Research in Community and Public Health Nursing

Most-read articles are from the articles published in 2022 during the last three month.

Original Articles

The Burden Experience of Family Caregiver of Older Adults with Chronic Illness: Nova Yustisia, Titin Aprilatutini, Tuti Anggriani Utama, Mahmasoni Masdar; Res Community Public Health Nurs. 2023;34(2):85-95. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00304

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Purpose
This study aims to find out further about the burden on families in undertaking caregiving for the elderly with chronic illnesses.
Methods
A qualitative study was developed using in-depth interviews with 12 family caregivers selected by purposive sampling in July 2022. The thematic analysis was then carried out using the Colaizzi method, and N-Vivo 12 Qualitative Data Analysis Software was used to assist with the content analysis.
Results
The result from the experience interview analysis of caregivers participating in this study were 54 codes which were categorized into thirteen categories. Then, they were derived into four themes, as follows: 1) Physical burden of the caregivers for the elderly with chronic illness, 2) Psychological burden of the caregivers for the elderly with chronic illness, 3) Obstacle of caregivers for the elderly with chronic illness, 4) The state of caregivers who perform caregiving for the elderly with chronic illness.
Conclusion
The experience of caregivers in undertaking caregiving for the elderly with chronic disease has many obstacles, such as physical, psychological, and economic burdens. Caregivers often find positive aspects of their experiences while caregiving for the elderly, although their burden also constantly increases. Health facilities should pay serious attention to family caregivers and facilitate programs that can help reduce the burden on family caregivers.

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Relationship between Care Burden and Health Anxiety in the Family Caregivers of the Older Adults with Alzheimer’s Disease
Mohammad Sadegh Sargolzaei, Daniyal Kohestani, Tahereh Alsadat Khoubbin Khoshnazar, Hossein Asghari Asl
Ageing International.2023;[Epub] CrossRef

Bidirectional Relationship Between Depression and Frailty in Older Adults aged 70-84 years using Random Intercepts Cross-Lagged Panel Analysis: Ji Hye Shin, Gyeong A Kang, Sun Young Kim, Won Chang Won, Ju Young Yoon; Res Community Public Health Nurs. 2024;35(1):1-9. Published online February 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00381

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Abstract PDF: Purpose
Depression and frailty are common health problems that occur separately or simultaneously in later life. The two syndromes are correlated, but they need to be distinguished to promote successful aging. Previous studies have examined the reciprocal relationship between depression and frailty, but there are limitations in the methods or statistical analysis. This study aims to confirm the potential prospective bidirectional and causal relationship between depression and frailty.
Methods
We used data from 887 older adults aged 70 to 84 from the Korean Frailty and Aging Cohort Study (KFACS) in 2016, 2018, and 2020 (3 waves). We separated the within-individual process from the stable between-individual differences using the random intercepts cross-lagged panel model.
Results
Significant bidirectional causal effects were observed in 2 paths. Older adults with higher depression than their within-person average at T1 had a higher risk of frailty at T2 (β=.22, p=.008). Subsequently, older adults with higher-than-average frailty scores at T2 showed higher depression at T3 (β=.14, p=.010). Autoregressive effects were only significant from T2 to T3 for both constructs (Depression: β=.16, p=.044; Frailty: β=.13, p=.028). At the between-person level, the correlation was significant between the random intercepts between depression and frailty (β=.47, p<.001).
Conclusions
We find that depressed older adults have an increased risk of frailty, which contributes to the onset of depression and the maintenance of frailty. Therefore, interventions for each condition may prevent the entry and worsening of the other condition, as well as prevent comorbidity.

