Research in Community and Public Health Nursing

Original Articles

[English] Factors Associated with Subjective Health Status among People with Spinal Cord Injury: An Application of the International Classification of Functioning, Disability and Health Model: Haesun Lee, Hye Jin Nam, Ju Young Yoon; Res Community Public Health Nurs. 2025;36(1):73-84. Published online March 5, 2025; DOI: https://doi.org/10.12799/rcphn.2025.00962; Funded: National Research Foundation of Korea, Ministry of Education

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Abstract PDF: Purpose
This study aimed to identify factors influencing subjective health status among individuals with spinal cord injury (SCI) using the International Classification of Functioning, Disability and Health (ICF) model.
Methods
This study analyzed secondary data from the 2021 Survey on the Status and Needs of Individuals with SCI conducted by the Korea Spinal Cord Injury Association. A hierarchical multiple regression analysis was conducted in four steps. Independent variables included sociodemographic factors, satisfaction with medical services (environmental factor), the need for weight control, the need for nutritional education, the need for dietary management, and disability acceptance (personal factors) along with exercise and activity of daily living (activity and participation factors). These factors were added sequentially at each step based on the ICF model.
Results
A total of 513 participants were analyzed in this study, with an average subjective health status of 5.51±2.39. Higher satisfaction with medical services (β=.27, p<.001), frequent exercise (β=.19, p=.008), and a greater level of activities of daily living (β=.02, p<.001) were significantly associated with improved subjective health status. Conversely, a lower need for nutritional education (β=-.25, p=.042) was negatively associated.
Conclusion
This study highlighted satisfaction with medical services, nutrition education needs, exercise frequency, and activities of daily living as important factors. These findings provide insight into how the health status of individuals with SCI can be enhanced through targeted interventions and support from healthcare providers.

[English] Effect of Remote Health Interventions on Blood Pressure Control and Quality of Life for Hypertension Self-management: A systematic review and meta-analysis: YingMei Yuan, MeiLing Song; Res Community Public Health Nurs. 2025;36(1):150-164. Published online March 31, 2025; DOI: https://doi.org/10.12799/rcphn.2024.00570; Funded: Department of Science and Technology

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Abstract PDF: Objective: To evaluate the effect of remote health interventions on self-management of hypertension.
Methods
We systematically searched the literature for studies published in English in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Cochrane Central Register of Controlled Trials. The database was used to search for relevant studies with full text and evaluate the remote health interventions for hypertension self-management versus usual care for hypertension. RevMan 5.4 was used for data analysis.
Results
A total of 19 studies eventually met our inclusion criteria. The results showed that the remote health interventions group could significantly reduce the levels of SBP (MD=5.67, 95% CI=4.12-7.22, p<.001) and DBP (MD=1.88, 95% CI=1.16- 2.60, p<.001), compared with usual care group, it also significantly improving the patient's quality of life (SMD=0.84, 95% CI=0.32- 1.37, p=.002), reduce waist circumference (MD=2.39, 95% CI=0.35-4.44, p=.020) and BMI (MD=0.49, 95% CI=0.06-0.91, p=.020), and significantly increasing the physical activity of patients (SMD=0.19, 95% CI=0.06- 0.31, p=.004). No obvious publication bias was found in this meta-analysis.
Conclusion
This study showed that remote health interventions for self-management can significantly improve patients’ quality of life with hypertension and better BP control than usual care. Further studies could be assess the long-term clinical effectiveness and economic evaluation of remote health interventions for self-management.

[English] A Phenomenological Study on Vietnamese Immigrant Mothers Married to Koreans’ Parenting Experience in Preventing Infant Accidents and Injuries: Mi-Seon Kim, Mi Hye Kim, Sunhwa Park; Res Community Public Health Nurs. 2025;36(1):99-111. Published online March 31, 2025; DOI: https://doi.org/10.12799/rcphn.2024.00829; Funded: National Research Foundation of Korea, Ministry of Science and ICT

