later, 1 year later, 2 years later, 3 years later.
RESULT
1. Stop-smoking rate of smoking cessation program participants was 43.5% 6 months later, 35.6% 1 year later, 24.4% 2 years later, 45.5% 3 years later. 2. The mean of nicotine dependency for continuing smokers was significantly decreased 6 months later(paired-t=4.719, p=.000). 3. The mean of nicotine dependency for continuing smokers was significantly decreased 1 year later(pired-t=4.296=.000). 4. The mean of nicotine dependency for continuing smokers was significantly decreased 2 years later(paired-t=2.778, p=.000). 5. The mean of nicotine dependency for continuing smokers was significantly decreased 3 years later(paired-t=2.795, p=.000).
CONCLUSION
The smoking cessation program was effective to induce cessation in the adult smoker, and to decrease nicotine dependency in the continuing adult smoker.

Effects of Self-foot Reflexology Shown in Hypertension Workers: Nam Hyun Cha; J Korean Acad Community Health Nurs. 2002;13(1):17-29. Published online March 31, 2002

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Abstract PDF: This study was carried out to investigate the effect of Self-foot reflexology (SFR) on the hypertension of workers. The purpose of the research was to evaluate: levels of knowledge, physical and emotional condition, work stress and fatigue on the hypertension of employees in the workplace. Quasi-experimental study was designed in the setting of a nonequivalent control and experimental Group applied by the pre and post test. The total subjects undertaken in the study were total of 34 employees working in three companies in Seoul. The SFR program was consisted of 6 phases. There were 2 minutes for preparation, 4 minutes for slow down, 26 minutes for base reflex, symptoms of a disease reflex and excretion reflex stimulation. Finally, there was 20 minutes relaxation in a comfortable posture and drinking hot water after blood pressure was checked in the order. This program was running 55 minutes a day everyday three times a week during the entire 8 week course. The finding showed blood pressure was reduced significantly. Moreover, the level of total cholesterol, high and low density lipoprotein cholesterol, depression, work stress, and fatigue were decreased in the study. But, they were not statistically significant except as it related to Group comparisons in time. The level of state anxiety was statistically significant between 2 Groups, but not in the time comparison of both Groups. As a summary of the study results, the SFR program was regarded as contributing to the physical and emotional promotion of employees. It had partially increased body circulations of functional organ related to the SFR sites. And, it improved relaxation of physical and mental condition through energy movement 'Chi'. Therefore, the SFR technique should be considered as an effective skill of a nursing program. Furthermore, it can be newly adopted as a nursing curriculum as a part of alternative treatment. However, it still needed to testify its effects through the review study.

Comparison of Depression-level of Poor Elderly and Elderly: Seon Suk Kwon, Yeon Kang Chung, Hye Jin Kwon; J Korean Acad Community Health Nurs. 2002;13(1):30-38. Published online March 31, 2002

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Abstract PDF: The purpose of this study was to compare the Depression levels of the poor and elderly as well as the elderly who were residents in a community. The author studied the Depression levels of 117 poor and elderly individuals and 183 elderly individuals all 65 years or older living in Suwon City. This study has been done using a directinterview structured Questionnaire and Korean Form of Geriatric Depression Scale (KGDS) from May to July in 1999. The results can be summarized as following; 1. With Case and Control group there was no significant difference with respect to gender, age, education level, or religion. But was significantly different regarding marriage state, if subjects were living together, type of residency, province, and place of toilet(P<0.05). 2. Smoking and Hwa-pyung was a large number of case group more than control group, and alcohol was more control group than case group(P<0.05). 3. There was a similiar taking medicine and kind of body symtom of case and control group. 4. The mean score of perceived KGDS of the poor elderlys was 17.87+/-5.97 out of 30, and that of the elderlys was 13.35+/-6.00 out of 30(P<0.001). 5. In a simple correlation analysis of elderlys, education, marital status, residency, son and daughter, position of toilet, elderly center, alcohol, Wha-byung, disease. 6. In a multiple regression analysis, Hwabyung, elderly center, education, smoking, disease, son and daughter.

