Research in Community and Public Health Nursing

Original Articles

[English] The Influence of Self-Esteem and Attitudes toward Organ Donation and Euthanasia on Attitudes toward Advance Directives in Married Middle-Aged Adults: A Cross-Sectional Study: Eun-Ho Ha; Res Community Public Health Nurs. 2026;37(2):136-151. Published online June 30, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01487

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Abstract PDF: Purpose
Preparation for organ donation, euthanasia, and advance directives (AD) during midlife contributes to a dignified end-of-life experience. Self-esteem functions as a key psychological resource in this process. This study aimed to examine self-esteem (SE) and attitudes toward organ donation (ATOD), euthanasia (ATE), and advance directives (ATAD), and to assess their effects on ATAD among married middle-aged adults. Methods: A total of 154 middle-aged adults residing in six community regions across Korea participated in the study. Data were analyzed using SPSS version 23.0, employing descriptive statistics, correlation analysis, and hierarchical regression. Results: SE was positively correlated with ATOD (r=.386, p<.001), ATE (r=.170, p=.035), and ATAD (r=.462, p<.001). ATE was positively correlated with ATOD (r=.402, p<.001), and ATAD was positively correlated with ATOD (r=.677, p<.001) and ATE (r=.384, p<.001). Hierarchical regression analysis demonstrated that ATOD (β=.22, p=.002), being in the 40∼49 age group (β=.19, p=.006), lack of awareness of AD (β=−.18, p=.002), SE (β=.14, p=.016), lower frequency of thinking about organ donation (β=−.13, p=.035), and absence of religion (β=−.10, p=.025) were significant predictors of ATAD. These variables collectively explained 74% of the total variance in ATAD. Conclusion: The findings underscore the need to develop multidisciplinary educational strategies aimed at enhancing key factors that influence ATAD among married middle-aged adults.

[Korean] Institutionalization of Visiting Nursing Services Provided By Public Health Centers and the Formation of Employment Structures for Visiting Nurses, 1990–2012: Yeon Yi Song, Dahye Jeong; Res Community Public Health Nurs. 2026;37(2):152-165. Published online June 30, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01333

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Abstract PDF: Purpose
This study aims to examine the history of visiting nursing services at Korean public health centers from 1990 to 2012 in Korea’s historical and institutional context.
Methods
We collected and analyzed materials from metropolitan/provincial archives; government policy documents; guidelines and reports from the Korea Health Industry Development Institute and Korea Health Promotion Institute; newspapers; the Public Health Nursing Newsletter(Bogeon Ganho Sosik); and memoirs of public health center nurses.
Results
Visiting nursing was formalized in the 1990s through Seoul pilot projects and took root as a public health service focused on low-income populations. After the 1997–1998 financial crisis of Korea, a public-works–based visiting nursing project expanded and standardized services nationwide but entrenched a short-term, low-wage employment structure. Driven by Health Plan 2010(HP2010), established in 2002, the 2005 Urban Visiting Health Pilot Project, and the 2007 Customized Visiting Health Care Services, the program’s target population and workforce expanded markedly, and nationwide implementation began. In the early 2000s, guidelines and training materials were developed and the Field Management Training Program(FMTP) was introduced, strengthening professional capacity; however, establishing sustainable regular staffing and a stable training system remained limited.
Conclusion
Between the 1990s and 2012, visiting nursing at public health centers became institutionalized and expanded into a nationwide, routine program, accompanied by changes in program nomenclature, staffing standards, and delivery modalities. Maintaining visiting nursing as a core universal service of public health centers requires public systems that foster the accumulation of visiting nurses’ professional expertise and reflect the value of care.