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Abstract PDF: Purpose
This study aims to analyze the essence of infant parenting experiences of Vietnamese immigrant mothers married to Koreans’.
Methods
The study participants are mothers who came to Korea from Vietnam as marriage immigrants, and have an experience of parenting infants in less than one year or are currently parenting infants. Data collection was carried out by interviews, and Colaizzi’s phenomenological method was used for analysis.
Results
Total 17 meaning units, 8 themes and 3 theme clusters were identified. The three theme clusters are as follows: 1) A strange land, journey to ‘mother’, 2) A moment of carelessness, an unexpected accident, 3) The first step to safe parenting.
Conclusion
Vietnamese immigrant mothers have experienced of a sudden transition to motherhood in Korea, and have raised their infants in a bicultural environment. While raising their infants, they have encountered unexpected accidents due to differences in parenting culture and lifestyle. Nevertheless, Vietnamese immigrant mothers have made efforts to care for their infants safely and have shared parenting responsibility with their husbands. They also recognized the need for infant safety education based on community support. Therefore, in the future, infant safety education programs that consider cultural differences will be necessary.

[English] Impact of Marital Dissolution Timing and Duration on Self-Rated Health of Marriage Immigrants in Single-Person Households in South Korea: Duckhee Chae, Kyeong Hwa Kang, Nakyung Kim, Keiko Asami, Jongdae Kim; Res Community Public Health Nurs. 2025;36(1):122-129. Published online March 31, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01011; Funded: Ministry of Education, National Research Foundation of Korea

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Abstract PDF: Purpose
This study examined associations between timing of marital dissolution, duration since marital dissolution, and self-rated health among marriage immigrants in South Korea who live in single-person households.
Methods
This cross-sectional study employed a secondary analysis of data from the 2021 Korean National Multicultural Family Survey. We performed binary logistic regression analyses to examine the relationships between the variables of interest while controlling for social support, economic well-being, psychological well-being, and sociodemographic characteristics. Data from 407 marriage immigrant single-person households were included in the analyses.
Results
Marriage immigrants’ self-rated health fluctuated over time but generally exhibited a downward trend following marital dissolution. After controlling for confounders, marital dissolution after age 50 and longer duration since dissolution (e.g., 3-6 years and 9+ years) were associated with increased odds of poor self-rated health. Unemployment and depressive symptoms significantly increased the odds of poor self-rated health, while higher social support had a protective effect.
Conclusion
Transitioning to singlehood after marital dissolution may have long-term negative health consequences, particularly for those experiencing this transition later in life. Proactive interventions focusing on social support and health resource acquisition within the initial 3 years of separation may be crucial to mitigate health decline.

[English] Associations between Self-esteem, Social Support, Family Empowerment, and Health Empowerment among Children during the COVID-19 Pandemic: Hye-Jin Kim; Res Community Public Health Nurs. 2025;36(1):49-58. Published online March 31, 2025; DOI: https://doi.org/10.12799/rcphn.2024.00794; Funded: National Research Foundation of Korea

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Abstract PDF: Purpose
This study aimed to identify associations between self-esteem, social support, family empowerment, and health empowerment among children during the COVID-19 pandemic.
Methods
A cross-sectional study was conducted among fifth- to sixth-grade children and their parents who were recruited from C elementary school in Gangwon-do, South Korea. The health empowerment, self-esteem, and social support as reported by children were measured by the Korean version of Health Empowerment Scale (K-HES), Self-Esteem Scale, and Perceived Social Support, respectively. The family empowerment as reported by parents of children was measured by the Family Empowerment Scale. Linear regression analysis was performed.
Results
Of the participants, children’s self-esteem (β=.46, p<.001) and social support (β=.47, p<.001) and parents’ family empowerment (β=.27, p=.008) were significantly and positively associated with children’s health empowerment.
Conclusion
Among children in health-vulnerable environments due to the COVID-19 pandemic, establishing interventions for improving health empowerment needs to be considered as a nursing strategy for self-esteem, social support, and family empowerment at the intrapersonal and interpersonal levels.

[English] Malnutrition Risk in Community-Dwelling Older Adults with Dual Sensory Declines: Focusing on Social Determinants of Health: Ha Na Jeong; Res Community Public Health Nurs. 2024;35(4):325-338. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00675; Funded: Konyang University

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Abstract PDF: Purpose
As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines.
Methods
The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines.
Results
1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk.
Conclusion
These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.