The Correlational Study on Health-promoting Behavior, Life Satisfaction and Self-esteem of the Elderly: Yeon Hee Choi, Kyung Shin Paek; J Korean Acad Community Health Nurs. 2002;13(1):39-48. Published online March 31, 2002

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Abstract PDF: PURPOSE
This study was done to describe the correlation among the elderly's health-promoting behavior, life satisfaction and sel-festeem.
METHOD
The subjects were a volunteer sample of 200 elderly in Kyungsan city. The instruments for this study were Health Promoting Lifestyle Profile(47 items), Life Satisfaction Scale(20 items) and Self-Esteem Scale(10 items). Frequency, percentage, t-test, ANOVA, Duncan test and Pearson's correlation coefficient with SAS program were used to analyze the data.
RESULT
1) The average item score for the health-promoting behavior was 3.23; the highest score on the subscale was self-actualization and nutrition(M=3.45) with the lowest being exercise(M=2.98). 2) The average item score for the life satisfaction was 2.98. 3) The average item score for the self-esteem was 3.41. 4) Health-promoting behavior was significantly different according to age, marital status, religion and participation in society circles. 5) Life satisfaction was significantly different according to marital status and participation in society circles. 6) Self-esteem was significantly different according to participation in society circles. 7) Health-promoting behavior was positively related to life satisfaction and self-esteem. Life satisfaction was positively related to self-esteem.
CONCLUSION
It follows from this study that there is a very strong correlation among the elderly's health-promoting behavior, life satisfaction and self-esteem. Therefore health promoting programs that increase life satisfaction and self-esteem should be developed to promote a healthy lifestyle of the elderly.

A Study on Health Behaviors and Medication Compliances of Hypertensive Patients in a Rural Area: Keum Ee Kim; J Korean Acad Community Health Nurs. 2002;13(1):49-56. Published online March 31, 2002

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Abstract PDF: This study was performed to identify the health behaviors and medication compliances of hypertensive patients in a rural area, from May 1 to July 31, 2001. The subjects were 100 hypertensive patients who were registered at the Health Center in Goeje City. The data was collected by face-to-face interviews with a 25-item questionnaire on health behaviors, and analyzed by the Chi-square test on each variable. The results were as follows: Approximately 76% of the subjects were currently taking drug medication. In the comparison of health behavior rates between male and female, there were statistically significant differences in smoking (p<.000), alcohol(p<.003), low salt diet(p<.014), and the health behavior rates of female were higher than those of male. In the comparison of socioeconomic factors by medication compliance, there was statistically significant difference in sex(p<.001), and the medication compliance rate of female was higher than that of male. In the comparison of subjects' perception by medication compliance, there were statistically significant differences in seriousness of hypertension (p<.001) and medication period for hypertension care (p<.004). The medication compliance rate of the group of subjects who took the threat on their hypertension seriously was higher than that of the group who didn't, and the medication compliance rate of the group who knew that they should take medication for the rest of their life was higher than that of the group who didn't. These results suggest that community health education programs and distribution of information must be emphasized in order to increase medication and to encourage behavior changes for promoting health.

Health Management and Educational Needs of Chronic Type B Hepatitis: Mae Ja Kim, Sun Oak Lee, Gye Young Shin, Eun Kyung Kim, Mi Ra Jang; J Korean Acad Community Health Nurs. 2002;13(1):57-67. Published online March 31, 2002

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Abstract PDF: PURPOSE
Chronic hepatic disease is caused by inappropriate management of the hepatitis B virus. In Korea, there is an increasing number of chronic hepatic patients, who are at risk of dying from liver failure or hepatocellular carcinoma. Therefore it is important to manage the hepatitis B virus appropriately.
METHOD
The patients diagnosed with chronic hepatic disease or HBV carrier who registered at a community health center or hospital were assessed regarding health man agement status and educational needs. The data was collected from 179 persons by convenient sampling between May, 2000 and April, 2001. The data were was analyzed for general characteristics using the descriptive method, factors influencing educational needs and health management using t-test and ANOVA.
RESULTS
1. The average health management score was 18.2 from 12 to 24 range. Those who unknown were unaware of the presence of HBsAg, attending the educational program and keeping undergoing treatment at the community health center or hospital were had a higher management score(p<.05). 2. The educational needs regarding nutritional management(64.8%) was the highest topic with chronic hepatitis patients. The second highest topic was spreading prevention among family members (52.0%), and keeping medication (45.8%), the degree of physical activities(44.1%), and spreading prevention in public(39.1%). Those who were unaware of the presence of HBsAg (p<.001), less than 12 months after HBsAg (+)(p<.05), keeping treatment (p<.05) were higher educational needs. 3. The use of alternative therapy was 27.9% of subjects. The subjects thought it was helpful for disease management(42.1%), mostly, family members and relatives recommended to use (57.9%), and medical regimen was ignored during the alternative therapy.
CONCLUSION
Based on the results, an educational program about prevention of type B hepatitis and management for patients having type B hepatitis should be developed.