[English] Influence of Smartphone Dependence, Mental Health, and Resilience on Military Life Adjustment Among Soldiers: A Cross-Sectional Study: Soonnam Shin, Kyungja Kang; Res Community Public Health Nurs. 2026;37(1):1-13. Published online March 31, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01291

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Abstract PDF: Purpose
This study aimed to examine the influence of smartphone dependence, mental health, and resilience on military life adjustment among soldiers.
Method
Data from a total of 173 subjects were collected from February 11, 2025 to March 8, 2025, using a self-report questionnaire. The data were analyzed using independent t-tests, one-way ANOVAs, the Scheffé test, Pearson’s correlation coefficient, and multiple linear regression analysis.
Results
Resilience (β=.65, p<.001), high-risk smartphone dependence (β=-.17, p=.001), mental health (β=-.14, p=.027), and the experience of difficulties in military life (β=-.12, p=.001) were identified as factors influencing military life adjustment. These variables accounted for 83.0% (F=67.92, p<.001) of the variance in military life adjustment.
Conclusion
The findings of this study demonstrate the necessity of developing integrated intervention programs to enhance military life adjustment among soldiers. In particular, as resilience was identified as the most influential factor, interventions aimed at strengthening resilience, along with strategies for regulating smartphone use, promoting mental health, and alleviating service-related stress, are warranted.

[English] Socio-Demographic and Psychological Factors Influencing the Happiness of Gyeongsangbuk-do Residents: Sung Jung Hong, See Jo Kim, Nam Hyun Cha; Res Community Public Health Nurs. 2025;36(4):435-446. Published online December 31, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01277

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Abstract PDF: Purpose
This study examined the effects of sociodemographic factors, health behavior, and psychological-emotional characteristics on stress, depression, and happiness among residents of Gyeongsangbuk-do and explored the relationships among these variables.
Methods
A cross-sectional analysis was conducted using data from the 2022 Korean Community Health Survey. The sample included 21,490 residents of Gyeongsangbuk-do. Multiple linear regression and Pearson correlation analyses were performed to identify predictors of psychological well-being.
Results
Participants showed high prevalence of health risk behaviors, including alcohol consumption (76.4%) and smoking (15.7%), while a majority engaged in regular physical exercise (79.3%). Despite this, the proportion reporting good or very good subjective health was lower than the national average (34.0% vs. 53.1%). Stress was positively correlated with depression (r=.24, p<.001) and negatively correlated with happiness (r=-.25, p<.001). Multiple regression analysis revealed that happiness was significantly associated with subjective health status (β=.07 to .27), stress (β=-.19), depression (β=-.17), suicidal thoughts (β=-.11), educational attainment (β=.03 to .10), smoking (β=-.08), physical exercise (β=.04), and income level (β=-.03 to .04). The final model explained 25.6% of the variance in happiness (adjusted R²=.256, F=337.76, p<.001).
Conclusion
Happiness among Gyeongsangbuk-do residents was influenced by a combination of sociodemographic, health behavioral, and psychological-emotional factors. These findings provide foundational evidence for developing regionally tailred strategies to improve community mental well-being.

[English] Factors Associated with Work Engagement of Home-Visit Care Workers Based on Job Demands–Resources Model: A Quantitative Cross-Sectional Study: Hanyi Lee, Hyeon Sik Chu; Res Community Public Health Nurs. 2025;36(4):396-406. Published online December 31, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01221

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Abstract PDF: Purpose
The aim of this study is to identify the factors associated with work engagement among home-visit care workers in South Korea, the Job Demands–Resources (JD-R) model was used as a guiding theoretical framework. Methods: This descriptive correlational study used secondary data from the 2020 Survey on the Service Environment of Home Care Workers by the Korea Institute for Health and Social Affairs. Participants were 509 certified home-visit care workers from Seoul and Chungcheong, each caring for one recipient. Measures included emotional labor, self-rated health, relationship quality with care recipients, and work engagement. Data were analyzed using hierarchical multiple regression. Results: Work engagement was negatively associated with emotional labor and positively associated with self-rated health, relationship quality with care recipient, and satisfaction with the care environment. Emotional labor remained a significant negative relationship, while self-rated health and relationship quality with care recipients emerged as key positive relationships. The final model explained 17.0% of the variance. Conclusions: These findings support the applicability of the JD-R model in understanding work engagement among home-visit care workers. Although job demands such as emotional labor may hinder engagement, individual and relational resources play protective and motivating roles. The diminished influence of physical and environmental factors in the presence of strong personal resources highlights the importance of a balanced approach that strengthens the emotional, physical, and relational capacities to support sustainable engagement.