[English] Digital Health Literacy and Associated Factors Among Older Adults Living Alone in South Korea: A Cross-Sectional Study: Minhwa Hwang, Gahye Kim, Seonghyeon Lee, Yeon-Hwan Park; Res Community Public Health Nurs. 2024;35(4):389-400. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00766; Funded: National Research Foundation of Korea, Ministry of Science and ICT

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Abstract PDF: Purpose
This study aimed to examine the level of digital health literacy and identify factors associated with digital health literacy among older adults living alone in South Korea.
Methods
A cross-sectional study was conducted on 140 older adults aged 65 and above who live alone. Descriptive statistics and non-parametric methods were used to explore the relationship between digital health literacy and independent variables. A generalized linear model was used to identify factors associated with digital health literacy.
Results
Among 140 smartphone-owning older adults living alone, 52.1% were using the Internet via digital devices, and the participants’ average digital health literacy score was 6.64±7.46. Univariate analysis results showed significant differences in digital health literacy according to age, education level, and multimorbidity. The factors associated with digital health literacy were identified as gender (B=−0.36, p=.031), age (B=−0.06, p<.001), education level (B=0.12, p<.001), and sleep problems (B=−0.06, p=.006).
Conclusion
Despite widespread Internet and smartphone use, older adults living alone with chronic diseases showed low levels of digital health literacy, which were significantly associated with gender, age, education level, and sleep problems. Enhancing digital health literacy among vulnerable populations is crucial for the effective implementation of digital health services. Collaborative efforts, including tailored digital health interventions to enhance the digital health literacy of vulnerable populations and supportive policies, are essential to bridge the digital divide and promote health equity.

[Korean] Factors Influencing Participation in Hypertension Management Education Among Diagnosed Hypertensive Patients in Busan: Utilizing the 2021 Community Health Survey: Hye Jung Jun, Kyoung Mi Kim; Res Community Public Health Nurs. 2024;35(4):424-433. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00759; Funded: Korea Disease Control and Prevention Agency

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Abstract PDF: Purpose
This study investigated the completion rate of hypertension management education and its influencing factors among adults in the Busan region, utilizing data from the 2021 Community Health Survey.
Methods
The study included 3,660 adults aged 19 years or older who had been diagnosed with hypertension. Data were analyzed using SAS 9.4, focusing on demographic, socioeconomic, and health status characteristics.
Results
The results indicated that 22.1% of participants had completed hypertension management education. Key influencing factors varied by region: in the Western region, age, income, education level, marital status, and life satisfaction were significant factors associated with participation in hypertension management education. In the Southern region, income and education level were identified as relevant factors. Additionally, in the Central and Eastern regions, education level was a significant determinant.
Conclusion
Therefore, tailored hypertension management education programs that consider age, income, marital status, and life satisfaction are essential for residents in the Western region of Busan. Moreover, it is critical to enhance access to hypertension management education for low-income populations in the Southern region. Educational programs should also be designed to align with the educational levels of Busan residents to ensure effective hypertension management education.

[English] Association between Hearing Difficulty, Masticatory Difficulty, and Risk of Cognitive Impairment: Analysis of the Korean Longitudinal Study of Aging Data (2006-2020): Sook Hee Choi, Yun Hee Kim; Res Community Public Health Nurs. 2024;35(4):434-448. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00745; Funded: Youngsan University

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Abstract PDF: Purpose
This study aimed to identify the association between hearing difficulty, masticatory difficulty, and cognitive impairment using data from the Korean Longitudinal Study of Aging.
Methods
This secondary data analysis included 6939 Korean adults aged 45 or older with no cognitive impairment at baseline. Self-reported questionnaires measured hearing and masticatory difficulty, and cognitive impairment were assessed using the Korea Mini-Mental State Examination (K-MMSE). Cox models were used to estimate the risk of cognitive impairment associated with the coexistence of hearing and masticatory difficulty.
Results
People who coexisted with hearing and masticatory difficulty were 2.4%. The incidence rate of cognitive impairment was 37.7% for the study sample and higher in females than males. Compared to people without hearing and masticatory difficulty, the total study sample with the coexistence of hearing and masticatory difficulty had a higher risk of cognitive impairment (HR: 1.26, 95% CI: 1.03–1.56), females with the coexistence of hearing and masticatory difficulty had a greater risk of cognitive impairment (HR :1.52 95% CI: 1.11–2.09).
Conclusion
Coexistence of hearing and masticatory difficulty increased females' cognitive impairment risk. It is recommended to check hearing and masticatory function in a timely, which may be effective in detecting individuals at high risk of cognitive impairment.