The Comparison of Health Promoting Behaviors for the Korean Elderly residing in Korea and Japan: Kyung Min Park; J Korean Acad Community Health Nurs. 2002;13(1):68-78. Published online March 31, 2002

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Abstract PDF: This study intended to analyze the health promoting behaviors by comparing various factors according to the residence areas(Korea or Japan) of Korean Elderly, and to present basic data in planning systematic and effective programs of health promotion for each residence area. The subjects of this study were 164 Korean elders in Daegu, South Korea, and 164 elders in Aichi prefecture, Japan. Data was collected by interviews and self-administered questionnaires from the 1st to the 20th of April in 2000. The tool for this study was based on Walker et al. (1987)'s Health Promotion lifestyle Profiles(HPLP). The analysis was performed with Cronbach's chi2-test, t-test, ANCOVA, Kendal tau, Pearson correlation, and Stepwise Multiple Regression test using SPSS program. The results are as follows: 1. There was a significant difference in occupation(chi2=41.3, p=0.000), the source of the pocket money(chi2=114.36, p=0.000) by the residence areas in terms of socio-demographic characteristics. 2. There was a significant difference between the two groups on the health promoting behaviors (t=-8.19, p=0.000). The score of elders group in the South Korean group on health promoting behaviors was 2.32, showing 0.33 lower than that of the elders group in Japan(2.65). 3. ANCOVA involving occupation and the source of pocket money as co-variables, showed significant differences (F=15.37, p=0.000) regarding health promoting behaviors according to the residence areas. 4. In consideration of variables that have an influence on health promoting behavior by residence areas, pocket money occupied 11.5% of health promoting behavior in the elders group in South Korea. In the elders group in Japan. pocket money occupied 18.1% of health promoting behavior and 20.6% including education. The suggestions based on the results of this study are as follows: 1. It is necessary to develop tealth promoting programs considering the residence areas of Korean elders. 2. It is necessary to develop social programs for improving the education level and solving pocket money problems, which are the significant factors for the health promoting behavior of Keran elders.

Effect of a Resident and Indoor Environmental Characteristics on the House Dust Mites Allergen: Yong Soon Kim, Jee Won Park, Young Shin Song; J Korean Acad Community Health Nurs. 2002;13(1):79-88. Published online March 31, 2002

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Abstract PDF: PURPOSE
The purpose of this study was to identify the indoor environment i.e. house type and age, ventilation method, use of bed & sofa, cockroach, ants, etc. on HDM (House dust mites), especially Der fI allergen.
METHOD
Samples of dust from mattresses, pillows and the floor were collected by using a vacuum cleaner from April, 2000. The amount of Group I allergen(Der. fI) of HDM (house dust mites) were measured by two-site ELISA. Indoor Environmental characteristics were accessed by using questionnaires on 178 house wives living in the Seoul area.
RESULTS
The amount of HDM allergen (Der fI) was higher in sofa using house. There were higher concentrations of HDM allergen (Der Fl) in sofas made from quilt material than for those that were made from leather. Homes that had pets like dogs living in them had higher concentrations of HDM allergen (Der fI) than without dogs.
CONCLUSION
The photophobic mites thrive in dark, warm and humid environments; Items such as pillows, mattresses, box springs, blankets, carpets, and upholstered furniture should be considered ideal environments for the mite. Therefore, an indoor environmental control program should be carried out to avoid the HDM allergen.