Urban-Rural Differences in Prevalence of Depressive Symptoms and Its Related Factors Among Older Adults: Findings from the Korean Longitudinal Study of Aging: Bongjeong Kim, Jinseub Hwang, Dohyang Kim, Soo Jin Kang; Res Community Public Health Nurs. 2024;35(1):51-63. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00388

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Abstract PDF: Purpose
Many studies exist on factors associated with depressive symptoms in urban and rural older adults; however, studies using a longitudinal design are scarce. This study aimed to determine whether there is a difference in the prevalence of depressive symptoms and their associated risk factors over time between urban and rural areas using a longitudinal sample of Korean older adults.
Methods
Data from the Korean Longitudinal Study of Aging (2006–2020) of older adult participants ≥65 years without depressive symptoms were analyzed. A generalized estimating equation model was employed for repeated measures analysis.
Results
As the time of living in the area increased, the prevalence risk of depressive symptoms in older adults increased in urban areas compared to rural areas in adjusted Model 2. In urban areas, less social contact with neighbors was significantly associated with a higher risk of depressive symptoms. In rural areas, occasional social contact with children was significantly associated with a lower risk of depressive symptoms. The prevalence of depressive symptoms was associated with five components of successful aging with some variations observed based on urban and rural residential areas.
Conclusions
Our findings suggest that understanding the longitudinal impact of residence on depressive symptoms provides valuable insights into the relationship between urban/rural areas and depressive symptoms. This study highlights the need for nursing intervention efforts aimed at promoting successful aging and increasing social contact with children or neighbors.

Home-based walking intervention for middle-aged migrant women using 360-degree virtual videos and a wearable activity tracker: A mixed-methods pilot study: Duckhee Chae, Keiko Asami, Jaseon Kim, Kukhyeon Kim, Jeeheon Ryu, Ardith Z. Doorenbos; Res Community Public Health Nurs. 2024;35(1):10-21. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00339

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Abstract PDF Supplementary Material: Purpose
To sustain behavior change, an intervention strategy that considers the contribution of affect to daily physical activity behavior regulation is needed. Although virtual reality-based physical activity interventions have the potential to improve emotional status, interventions using virtual reality videos in a free-living environment are lacking. This pilot study assessed the feasibility and preliminary efficacy of a home-based intervention using 360-degree virtual videos and wearable activity trackers to improve mood and physical activity.
Methods
A one-group pilot study of 12 middle-aged migrant women asked participants to watch virtual reality videos and perform moderate-intensity walking 5 days per week for 4 weeks, then complete surveys and focus group interviews. The intervention’s feasibility and preliminary efficacy were assessed by examining recruitment, retention, adherence, acceptability, mood, physical activity, and exercise self-efficacy.
Results
A word-of-mouth approach was effective for recruiting participants. Although the weekly intervention adherence rate ranged from 53.5% to 83.5%, retention (92.3%) and acceptability (91.7%) were high. Participants were satisfied with the “visual status indicators,” “sense of accomplishment and confidence,” “emotional engagement and sense of presence,” “joy from exercise,” “external motivation through supervision,” “easy to control virtual reality device,” and “extra benefits” of the intervention. Participants had significant decreases in negative affect (p=.016). Positive affect, physical activity, and exercise self-efficacy showed trends toward improvement.
Conclusion
This home-based intervention employing virtual reality videos and Fitbit activity trackers is feasible and shows preliminary efficacy in improving mood. Further research is warranted to evaluate its effectiveness in a more rigorous randomized controlled trial.

Current Status and Associated Factors of Emotional Distress Due to COVID-19 Among People with Physical Disabilities Living in the Community: Secondary Data Analysis using the 2020 National Survey of Disabled Persons: Bohye Kim, Ju Young Yoon; Res Community Public Health Nurs. 2024;35(1):37-50. Published online February 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00374

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Abstract PDF: Purpose
This study aimed to assess the current situation and factors associated with emotional distress due to COVID-19 among people with physical disabilities living in the community, using a Social-Ecological Model.
Methods
A secondary data analysis was performed using data from the 2020 National Survey of Disabled Persons. The study participants were 1,654 participants aged 19 years or older with physical disabilities. For data analysis, complex sample logistic regression was conducted to identify factors associated with emotional distress due to COVID-19 in people with physical disabilities.
Results
The results showed that 55.7% of people with physical disabilities living in the community experienced emotional distress due to COVID-19. This emotional distress was influenced by various factors, including intrapersonal factors (activities of daily living, difficulty in getting information about COVID-19, difficulty in obtaining and using equipment related to COVID-19), interpersonal factors (satisfaction with the number of friends), and community/policy factor (support related to COVID-19 from national and local governments).
Conclusion
It is recommended to develop tailored interventions to prevent mental health issues among people with physical disabilities by considering the factors related to their emotional distress in the event of future infectious disease disasters.

