Research in Community and Public Health Nursing

Volume 18 (1); March 2007

Original Articles

Factors Predicting Medication Compliance among Elderly Visitors of Public Health Centers: Hyeon Suk Kim, Hee Young Kim; J Korean Acad Community Health Nurs. 2007;18(1):5-13. Published online March 31, 2007

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Abstract PDF: PURPOSE
The purpose of this study is to investigate compliance with prescribed medication in the elderly visiting public health centers.
METHOD
Data were collected from 665 elders living in Seoul and the Gyeonggi Province during the period from February 21 to June 30 in 2006. The data were collected through individual interviews and were analyzed using correlation and multiple regression analysis with the SAS 9.1 program.
RESULTS
The mean of medication compliance was 2.97(+/-.68) on a 5-point Likert scale. Specifically, compliance 3.14(+/-.70) for medication dose, 2.94(+/-.77) for medication frequency, and 2.84(+/-.79) for medication time. The elderly with a higher level of education (beta=.095, p<.001), with health insurance (beta=.208, p=.0009) and with a higher level of family support (beta=.040, p=.0306) showed a higher level of mediation compliance. Female elders (beta=.142, p<.001) kept higher medication compliance than male ones.
CONCLUSION
These findings suggest that people with low education, low socioeconomic status and less family support need more education before medication. The evaluation of medication compliance needs to be encouraged before starting medication to distinguish those who may not comply with medical prescription. Predictive factors identified in this study must be considered when designing interventions, program development and education for appropriate medication management for the elderly.

Experience of Falls and Predictors of Falls in the Elderly at Senior Citizens' Centers: In Young Yoo, Jung Hyun Choi; J Korean Acad Community Health Nurs. 2007;18(1):14-22. Published online March 31, 2007

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Abstract PDF: PURPOSE
The purpose of this study was to investigate the experience of falls, the fear of falling and fall efficacy and identify the predictors of falls in the elderly at senior citizens' centers.
METHOD
The subjects of this study were 106 elders who used senior citizens' centers in Chungcheongbuk-do, Korea. Data were collected from May to June, 2006 through a survey using a structured questionnaire.
RESULT
Of the elderly sampled, 35.8% experienced falls during the last 1 year. Of falls experienced by the elderly, 53% occurred indoors, 47% outdoors, 15.8% in the bathroom or toilet. In addition, 57.8% of the elderly had injuries on the hip and waist related with falls. The fear of falling was higher in those with experience in falls than in those without. Factors affecting the elders' falls were age (OR=1.113, 95% CI=1.012-1.224), the number of chronic disease (OR=2.342, 95% CI=1.365-4.019) and the fear of falling (OR=4.279, 95% CI=1.901-9.634). The predictor of the frequency of falls was fall efficacy (R2=24.9).
CONCLUSION
As a result, it is essential to develop fall prevention programs based on the fear of falling, fall efficacy, chronic diseases and medication state. And in senior citizens' centers, fall prevention safety education should be activated as a health promotion program.

Factors Influencing the Well-being of the Aged in Rural Areas: Mi Hye Hwang; J Korean Acad Community Health Nurs. 2007;18(1):23-31. Published online March 31, 2007

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Abstract PDF: PURPOSE
This study was to investigate factors influencing the well-being of the aged in rural areas.
METHOD
The subjects consisted of 250 elders living in rural areas of Kyungsangbuk-do. Data were collected by questionnaire surveys using convenience sampling. The instruments used in this study were the Well-being Scale by Chang (1999), the perceived health status developed by Speake, Cowart, and Pellet (1989), and the Social Support Scale developed by Song (1991). Data were analyzed using the SPSS program through descriptive statistics, t-test, ANOVA, Duncan's multiple-range test, Pearson Correlation Coefficient and stepwise multiple regression.
RESULTS
The most powerful predictor of well-being was social support, and then religion, health status, living expenses, and habitation accounted for 42.95% of variance in the well-being of the aged in rural areas.
CONCLUSION
These results suggest that perceived health status and social support can be potential risk factors in the well-being of the aged. The findings of this study provide the basis of program development to improve the well-being of the aged in rural areas.

Coping with Experiences in Multiple Chronic Diseases in the Rural Elderly: Eun Ok Joung, Sung Bok Kwon, Ok Hee Ahn; J Korean Acad Community Health Nurs. 2007;18(1):32-41. Published online March 31, 2007

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Abstract PDF: PURPOSE
The purpose of this study was to describe how the rural elderly cope with experiences in multiple chronic diseases.
METHOD
Data were collected through participant observation and in-depth interview using ethnography. The participants were 9 women and 2 men who aged over 65, were living in rural community, and had experienced two or more chronic diseases.
RESULTS
According to the results of this study, those who had experienced multiple chronic diseases went through the stages of 'recognizing of revealed symptoms', 'discovering of disease', 'overcoming', 'neglecting', 'discovering another disease', 'being frustrated' and 'living with suffering'.
CONCLUSION
The results of this study are expected to be utilized as basic materials to develop a nursing intervention program for effective management of chronic diseases.