[English] Effects of a School-Based Health Education for Cardiovascular Disease Prevention Among High School Girls: Minah Kang, Jina Choo; Res Community Public Health Nurs. 2024;35(4):363-374. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00647; Funded: College of Nursing, Korea University, National Research Foundation of Korea, Ministry of Science and ICT

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Abstract PDF: Purpose
We aimed to evaluate effects of a school-based health education for cardiovascular disease (CVD) prevention among high school girls.
Methods
Non-randomized cluster trial was conducted by recruiting two female high schools located in Seoul and allocating one school as a cluster to an experimental group and the other school as the other cluster to a control group. Participants were 169 first-year female high school students in two clusters. Of the participants, 84 were recruited in the experimental group and 85 in the control group. An intervention was an eight-week "School-based Health Education for CVD prevention". The experimental group received the intervention, while the control group received a CVD prevention handout. Measures were knowledge, self-efficacy, and health behaviors for CVD prevention. The pre-test and post-test were conducted.
Results
The experimental group participating in "School-Based Health Education for CVD Prevention" had significantly higher changes in knowledge, self-efficacy scores to prevent CVD, and health behaviors than the control group over eight weeks.
Conclusions
The "School-based Health Education for CVD Prevention" program may improve high school students' knowledge and self-efficacy as determinants of health behaviors as well as health behaviors to prevent cardiovascular disease.

[English] Factors Associated with Homosexual Adolescents in South Korea: Jong Gun Kim; Res Community Public Health Nurs. 2024;35(3):207-215. Published online September 30, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00332; Funded: Hoseo University

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Abstract PDF: Purpose
The purpose of this study was to investigate factors related to homosexual adolescents in South Korea.
Methods
Using statistics from the 12th (2016) Korea Youth Risk Behavior Web-based Survey, hierarchical logistic regression analysis was conducted. The study sample comprised 65,528 middle and high school students aged 12 to 18 years.
Results
The significant predictors of homosexual intercourse were gender, attempted suicide, bullying at school experience, ever drinking, ever smoking, habitual or purposeful drug use, cohabitation with family, weekly allowance, and mother’s education levels.
Conclusions
The results suggest that gender-related interventions should be considered in school health education programs and that sexual health interventions for high-risk groups may be needed, given the factors predicting homosexual intercourse.

[English] Developing a community-based, multicultural-friendly prenatal education pilot program: EunSeok Cha, Sojung Lee, Gui-Nam Kim, Byung Hun Kang, Minsun Jeon; Res Community Public Health Nurs. 2024;35(3):226-239. Published online September 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00507; Funded: Chungnam National University

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Abstract PDF: Purpose
The purpose of this study was to examine the acceptability, availability and sustainability of a pilot prenatal program developed by an interdisciplinary team.
Methods
Out of 19 multicultural women participated in the 6-session prenatal program, 6 women took part in an exit- focus group interview as a part of formative evaluation. The verbatim transcriptions of semi-structured interview data were analyzed using conventional content analysis.
Results
In general, the participants expressed high satisfaction with program content, educators and education methods. A hybrid model including health professionals and community health workers and using online and offline education modes was suggested as a way to disseminate the program at a national level. Interventions using aesthetic approaches such as music and an integrated method such as the introduction of available social services in pregnancy and during the postpartum period may play a role as the facilitator of the program participation of multicultural women. These approaches may also help them develop healthy coping skills, problem solving skills and empowerment in multicultural childbearing women who need to adjust to life in a new country simultaneously taking a new role as a mother.
Conclusion
An interdisciplinary prenatal program using a holistic approach contributes to enhancing multicultural women’s empowerment to become a mother in a new country.