[English] Education Needs for Public Health Crisis Using an Importance-Performance Analysis and Borich Needs Assessment Model: Focused on Aircraft Quarantine Officials: Jiyun Park, Gye Joung Yeom, Seok Hwan Kim; Res Community Public Health Nurs. 2025;36(4):361-372. Published online December 31, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01193

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Abstract PDF: Purpose
This study aimed to investigate the importance and performance levels of the duties related to public health crisis response of the aircraft quarantine officials and to analyze their educational needs for public health crisis. Methods: The subjects were quarantine officials at Incheon airport in Korea, and data from a total of 121 individuals were utilized for analysis. Data were analyzed by an independent t-test, paired t-test, and one-way ANOVA for the importance and performance of duties regarding public health crisis according to general characteristics. An Importance-performance analysis (IPA) and Borich needs assessment model were used to analyze public health crisis education needs. Results: The IPA analysis revealed that the area requiring focused improvement efforts (concentrate here), where importance is high, but performance is low, primarily includes epidemiological investigation of emerging infectious diseases. The Borich needs assessment was used to identify the following priority items: epidemiological investigation of emerging infectious diseases, occurrence of social disaster after patient isolation, donning and doffing of personal protective equipment (PPE), and epidemiological investigation of respiratory infectious diseases. Conclusion: Based on these results, it will be necessary to develop and implement practical education and training programs for aircraft quarantine officials.

[English] Factors Influencing Care Coordination for Chronic Disease Patients with a Usual Source of Care: Hyunsang Kwon, Ju Young Yoon; Res Community Public Health Nurs. 2025;36(3):339-351. Published online September 30, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01186

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Abstract PDF: Purpose
Care coordination is a key function that enables consistent and integrated care by connecting various medical, welfare, community resources throughout a patient’s healthcare journey. This study was aimed at examining the provision of care coordination and its associated factors among adult patients with hypertension or diabetes who have a usual source of care, using Andersen’s Behavioral Model. Methods: A total of 2,576 adults with hypertension or diabetes who reported having a usual source of care were analyzed by using data from the 2021 Korea Health Panel Survey. Both patient-level and provider-level variables were categorized into predisposing, enabling, and need factors based on Andersen’s model. Complex sample logistic regression analysis was performed. Results: Only 44.7% of participants reported experiencing care coordination. The likelihood of receiving care coordination was significantly lower among females, and higher among those not currently employed, those not engaging in regular physical activity, individuals with multiple chronic conditions, and those whose usual source of care was a general practitioner. Conclusion: Care coordination is essential for ensuring continuity of care and effective management among patients with chronic conditions, and it is influenced by both patient and provider characteristics. As Korea prepares to launch a nationwide community-based integrated care system in 2026, care coordination will serve as a vital foundation for linking local resources and delivering comprehensive care. Based on the patient and provider factors identified in this study, effective support at the policy and system levels will be necessary to operate and sustain this function.

[English] Path Analysis of Factors Influencing Health-Related Quality of Life for Community-Dwelling Vulnerable Older Adults with Chronic Diseases in Korea: Hyun-Ju Lee; Res Community Public Health Nurs. 2025;36(3):315-327. Published online September 30, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01067

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Abstract PDF: Purpose
This study aims to construct and verify a path model for the factors affecting health-related quality of life (HRQoL) in community-dwelling vulnerable older adults with chronic diseases in Korea. Methods: The sample included 195 community-dwelling vulnerable adults aged 65 years and above with chronic diseases in Korea. Structured questionnaires were collected from April to June 2022. Data were analyzed using SPSS 28.0 and AMOS 28.0 programs. Results: The hypothesized path model significantly explained HRQoL in community-dwelling vulnerable older adults with chronic diseases, with a high explanatory power (48.0%). Self-rated health (SRH) and self-efficacy for managing chronic disease (SEMCD) had a significant direct effect on HRQoL. The number of diseases, depressive symptoms, social support, and digital literacy indirectly affected HRQoL. Conclusion: To improve HRQoL in community-dwelling vulnerable older adults with chronic diseases, integrated community health-management programs should focus on enhancing SEMCD and SRH, while incorporating depression screening, social support, and digital literacy education.