Research on Health and Health Care of the Korean American Elder Population in the United States: Chin Kang Koh; J Korean Acad Community Health Nurs. 2007;18(1):42-55. Published online March 31, 2007

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Abstract PDF: No abstract available.

Content Analysis of Exercise Programs for the Elderly in Korean and Foreign Articles: Ki Wol Sung; J Korean Acad Community Health Nurs. 2007;18(1):56-68. Published online March 31, 2007

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Abstract PDF: PURPOSE
The present study analyzed the contents of exercise programs for the elderly in Korean and foreign articles.
METHOD
This study analyzed 27 Korean and 20 foreign exercise-related articles selected from Web DBs using keywords 'exercise', 'exercise program' and 'exercise effect'. The collected data were analyzed using SPSS 11.5 through descriptive statistics, chi2 test and Fisher's exact test.
RESULTS
In the description of population, random sampling and informed consents, foreign articles were higher than Korean articles. In research design, foreign articles randomized controlled trials (RCTs) higher than Korean articles. The contents of exercise programs in the Korean and foreign articles were aerobic, walking and stretching. On the effects of exercise programs in the Korean articles, walking showed the highest frequency in the physical strength as well as muscle strength, balance and flexibility. In the foreign articles, walking and stretching showed high frequency in physical strength.
CONCLUSION
Contents significant in exercise programs for the elderly were walking and stretching. In addition, regular exercise had a positive effect on muscle strength, flexibility and balance in the elderly.

The Effects of a Combined Exercise Program and Telephone Counseling on Physiological Functions, Self-efficacy and Depression in Obese Middle-aged Women: Nam Hee Park, Chae In Han, Eun Oak Choi; J Korean Acad Community Health Nurs. 2007;18(1):69-78. Published online March 31, 2007

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Abstract PDF: PURPOSE
This study was to determine the effects of a combined exercise program and telephone counseling in obese middle-aged women. The study also attempted to measure the effects of the program on physiological functions, self-efficacy and depression.
METHOD
This research employed a nonequivalent control group pretest-posttest design. The experimental group consisted of 29 obese middle-aged women, and the control group of 30 women. The subjects in the experimental group participated in a combined exercises program and telephone counseling for 12 weeks.
RESULTS
After performing the program for 12 weeks, BMI (p=.000), percent body fat (p<.007), TC (p=.026), TG (p=.035) and depression (p=.012) in the experimental group decreased significantly compared with the control group. Self-efficacy (p=.000) in the experimental group increased significantly compared with the control group after the program.
CONCLUSION
From these findings, it was confirmed that a combined exercises program and telephone counseling for obese middle-aged women can increase self-efficacy and decrease BMI, percent body fat, total cholesterol, triglyceride and depression. Therefore, this program can be utilized for various population groups including women, and further researches are required on programs for men.

The Effect of a Physical Exercise Program Using Elastic Bands in the Attitude of Physical Exercise and the Degree of Joint Pain: Shin Jeong Kim, Geum Hee Jeong, Soon Ok Yang; J Korean Acad Community Health Nurs. 2007;18(1):79-89. Published online March 31, 2007

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Abstract PDF: PURPOSE
The purpose of this study was to identify the effects of a physical exercise program using elastic bands in rural area women.
METHOD
This study adopted a pre-post test design. The subjects were 89 rural area women who were selected from four community health care centers. The physical exercise program was executed 30 times for 10 weeks (3 times a week) from August 23 to October 31, 2003.
RESULTS
There was a significant difference in the attitude of physical exercise (t=-5.517, p=.000). In the degree of joint pain, there were significant differences in the flextion and extension of the shoulder joint (t=2.557, p=.020; t=5.625, p=.000), and there was a significant difference in the flextion of the knee joint (t=4.747, 0=.000) but there was no significant difference in the extension of the knee joint (t=1.795, p=.083).
CONCLUSION
Physical exercise programs need to be implemented and spread continuously.