Denver II Developmental Screening Test: A Cross Cultural Comparison: Hee Sun Shin, Kyung Ja Han, Ka Sil Oh, Jin Joo Oh, Mi Na Ha; J Korean Acad Community Health Nurs. 2002;13(1):89-97. Published online March 31, 2002

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Abstract PDF: PURPOSE
The purpose of this study is to explore the validity of the application of the Denver II developmental screening test to Korean children. This screening test, which was developed and standardized in United States, was designed to screen for developmental delay in Korea, and to compare the levels of development of Korean children with the development of children from the U.S.
METHOD
Quota sampling. NP To facilitate field sampling, the age range used from 0 to 6 years old, was split into 10 different age groups. Sample size was estimated according to residence. 1,054 children were recruited from Seoul's metropolitan, urban and rural areas. NP To fill the quota established, the Recruitment and testing of children was done at public health centers, pediatric outpatient clinics of general hospitals and a child care center. The 25, 50, 75 and 90 percentiles were identified by using logistic regression analysis and were calculated as norms. The items in which the ages of both 50 and 90 percent passing differed more than 20 percent by the calculation was identified for comparison. NP RESULT: There were significant differences found in 45 items between Korean children and the children from the City of Denver as it relates to age differences. 90% of the sample passed items among 125 items from 4 sectors, e.g., personal- social, fine motor adaptive, language, and gross motor sectors. Korean children were found to be advanced in 9 items, whereas there were significant differences found in 38 items in our comparison of the two countries for age differences when 50% of sample pass items. Korean children were found to be advanced in 16 items. NP CONCLUSION: The result showed that there was a discrepancy in the developmental norms. It could be explained by the differences in the developmental environment, including child rearing patterns and ethnicity. Therefore, a restandardization of the Denver Screening Test is necessary as it relates to its application on Korean children. This restandardization is necessary in order to avoid both under and over-referrals of children with developmental abnormality. The modification of items in the language sector is especially suggested.

A Critical Review of Health Behavior Studies of Adolescents Conducted in Korea: Nam Hee Park, Hae Jung Lee; J Korean Acad Community Health Nurs. 2002;13(1):98-114. Published online March 31, 2002

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Abstract PDF: PURPOSE
This review examined literature relevant to adolescent's health behavior in order to identify key behaviors and factors related to health behaviors for targeting health promotion interventions.
METHOD
A critical review of 29 research articles was carried out using the guidelines suggested by Cooper.
RESULT
The majority of the studies were descriptive and cross-sectional. Generally, the study includes sub-dimensions such as general hygiene and daily life habit, safety and accident prevention, nutrition and eating (tobacco, drinking), exercise, mental health and stress management, health duty (drug, health examination, disease prevention). Factors highly related to health behaviors were age, living areas, economic status, parent health behaviors, parent health concern, social support, friends influence, self-efficacy, self-esteem, locus of control, and the perceived health status. Sex, parent education and health knowledge were not related to health behaviors of adolescents.
CONCLUSION
Several conceptual and methodological problems were identified in the studies review, such as restricted conceptualization of health behaviors and sampling issues which limit the generalizability of the study outcomes. Further research is needed to enhance the concept clarification and generalizablity of the study results.

A Study on Obesity Index, Body Shape Satisfaction and Body Shape Esteem according to Weight Perception in Elementary Students: Kyung Shin Paek; J Korean Acad Community Health Nurs. 2002;13(1):115-123. Published online March 31, 2002