[English] The Effects of Health Care Empowerment Program for Vulnerable Elderly Women with Hypertension: Yunkyoung Jung; Res Community Public Health Nurs. 2025;36(3):281-291. Published online September 30, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01039

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Abstract PDF: Purpose
This study aimed to develop and apply a self-management competency enhancement program based on Johnson’s Model of Health Care Empowerment for vulnerable elderly women with hypertension. Methods: A quasi-experimental, non-equivalent control group design was used. Participants were 38 elderly women aged 65 and older receiving customized home visiting health care in G city. They were assigned to either the intervention or control group. The program consisted of eight 60-minute sessions, and was held twice a week for four weeks. Blood pressure (BP) and lipid levels, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured at three time points: before, immediately after, and four weeks after the intervention. Health literacy, self-efficacy, and depressive symptoms were assessed using structured questionnaires. Data were analyzed using repeated measures analysis of variance (ANOVA), independent t-tests, the Friedman test, and the Mann-Whitney test. Results: The program significantly improved health literacy (p<0.01) and self-efficacy (p<0.01). However, no significant differences were observed between groups in blood pressure, lipid levels, or depressive symptoms. Conclusion: The health care empowerment program is a viable community health nursing intervention for enhancing health literacy and self-efficacy in vulnerable elderly women with hypertension.

[English] Comparison of Quit Rates and Predictors in Korean Inpatient and Residential Smoking Cessation Programs: A Secondary Data Analysis of Data from the National Smoking Cessation Services: Youngmee Ahn, Soyoung Jung, Hunjae Lee, Jung-Ae Cho, Min Sohn; Res Community Public Health Nurs. 2025;36(2):210-220. Published online June 27, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01004

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Abstract PDF: Purpose
Inpatient and residential smoking cessation programs in Korea have demonstrated relatively high quit rates, with residential programs consistently outperforming inpatient ones. However, simple comparisons are limited by differences in participant characteristics and eligibility criteria. This study aimed to determine whether program type independently influences quit rates, using both self-reported and biochemically verified outcomes.
Methods
This descriptive study conducted a secondary analysis of data from 17,290 participants enrolled in national smoking cessation services across 18 regional tobacco control centers (2018-2020). Data included demographics, smoking history, and program participation. Quit status at 4 weeks, 12 weeks, and 6 months was assessed through self-report and biochemical verification. Multivariate logistic regression was used to evaluate the independent effect of program type on 6-month quit outcomes.
Results
The mean age of participants was 54.8 ± 12.0 years, and 14.5% were women. At 6 months, self-reported quit rates ranged from 16.5% to 34.1% for the inpatient program and from 26.0% to 62.8% for the residential program. Biochemically verified rates ranged from 8.6% to 19.0% (inpatient) and 11.9% to 46.7% (residential). After adjusting for confounders, program type was significantly associated with self-reported quitting (aOR = 0.80; 95% CI = 0.72-0.89; p < .001), but not with biochemically verified quitting (aOR = 0.91; 95% CI = 0.82-1.01; p = .082).
Conclusion
Although residential programs showed higher self-reported quit rates, program type did not predict verified cessation. This suggests differences in participant characteristics may drive outcomes. Further research should identify effective, evidence-based components for sustained quitting.

[English] Factors Influencing Suicidal Ideation among Korean Workers: Myeong Hwa Lee, Eun Suk Choi; Res Community Public Health Nurs. 2025;36(2):179-191. Published online June 27, 2025; DOI: https://doi.org/10.12799/rcphn.2024.00864

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Abstract PDF

Purpose
This study aimed to identify factors influencing suicidal ideation among workers using data from the 2021 Korea National Health and Nutrition Examination Survey (KNHANES VIII-3), providing foundational data for workplace suicide prevention programs.
Methods
This descriptive correlational study analyzed data from 2,287 employed workers using hierarchical logistic regression to examine relationships between general characteristics, health behaviors, physical and mental health, and suicidal ideation.
Results
The prevalence of suicidal ideation among workers was 3.6%. The primary influencing factors were lower educational level (≤ middle school; OR = 3.33), depression (OR = 10.77), generalized anxiety disorder (OR = 4.63), mild anxiety (OR = 2.51), and stress (OR = 1.82). Mental health variables significantly increased explanatory power from 8% to 37%.
Conclusion
These findings highlight the critical role of mental health, particularly depression and anxiety, in predicting suicidal ideation among workers. Workplace mental health management programs should include comprehensive mental health assessments and early intervention strategies addressing not only severe conditions but also mild anxiety symptoms.