A Diagnostic Study on the Development of a Health Promotion Program for Vinyl House Farmers: Chung Nam Kim, Kyung Soon Lim; J Korean Acad Community Health Nurs. 2007;18(1):90-101. Published online March 31, 2007

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Abstract PDF: PURPOSE
The purpose of this study was to investigate influencing factors of health problems which the vinyl house farmers had experienced.
METHOD
Based on PRECEDE model, this study was done with 110 respondents(50 to 69 years old), working in vinyl house and living in the remote area where the primary health post located.
RESULTS
Quality of life was low in economical status, emotional status, and physical function. Health problems were founded as pain and chronic fatigue that were caused by physical symptoms, weakened physical strength, and increased blood pressure and cholesterol. Behavioral and environmental factors were related with lack of exercise, irregular eating habit, curtailed sleep, overwork, wrong working postures, stress, and non-fulfillment of safety standard during spraying pesticide. Self efficacy was low in excercise practice, working way, and stress management.
CONCLUSION
The Health Promotion Program for vinyl house farmers should be developed to improve health promoting behavior and self efficacy, to reduce stress, and to strengthen physical function.

The Association of Health Behaviors with Musculoskeletal Diseases in Adults: Yoon Jung Lee, So Young Lee, Soon Lae Kim, Hea Sun Jung, Kyung Mi Yang, Jong Eun Lee; J Korean Acad Community Health Nurs. 2007;18(1):102-111. Published online March 31, 2007

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Abstract PDF: PURPOSE
This study attempted to understand health behaviors and analyze the association of the health behaviors with musculoskeletal diseases in adults.
METHOD
The subjects of this study were 6,946 adults aged between 20 and 65 who had participated in the 2001 National Health Nutrition Survey. The instrument was composed of Health Interview Survey (HIS), Health Behavior Survey (HBS) and Health Examination Survey (HES), which were used in the 2001 National Health Nutrition Survey. Data were analyzed using SPSS 10.1 by applying chi2 and multivariate logistic regression.
RESULTS
1. The present smoking rate was 46.5% and the present drinking rate was 81.2%. 2. Of the subjects, 22.7% were overweight (BMI> or =25), and 28.1% were exercising regularly. 3. Major factors affecting musculoskeletal diseases were low education, poor economic state, smoking, and BMI. Middle school graduates were 2.54 times more likely to have musculoskeletal diseases than college graduates. The risk was 1.83 times higher in indigent respondents than in affluent ones, and 1.43 times higher in smokers than in non-smokers.
CONCLUSION
Therefore, in order to reduce musculoskeletal diseases in adults, other various factors should be looked into, and public education about appropriate posture and exercise should be carried out in community. Additionally, concentrated intervention programs for patients with musculoskeletal diseases should be performed.

Characteristics of Subgroups on Patients with Hypertension for Hypertension Management: Based on Knowledge, Attitudes, and Behavior Related to Medication and Health Lifestyle: Yang Heui Ahn; J Korean Acad Community Health Nurs. 2007;18(1):112-122. Published online March 31, 2007

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Abstract PDF: PURPOSE
The purpose of this study was to identify and profile distinct subgroups of patients with hypertension based on knowledge, attitudes, and behavior regarding their medication and health lifestyle.
METHOD
A descriptive-exploratory research design was employed. Two hundred and twenty-three patients with hypertension using W Public Health Center were randomly recruited on the basis of being over 30 of age. Upon the receipt of their written consents, direct interview with a structured questionnaire were conducted by a public health nurse. Descriptive statistics and chi2-test were utilized.
RESULTS
Three subgroups were identified. Group I members had a low score on all three factors including knowledge, attitudes and behavior related to medication and health lifestyle. Group II members had a low score on one or two of the factors. Group III members had a high score on all three factors. The three subgroups were significantly associated with education level, economic status, non-smoking and non-drinking.
CONCLUSIONS
Further research should be conducted to validate these findings and test tailored nursing intervention for patient compliance.

A Study on the Performance Level, the Awareness of the Importance, and Improvement of School Health Promotion Programs: Hyun Ju Ryu, Jeong Sook Park; J Korean Acad Community Health Nurs. 2007;18(1):123-135. Published online March 31, 2007