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Abstract PDF: PURPOSE
The purpose of this study was to identify the obesity index, body shape satisfaction and body shape esteem according to weight perception in elementary school students.
METHOD
The data were collected by using a questionnaire and physical examination records. The subjects were comprised of 669 children, all 12-years old, obtained from five (5) different elementary schools located in Jechoen. Data were analyzed with frequency, percentages, Chi-square test, ANOVA using the SPSS program.
RESULTS
12.5% of male students, 11.1% of female students perceived themselves obese. There were significant differences in obesity index according to weight perception in male students (chi2=140.47, p= .000), in female students (chi2=130.99, p= .000). The percentages corresponding to normal body weight were highest with students who thought themselves thin in male students and self-perceived normal in female students. But in female students, 23.3% of self-perceived thin students, 37.8% of students who thought themselves obese corresponded to normal body weight actually. There were significant differences in body shape satisfaction according to weight perception in male students(chi2=140.47, p= .000), and in female students(chi2=130.99, p= .000). The percentages of body shape satisfaction were highest with students who thought themselves normal in male students while and in female students, the students who thought themselves thin were highest. There were significant differences in body shape esteem according to weight perception for male students (F=17.67, p= .000), and in female students (F=13.95, p= .000). The mean scores of body shape esteem were highest with students who thought themselves normal in male students and thin in female students. The students who thought themselves obese were lowest. There were significant differences in weight perception according to father's body shape (chi2=13.72, p= .008) in male students and father's educational level (chi2=14.90, p= .021), mother's educational level (chi2=17.73, p= .007), mother's body shape (chi2=13.07, p= .011) in female students.

The Relationship between Family Support and Ego Identity of Young People: Jung Nam Kim, Yun Hee Kwon; J Korean Acad Community Health Nurs. 2002;13(1):124-136. Published online March 31, 2002

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Abstract PDF: In the present study we have attempted to explore the relationship between family support that young people receive and the level of Ego Identity that they develop. We started the present study with the purpose of providing parish nurses with some basic data for nursing intervention for family and school nursing, as well as for community health care. We conducted the present study during the period of October 15, 2001 through November 5, 2001. The objects of this study were Inmunge High School students chosen from a school in Daejon. The subject students were selected randomly from each grade in that school. The numbers of subjects selected randomly from each grade in that school. The numbers of subjects selected were 120 boys and 113 girls (total: 233). The research tool that we used to measure perceived family support received by students was on that Ga Eon Lee revised for high school students on the basis of Cobb's theory. To measure the subject students' Ego Identity level we used Bong Yon Sho's 'Ego Identity Scale', that he revised form Dignan's 'Ego Identity Scale' for Korean high school students. Data were analyzed with SPSS Win 10.0 program using statistics of frequencies, percentage, t-test, ANOVA, and Pearson correlation coefficient. The findings of the present study indicate that: 1) The mean of family support that subject students feel that they received was 39.99 on the family support scale, and the mean of the students on the Ego Identity scale was 186.16. 2) The support that the subjects received from their own family had a statistically significant correlation with their Ego Identity (r=.93, p=.00). 3) Various factors had a significant correlation with the level of family support perceived by the subjects: the subject's grade (F=3.35, p=.04), the subject's religion (t=6.39, p=.00), the family's economic situation (F=9.14, p=.00) the birth order (F=27.60, p=.00) the father's education (F=23.17, p=.00), the mother's education (F=28.70, p=.00), parental relationship (F=2657.03, p=.00) and the structure of the family (F=-9.65, p=.00). 4) Various factors had a significant correlation with the level of the subject's Ego Identity: the subjects religion (t=6.20, p=.00), the family's economic situation (F=12.56, p=.00), the birth order (F=22.85, p=.00), the father's education (F=10.37, p=.00), the mother's education (F=20.69, p=.00), parental relationship (F=938.73, p=.00), and the structure of the family (F=-8.74, p=.00). 5) Analyzing sources of support within the family, family members whom the subjects trust most (F=3.08, p=.03) and family members to whom they talk most (F=5.85, p=.00) showed the most significant differences. Analyzing sources of support within the family that affect the level of the subjects' Ego Identity, family members whom the subjects trust most (F=3.30, p=.02) and family members to whom they talk most also showed the most significant differences.