Factors influencing dementia preventive behaviors of older adults at high risk of dementia: Application of extended health belief model: So Hee Jung, Mee Ock Gu; Res Community Public Health Nurs. 2024;35(1):22-36. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00402

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Abstract PDF: Purpose
The purpose of this study was to identify the factors influencing dementia preventive behaviors of older adults at high risk of dementia based on extended health belief model.
Methods
The subjects were 140 older adults at high risk of dementia living in H-gun, Gyeongsangnam-do, Republic of Korea. The data was collected from April 21 to May 28, 2021 by using structured questionnaires. The data was analyzed using t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and hierarchical multiple regression by SPSS/WIN 24.0 program.
Results
The mean score of dementia preventive behaviors of older adults at high risk of dementia was 3.47±0.49 (range 1-5). The factors influencing dementia preventive behaviors were self-efficacy (β=.82, p<.001), cues to action(β=.17, p=.013), ages 75-79 (β=0.35, p=.003; reference: ages 65-69), ages ≥80 (β=0.27, p=.021; reference: ages 65-69), which together explained 82.0% of total variance in dementia preventive behaviors (F=25.21, p<.001).
Conclusion
Based on the results of this study, it is highly recommended to develop and apply the dementia prevention program that can increase self-efficacy and cues to action for improving dementia preventive behavior of older adults at high risk of dementia.

Smartphone dependency latent profile classification and association with emotional and behavioral difficulties among high school students in Korea: Eunjoo Kim, Min Kyung Song; Res Community Public Health Nurs. 2024;35(1):84-98. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00465

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Abstract PDF: Purpose
The pervasive integration of smartphones into adolescents’ daily lives has resulted in a concerning upsurge in smartphone dependency among high school students. Due to the diverse types and severity levels of smartphone dependency, there is a critical need for research to explore its heterogeneity. This study aimed to identify latent profile of smartphone dependency in high school students based on the four subdomains of smartphone dependency: disturbance of adaptive functions, virtual life orientation, withdrawal, and tolerance. In addition, we explored how emotional and behavioral difficulties differ according to the profiles.
Methods
We used data from 2,195 Korean high school students from the Korean Children and Youth Panel Survey 2018. Latent profile analysis (LPA) was performed to identify smartphone dependency latent profile. Statistical analysis including chi-square test, Analysis of Variance (ANOVA), and ranked Analysis of Covariance (ANCOVA) confirmed differences in smartphone use characteristics and emotional-behavioral difficulties according to the classified latent profile.
Results
LPA identified four distinct latent profiles of smartphone dependency among high school students; 1) Underdependent type, 2) Moderate type, 3) Habitual user type, and 4) Virtual space dependent type. The results of ranked ANCOVA, controlling for gender, geographical location, economic status, parental smartphone dependency, and relational variables, revealed that habitual user type exhibited significantly higher rates of attention deficit hyperactivity disorder, social withdrawal, and depressive symptoms compared to other types.
Conclusion
The identification of these profiles provides a foundation for developing tailored intervention programs for adolescents with different levels and patterns of smartphone dependency.