Citations

Citations to this article as recorded by

Joint Effect of Workplace Gender Discrimination and Gender Composition on the Mental Well-Being in Korean Workers
Yeseo Lee, Jongin Lee
Safety and Health at Work.2026; 17(2): 240. CrossRef

[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

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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] 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

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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] Reliability and Validity of the Korean Version of 8-item Health Literacy Assessment Tool (K-HLAT-8): Mirae Jo, Eun-mi Kwak; Res Community Public Health Nurs. 2024;35(4):351-362. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00682

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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 Health Literacy Assessment Tool (K-HLAT-8) for Korean adults.
Methods
The survey was conducted from April 1, 2020 to May 30, 2020 at a university hospital, a university, and one community picnic area with adults who understood the purpose of the study and voluntarily agreed to participate. A total of 220 adults participated in this study. After forward and backward translation of the original version of the Health Literacy Assessment Tool 8 (HLAT-8) into Korean, construct validity (confirmatory factor analysis), convergent validity, and reliability were evaluated. Convergent validity was confirmed through the correlation between the K-HLAT-8 and the Self-As Carer Inventory (SCI).
Results
Construct validity, evaluated using confirmatory factor analysis, showed good fit. The K-HLAT-8 showed a positive correlation with the SCI score. In terms of internal consistency, Cronbach’s α of the K-HLAT-8 was 0.85. For test-retest reliability, the intraclass correlation coefficient (ICC) was .99 (95% CI: 0.97~0.99).
Conclusion
The reliability and validity were confirmed, so K-HLAT-8 can be applied to evaluate the health literacy of Korean adults. Furthermore, these assessment results should be used as basic data to implement programs that can improve health literacy.

[English] The Effects of Adverse Childhood Experiences, Benevolent Childhood Experiences, and Community Integration on Resilience in Psychiatric Outpatients: Keum Ran Hong, Hye Kyung Lee; Res Community Public Health Nurs. 2024;35(4):313-324. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00598

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Abstract PDF

Purpose
The purpose of this study is to determine the impact of adverse childhood experiences, positive childhood experiences, and community integration on resilience in psychiatric outpatients.
Methods
The study subjects were 166 psychiatric outpatients in one general hospital in South Korea who were diagnosed with schizophrenia spectrum disorder, bipolar disorder, or depression disorder. The collected data were analyzed with the t-test, ANOVA, Pearson’s correlation coefficient, multiple regression analysis, using the SPSS/WIN 24 program.
Results
There were statistically significant differences in resilience in psychiatric outpatients according to age, religion, occupation, type of household, type of diagnosed disorder. In psychiatric outpatients, resilience showed a significant positive correlation with benevolent childhood experiences and community integration, but had a negative correlation with adverse childhood experiences. Multiple regression analysis for resilience in psychiatric outpatients revealed that the significant factors affecting resilience were community integration, benevolent childhood experiences, adverse childhood experiences, housing facilities (type of household), ages 40-49, and living alone (type of household). These factors explained 52.2% of the variance.
Conclusion
In order to improve the resilience of mentally ill people, a campaign is needed to increase the accessibility of community participation programs in mental health services for community integration and to publicize the influence of benevolent childhood experiences and adverse childhood experiences. Furthermore, it is necessary to identify individual factors such as residence type and age of mentally ill people, build a customized support system by considering their specific needs, and develop intervention programs to strengthen resilience.

Citations

Citations to this article as recorded by

Context matters: Longitudinal associations between childhood adversity and mental health outcomes of middle-aged and older adults in 26 countries during the COVID-19 pandemic
Xu Zong, Cassandra Simmons, Lei Yang
Journal of Affective Disorders.2025; 389: 119649. CrossRef

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