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Abstract PDF: PURPOSE
This study was carried out to suggest methods for improving school health promotion programs by investigating the daily activities and the performance level of environment management, the awareness of importance, and opinions on the revision of and knowledge about laws and regulations related to school health promotion programs.
METHOD
The subjects of this study were 289 school nurses in Gyeongsangbuk-do. The survey used a questionnaire containing 90 questions developed by the present researcher. Data were collected from July 5 to July 21, 2006 and analyzed using SPSS 12.0 for Windows.
RESULT
1. Regular check-up and drinking water management got the highest score in performance level. Sexual health and drinking water management got the highest score in the awareness of importance. 2. School nurses were aware of laws and regulations related to their clients (0.93), and the revision opinion was high on the whole (3.58). 3. According to general characteristics, the more educated school nurse were (F=6.80, p=.001) and the fewer students their school had (F=4.66, p=.010), the higher their performance level in daily activities was. The shorter their career in their work was (F=4.86, p=.008), the fewer classes their school had (F=5.04, p=.007) and the fewer students their school had (F=3.83, p=.023), the higher their awareness of importance was. 4. There was not any difference in the performance level of environment management according to general characteristics. The awareness of importance was highest in school nurses with experience less then ten years (F=3.66, p=.027). 5. There was not any difference in knowledge about laws and regulations according to general characteristics. The revision opinion was high in school nurses at schools with less than 18 classrooms (F=6.04, p=.003) and less than 500 students (F=4.24, p=.015).
CONCLUSION
When school nurses perform school health promotion programs actively and vigorously, the students can be healthy and national health promotion can be actualized fundamentally.

Predictive Factors of Adolescents' Illicit Drug Use: Hee Young Kim; J Korean Acad Community Health Nurs. 2007;18(1):136-145. Published online March 31, 2007

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Abstract PDF: PURPOSE
This study was attempted to illuminate danger signals through an extensive analysis of factors influencing adolescents' illicit drug use. On this basis, it built predictive factors of adolescents' illicit drug use.
METHOD
A questionnaire was distributed to 1,238 subjects living in Seoul, and of them 1,082 answers were analyzed using the SAS 8.2 program. Also logistic regression analysis was conducted based on the stepwise selection method for constructing the predictive factors.
RESULTS
The findings of this study are as follows. Individual-related factors were psychosomatic symptoms, self-esteem, fortune delinquent experience, and sexual-violence delinquent experience. Home-related factors were insincerity, threatening and the assessment of the parent (rearer)-adolescent communication type. Society-related factors were affection of friends and friends' attitude toward delinquency.
CONCLUSION
These findings of this study suggest that a broad intervention program should be provided to nurture wholesome youth culture related to illicit drug use. It is also recommended that a variety of individual, home and society-related programs should be developed for drug users.

Correlations among Meta Cognition, Critical Thinking and Self-efficacy of Nursing Students Studying through Problem Based Learning(PBL): Yoon Young Hwang, Chang Seung Park, Min Sun Chu; J Korean Acad Community Health Nurs. 2007;18(1):146-155. Published online March 31, 2007

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Abstract PDF: PURPOSE
This study was performed to examine the degree of meta cognition, critical thinking and self-efficacy and to identify correlations among the meta cognition, critical thinking, and self-efficacy of nursing students studying through PBL.
METHOD
The subjects were 140 nursing students who had studied through PBL over three terms at C College. Data were collected from August to September, 2005 using a structured questionnaire and analyzed using SPSS 10.0.
RESULTS
The mean score of meta cognition was 40.14 (SD=6.02), critical thinking was 181.46 (SD=14.49), and self-efficacy was 942.93 (SD=167.05). There was a statistically significant positive correlation between meta cognition and self-efficacy and age. Also, meta cognition had a positive correlation with appropriateness to nursing and interest in nursing knowledge, and critical thinking had a positive correlation with appropriateness to nursing, interest in nursing knowledge, interest in lab on campus and interest in clinical practicum. There were statistically significant positive correlations among meta cognition, critical thinking and self-efficacy.
CONCLUSION
Based on above results, further research should be done about many factors influencing nursing students' problem solving abilities for the development and application of many teaching methods for improving nursing students' meta cognition, critical thinking and self-efficacy.

The Implementation of PBL Module in Community Health Nursing: Kyung Hee Lee; J Korean Acad Community Health Nurs. 2007;18(1):156-164. Published online March 31, 2007

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Abstract PDF: PURPOSE
This study was to investigate adequate strategies of PBL in community health nursing for learning in the real community situation.
METHOD
Data were collected in a PBL class of 14 third-year students who solved problems and assessed PBL in community health nursing related to visiting nursing and chronic diseases.
RESULTS
The students guessed situations diversely, chose learning issues widely and mapped the learning concepts specifically. In the assessment of the presentation, the peers of the same group gave the highest score 29.00+/-3.36, the tutor lowest score 22.83+/-5.15. In 5-point Likerts scale, the group dynamic was highest (4.18+/-.61) and the presentation was lowest (3.59+/-.84).
CONCLUSION
The group needs to include students who have experiences in the practice at the health centers. The PBL class should be managed by the block system along with the conventional learning. Students needs to practice the self-directed learning and the presentation in a first semester and then PBL. The introduction of community health nursing begins with the conventional lecture and the programs on life circle and health centers through PBL in the comprehensive curriculums.

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