Influencing Factors for Work Engagement of COVID-19 Response Workers in Public Health Centers: Based on the Job Demands-Resources Model: Songran Park, Yeongmi Ha; Res Community Public Health Nurs. 2024;35(1):64-75. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00346

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Abstract PDF: Purpose
This study aimed to identify the influencing factors for work engagement of COVID-19 response workers in public health centers based on the JD-R model.
Methods
The participants were 119 civil servants and professionals of 20 public health centers with at least 6 months of work experience and have experience of COVID-19 response tasks in cities, districts and counties. The collected data were analyzed by descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficient and multiple regression using IBM SPSS 27.0.
Results
The factors influencing work engagement were age, career development opportunity, and person-job fit. The explanatory power of these variables was 61%.
Conclusion
In order to enhance the work engagement of public health center workers in responding to future infectious disease outbreaks, it is necessary to develop various strategies such as assigning job roles that aligned with individual characteristics, providing career growth opportunities even during infectious disease outbreaks, and designing tasks by taking into account age.

Review Article

Optimistic bias: Concept analysis: Miseon Shin, Juae Jeong; Res Community Public Health Nurs. 2024;35(1):112-123. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00360

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Abstract PDF: Purpose
The purpose of this study was to analyze and clarify the concept of ‘optimistic bias.’
Methods
A review of the literature was conducted using several databases. The databases were searched using the following keywords: optimistic bias, optimism bias, and concept analysis. The literature on optimistic bias was reviewed using the framework of Walker and Avant’s conceptual analysis process.
Results
Optimistic bias can be defined by the following attributes: 1) underestimation of personal risk, 2) vague confidence, 3) positive future prediction and 4) lack of risk recognition. The antecedents of optimistic bias are as follows: 1) risk perception, 2) self-efficacy, and 3) risk controllability. The consequences of optimistic bias are as follows: 1) reduced anxiety, 2) providing emotional stability, 3) negative consequences for preventive health behavior, 4) lack of attention to risk-related information, and 5) negative consequences for self-protection behavior.
Conclusion
The definition and attributes of optimistic bias identified by this study can provide a common understanding of this concept and help to develop a nursing intervention program effective in preventing, protecting, and improving health of subjects in the field of nursing practice.

Original Articles

Illness Experience of Glaucoma Patients: Hyeon ae Lee, Seon Nyeo Kim, Hwa Young Kim, Sue Kyung Sohn; Res Community Public Health Nurs. 2024;35(1):99-111. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00458

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Abstract PDF: Purpose
The purpose of this study was to understand and describe the experiences of patients with glaucoma.
Methods
Data were collected from March to April in 2023, through individual in-depth interviews with 10 glaucoma patients. Verbatim transcripts were analyzed using Colaizzi’s phenomenological analysis.
Results
Six theme clusters were extracted that described patients’ experiences: 1) The frightening disease unexpectedly discovered; 2) A dismal life gradually trapped in darkness; 3) Fear of the unseen; 4) Following treatment without any other options; 5) Grateful for the help but feeling miserable; 6) Realizing the importance of eyes and health.
Conclusion
The results of this study provide a deep understanding and insight into the experience of Glaucoma patients. Glaucoma patients experienced physical, mental, and social pain through the disease process. Therefore, psychological nursing interventions are needed to understand and reduce mental pain along with medical treatment to relieve physical symptoms in glaucoma patients. Furthermore, it will be necessary to prepare institutional support measures to minimize various social restrictions.

Validity and Reliability of the Korean Version of the Diabetes Acceptance and Action Scale (DAAS-K): Kawoun Seo; Res Community Public Health Nurs. 2024;35(1):76-83. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00430