[English] Exploring the Prevalence and Influencing Factors of Sexually Explicit Internet Material (SEIM) Consumption among Adolescents and Young Adults in Cambodia: Hyunjeong Cheon, Youngran Yang; Res Community Public Health Nurs. 2024;35(3):284-296. Published online September 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00633; Funded: Ministry of Education of the Republic of Korea, National Research Foundation of Korea

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Abstract PDF: Purpose
This study investigates the prevalence and factors associated with the consumption of sexually explicit Internet material (SEIM) among adolescents and young adults in Cambodia.
Methods
Utilizing a cross-sectional study design, data were collected through a survey administered to 1,271 participants. The survey focused on measuring SEIM consumption, sexual sensation seeking, perceived reality of SEIM, and sexual attitudes. Findings: The study revealed a SEIM prevalence of 27.2%, with notably higher rates among males (35.5%) than females (18.6%). Significant predictors of SEIM consumption included being male, having a father with a middle-level education, engaging in alcohol or substance consumption, spending more than five hours daily on electronic devices, having friends with sexual experience, frequent thoughts about sex, a heightened interest in sex compared to peers, perceiving SEIM as realistic, and maintaining a permissive attitude towards sex.
Conclusions
These findings underscore the importance of implementing education programs to address SEIM consumption and its potential risk factors. Such initiatives are crucial for preventing the use of SEIM among Cambodian youth, promoting a healthier understanding of sexuality, and fostering responsible online behavior.

Review Article

[English] A Systematic Review of Questionnaire Measuring eHealth Literacy: Jung-Won Ahn, Mi Young Kim; Res Community Public Health Nurs. 2024;35(3):297-312. Published online September 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00752; Funded: Gangneung-Wonju National University

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Abstract PDF

Purpose
This review aims to summarize the characteristics of currently used questionnaires measuring eHealth literacy and assess the quality of their psychometric properties in self-reported assessments within community settings.
Methods
The systematic analysis was conducted using the COnsensus-based Standards for the selection of health Measurement INstruments checklist to evaluate the methodological quality of studies on measurement properties.
Results
A total of 21 studies, including 19 questionnaires, were reviewed. The findings indicated that the quality of psychometric assessments for eHealth literacy was generally rated as 'good,' with most studies addressing multiple aspects of reliability and validity. Internal reliability, content validity, hypothesis testing, and responsiveness were particularly well-supported, each receiving over 10 sufficient ratings. However, there was limited evidence regarding measurement errors, test-retest reliability, criterion validity, and analyses of floor and ceiling effects.
Conclusion
This study contributes to the enhancement of eHealth literacy measurement tool selection and improves the reporting of their validity and reliability, thereby increasing the credibility of future research.

Citations

Citations to this article as recorded by

Current status of systematic review studies on patient-reported outcome measures published in Korean journals
Duck-Hee Chae, Jiyeon Lee, Eun-Hyun Lee
Research in Community and Public Health Nursing.2025; 36: 1. CrossRef

Original Article

[English] Prediction model of health checkup and cancer screening experience of elderly population using 2021 Community Health Survey: Myeunghee Han; Res Community Public Health Nurs. 2024;35(2):140-155. Published online June 28, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00500; Funded: Dong Yang University

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Abstract PDF: Purpose
This study was conducted to build a decision tree model composed of factors that predict whether or not the elderly population underwent health or cancer screening using the 2021 community health survey.
Methods
This study included 74,434 and 74,417 subjects who answered for experience of health checkup or cancer screening, respectively. This study used Chi-squared test, independent t-tests, and decision tree analysis to analyze the data.
Results
Regarding the health checkup, 78.1% of women received a health checkup, and among women, those aged 65-74 years who were not recipients of the basic livelihood service showed the highest participation rate of 85.0%. In case of men, those who were married and had no problems in daily activity showed the highest participation rate of 81.4%. In the case of cancer screening, for women, those who were 65-74 years old and were nonrecipients of basic livelihood benefits showed the highest participation rate of 75.3%. For men, the cancer screening rate was the highest at 74.3% in those who had no problems with mobility and were married.
Conclusion
It was found that the general and health characteristics of the elderly had a great influence on the health checkup and cancer screening. In order to develop a more improved screening system, screening rates and effects should be continuously observed and studied.

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