Exposure of Middle School Students to Pornography: Young Hee Yom, Yang So Yun, Kyu Eun Lee; J Korean Acad Community Health Nurs. 2002;13(1):137-146. Published online March 31, 2002

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Abstract PDF: PURPOSE
To analyze the exposure of middle school students to pornography.
METHOD
The Questionnaire. The data collected were from November 6 to November 12, 2000. The subjects of this study consisted of 664 middle school students in Kangwon Province. The data collected were analyzed using, percentage, mean, standard deviation, t-test and Pearson Correlation.
RESULT
The most frequently viewed program was computer pornography. Except no response about eighty-five percent (85%) of the subjects viewed the pornography prior to elementary school. Moreover, The subjects viewed pornography for the first time in a PC room. Lastly, this study found that there was a significant relationship between the frequency, consumed time and numbers of viewing media violence and the impulse to imitate and imitation acting after viewing the pornography.
CONCLUSION
Realistic and future-directed strategies should be developed for middle school students to decrease their exposure to pornography.

The Actual Condition of Smoking among University Students: Shin Jeong Kim, Sun Young Moon, Kyoug Soon Han; J Korean Acad Community Health Nurs. 2002;13(1):147-160. Published online March 31, 2002

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Abstract PDF: The purpose of this study was twofold: one, to provide basic data to prevent smoking among university students and two, to develop an effective no smoking program for university students. Two hundred and ten 210 university students who smoked were enrolled in the study. Data were collected from September, 1999 to January, 2000 using a questionnaire. The data collected were scored by using mean and standard deviation according to the motivations for smoking, the psychological characteristics and the motivation for not smoking. Each item was analyzed as an independent variable by the t-test and the ANOVA test. The results were as follows: 1. The average score of subjects' smoking motivation and psychologic characteristics was 2.59. 2. The average score of subjects' no smoking was 3.18. 3. With the respect to the general characteristics of subjects' smoking motivation and psychologic characteristics, there were significant difference in allowance for the month (F=6.197, P=.002), smoking reason (F=4.196, P=.003), smoking type(F=2.34, P=.035), father's smoking(F=3.119, P=.027), and smoking of close friend (F=4.430, P=.013). In subjects' no smoking motivation, there were significant difference in age (F=3.469, P=.033) and starting time of smoking(F=2.834, P=.039) 4. There was a significant correlation (r=.190, p=.007) between subjects' smoking motivation, psychologic characteristics and no smoking motivation.

Evaluation of Community Health Nursing Practice and Nursing Student's Clinical Experience at Public Health Centers: Jeong Mo Park, Suk Jeong Lee; J Korean Acad Community Health Nurs. 2002;13(1):161-170. Published online March 31, 2002

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Abstract PDF: PURPOSE
To evaluate community health nursing practice by nursing students for basic data to improve nursing practice education, and to determine the clinical practice experiences of nursing students at public health centers.
METHOD
According to methodological triangulation, all data was collected from March 2001 to June 2001 through prepared questionnaires with 62 Participants, and in depth interviews with 2 Participants, and content analysis with 8 Participants.
RESULTS
1. Clinical practice content was needed to make up professionally. 2. Clinical practice instructor was satisfied with teaching by community health nursing professor, but not by public health center nurse. 3. Clinical environment was perceived as good. 4. Clinical practice time was perceived suitable, but practice evaluation was given a low grade. 5. Experience of nursing students was grouped into 9 categories and 20 themes. 9 Categories are as follows: change of public health center image, difficulty in the personal relationship, positive personal relationships, doubt about the attitude, doubt about the task, tension, worth, ambivalance of the conference, feeling about the end stage of the clinical practice. Twenty themes are stereotypic of the public health care center: recognition, difficulty between tasks and interrelationships with the clients, decrease of self esteem due to deficiency of trust with the students, exchange of feelings in the relationships, the situation of clients was not considered, feelings were disregarded, not systematic, regarding students as supplementory manpower, independent work but not enough contents, anxiety & fear, self-trust, be skilled in the practice, pragmatic knowledge formation, understanding of the old person, self-study of oneself, live up to the expectation, consider as the job, dissolve the stress and impose burden, feeling the lack regarding active approach in the practice.
CONCLUSION
The students have perceived the need of community health nursing through the clinical practice. Clinical practice of community health nursing requires content supplement, correction of instruction by public center nurses, environmental alteration, evaluation criteria set up. Experience of clinical practice in the public health center was as follows: Getting rid of the stereotype about public health center, nursing students comprehended variety and were worth while to do clinical practice in spite of tension & anxiety and fear. And they thought to be a community nurse someday.

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