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Abstract PDF: Purpose
The purpose of this study was to evaluate the validity and reliability of the Korean version of the Diabetes Acceptance and Action Scale-Revised (DAAS-R) for Korean patients with type 2 diabetes.
Methods
The survey was conducted from September 1, 2021, to September 30, 2021, through a survey institution for patients diagnosed with diabetes who understood the purpose of the study and voluntarily agreed to participate. A total of 231 individuals with type 2 diabetes participated in this study. After performing forward and backward translations of the original version of the Diabetes Acceptance and Action Scale-Revised (DAAS-R) into Korean, its constructive validity (confirmatory factor analysis), concurrent validity and reliability were assessed. Concurrent validity was confirmed through the correlation between acceptance and action, quality of life, diabetes self-stigma, and experiential avoidance.
Results
Construct validity, measured using confirmatory factor analysis, showed a good fit. The DAAS-K was positively correlated with acceptance and action, quality of life, and negatively correlated with diabetes self-stigma and experiential avoidance. As for internal reliability, the Cronbach’s α of the DAAS-K was .95.
Conclusion
The DAAS-K can be applied to assess diabetes acceptance and action in Korean patients with type 2 diabetes and to compare the levels of psychological flexibility of patients with diabetes internationally.

Factors Influencing on Core Competencies in Disaster Nursing by University Hospital Nurses’ Experiences of Caring for Patients with COVID-19: Bo Won Choi, Yeong Mi Ha; J Korean Acad Community Health Nurs. 2022;33(2):247-258. Published online June 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.2.247

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Abstract PDF

Purpose
Considering that nurses perform critical roles for caring for patients during the COVID-19 pandemic, it is important to investigate core competencies in disaster nursing. This study aimed to identify influencing factors on core competencies in disaster nursing by examining relationships between attitudes toward disaster management, disaster preparedness, and core competencies in disaster nursing in university hospital nurses’ experiences of caring for patients with COVID-19. Methods The participants were nurses working in two university hospitals who had either experiences of caring for patients with COVID-19 or no experiences. A questionnaire was distributed to 198 participants between October and November 2021. Results The findings of multiple regression analysis demonstrated that the factors related to core competencies in disaster nursing in the participants were disaster preparedness (β=.80, p<.001) and nurses’ experiences of caring for patients with COVID-19 (β=.11, p=.007). Specifically, the factors related to core competencies in disaster nursing in those having experiences of direct caring for patients with COVID-19 were disaster preparedness (β=.84, p<.001) and marital status (β=.16, p=.001). The factors related to core competencies in disaster nursing in those with indirect caring for patients with COVID-19 were disaster preparedness (β=.75, p<.001) and an intention to participate in disaster response (β=.16, p=.037). Conclusion Based on this study, it is important to develop disaster nursing education programs focusing on the full spectrum of disaster management including disaster preparedness, disaster response, and disaster recovery training.

Citations

Citations to this article as recorded by

Influences of Nursing Professionalism and Nursing Intention on Disaster Nursing Competency among Nurses when a Disaster Occurs in a Community: Response to COVID-19
Hyun-Jung JANG, Yoon-Jung KOO, Sun-Yeon HONG, Jeong-Eon PARK, Soo-Jin BAE, Suk-Jin PARK
THE JOURNAL OF FISHERIES AND MARINE SCIENCES EDUCATION.2023; 35(2): 276. CrossRef
Influence of COVID 19 on Nursing Students’ Career Identity: A Cross-sectional Study
Na-geong Kim, Hye-Ryeon Park
The Open Nursing Journal.2023;[Epub] CrossRef
Effectiveness of an online training program for improving nurses’ competencies in disaster risk management
Jamileh Farokhzadian, Hojjat Farahmandnia, Asghar Tavan, Gülcan Taskiran Eskici, Faezeh Soltani Goki
BMC Nursing.2023;[Epub] CrossRef
The Influence of Infection Control Fatigue and Compassion Competence on Disaster Nursing Core Competencies of Nurses at COVID-19 Designated Hospitals
Jae-Hyun Ha, Hyun-Ju Lee, Ki-Ryeon Kim
Journal of Korean Academy of Fundamentals of Nursing.2022; 29(4): 461. CrossRef

Relationships of Self-leadership, Working Environment, and Professionalism among School Health Teachers: Joohee Kim, Young Ko; Res Community Public Health Nurs. 2023;34(4):294-306. Published online December 29, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00297

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Abstract PDF: Purpose
This study was conducted to examine the relationships of self-leadership, working environment, and professionalism, and to identify the factors that influence professionalism among school health teachers.
Methods
This study was a descriptive research study to identify the relationships of self-leadership, work environment, and professionalism among school health teachers. Data were collected from 198 people via an online survey using a structured questionnaire. The data were collected from February 7 to 24, 2023. The relationships of self-leadership, working environment, and professionalism were analyzed using multiple regression analysis.
Results
The score of self-leadership of school health teachers was 3.97 points out of 5, working environment was 3.28 points out of 5, and professionalism was 4.12 points out of 5. Professional accountability and competency development were influenced by behavioral strategies of self-leadership, cognitive strategies of self-leadership, and working environment. These variables explained 35.0% and 29.5% of professional accountability, respectively. Autonomy was influenced by age, cognitive strategy of self-leadership, and working environment, and these variables explained 19.2% of the variance of autonomy. Social recognition was influenced by behavioral strategy of self-leadership, and working environment, and these variables explained 28.0% of social recognition.
Conclusion
To enhance the professionalism of school health teachers, it is necessary to cultivate self-leadership that can overcome difficulties in work and properly self-criticize. Improving the working environment would help enhance the professionalism of school health teachers.

Factors Influencing Self-esteem Changes in Multicultural Adolescents: Using a Linear Mixed Model: Ji Yeong Seo, Min Ah Park, Myeung Hee Han; J Korean Acad Community Health Nurs. 2022;33(3):290-298. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.290

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Abstract PDF: Purpose
This study was conducted to determine factors influencing changes in the self-esteem of multicultural adolescents over time. Methods: A longitudinal design was adopted to analyze secondary data. This study used the 2nd, 4th, and 6th year data of Multicultural Adolescents Panel Study (MAPS) collected by the Korea Youth Policy Institute. The linear mixed model was utilized to analyze self-esteem changes over time. Results: The factors of sex and age of the students, the mother’s Korean writing ability, and the Filipino or Japanese mothers had a significant effect on the self-esteem change of multi-cultural adolescents over time. Specifically, it was found that female students’ self-esteem was decreased by 0.04 (t=-2.39, p=.017) more than male students over time. As the subject’s age and mother’s Korean writing ability increased, self-esteem was decreased by 0.01 (t=-2.53, p=.011) and 0.03 (t=-2.52, p=.012) over time. In addition, compared to that of those who had mothers from Korea, self-esteem of those who had Filipino or Japanese mothers was decreased by 0.04 significantly. Conclusion: Therefore, when developing a self-esteem promotion program, it is necessary to develop content by reflecting the characteristics of mothers as well as the gender and age of students. Furthermore, the significance of this study is in that it established a foundation for a positive self-identity of multicultural adolescents whose number is increasing recently by identifying factors affecting their self-esteem.

Experience Related to Acceptance of Illness among People with Early-Stage Dementia: A Phenomenological Study: Jaewon Park; Res Community Public Health Nurs. 2023;34(4):241-254. Published online December 29, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00157

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Abstract PDF: Purpose
This study aims to describe the structure of the experience related to acceptance of illness among people with early-stage dementia (PWED).
Methods
Participants were six people who had Alzheimer’s disease or vascular dementia. Their clinical dementia rating scores were 0.5 or 1. Data were collected from individual in-depth interviews. The collected qualitative data were analyzed based on Giorgi’s descriptive phenomenological method.
Results
The five constituents and eight sub-constituents were derived from the experience related to acceptance of illness among PWED; ‘Facing the changed me’, ‘Facing changes in roles and relationships with others’, ‘Conflict between recognizing and denying dementia in daily life’, ‘Perceiving the limits and accepting dementia’, and ‘Reconstructing daily life for the prolongation of the current health status’.
Conclusion
This study contributes to the expansion of the in-depth understanding of the experience related to acceptance of illness among PWED. The results of the study will be helpful as basic data for community health nurses to develop interventions to improve acceptance of illness of PWED.

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