Research in Community and Public Health Nursing

Original Articles

Good subjective health status and health-related quality of life in people with chronic kidney disease: A secondary analysis using the Korea National Health and Nutritional Examination Survey in 2019 and 2020: Jena Lee, Yujin Suh; Res Community Public Health Nurs. 2023;34(4):255-266. Published online December 29, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00262

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Abstract PDF: Purpose
This cross-sectional study aimed to describe subjective health status of people with chronic kidney disease (CKD), identify factors that affect good subjective health status and investigate the relationship between good subjective health status and health-related quality of life (HRQOL) in people with CKD.
Methods
This secondary analysis utilized data from the Korean National Health and Nutrition Examination Survey in 2019-2020. Participants (N=295) had an eGFR of ≤59 mL/min/1.73 m². Descriptive and inferential statistics were used to analyze the data. Univariate and multivariate logistic regression analyses were performed to identify factors affecting good subjective health status and examine the association between good subjective health status and HRQOL.
Results
Among all participants, 61.4% had good subjective health status, and the HRQOL index was 0.88 in people with CKD. Household income, activity limitation, stress, and the number of comorbidities in people with CKD were associated with good subjective health status. People with better subjective health status were more likely to be satisfied with self-care, usual activities, and pain/discomfort in HRQOL.
Conclusion
Good subjective health status is associated with better HRQOL. Therefore, subjective health status should be assessed early, and a nursing intervention program should be developed considering factors that can improve subjective health status in people with CKD.

What Determines the Health-related Quality of Life of Vietnamese Migrant Workers in Korea?: Jihyon Pahn, Heesuk Kim, Youngran Yang; Res Community Public Health Nurs. 2023;34(2):147-157. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00066

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Abstract PDF: Purpose
Over time, the number of migrant workers in Korea has shown a steady increase. Notably, among all migrant workers, those from Vietnam constitute the third largest group in Korea. The main objective of this study was to investigate the factors that influence the health-related quality of life of Vietnamese migrant workers. The study aimed to provide essential data for the development of customized nursing intervention programs and policy preparation in the future.
Methods
A total of 220 Vietnamese migrant workers aged between 18 and 64, who were employed in Korea through the Employment Permit System and had been residing in the country for more than 91 days, participated in this study.
Results
The study results revealed that physical activity (β=.19, p=.002), hope (β=.50, p <. 001), cohabitation with colleagues (β=.16, p =.003), and sleep hour (β=.11, p =. 031) had a statistically significant impact on health-related quality of life. The findings showed that higher levels of physical activity and hope were positively associated with higher health-related quality of life. Moreover, cohabiting with colleagues and sleeping for more than six hours were also significantly related to higher health-related quality of life.
Conclusion
Given these findings, it is imperative to develop programs that encourage physical activity and enhance the health-related quality of life of migrant workers from Vietnam. Policymakers and employers should also consider providing adequate living conditions that facilitate cohabitation with colleagues and sufficient time for sleep to improve the health and well-being of migrant workers.

A Path Analysis for Health-related Quality of Life in Long-term Care Insurance In-home Service Users: Je Hyun Kim, Seung Mi Park; Res Community Public Health Nurs. 2023;34(1):1-11. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00283

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Abstract PDF

Purpose
The purpose of this study is to construct and verify a path model for the factors affecting on quality of life in long-term care insurance in-home service users.
Methods
Total 246 participants using long-term care insurance in-home service were recruited from long-term care agencies. Data collection was conducted using a structured questionnaire from March 1st to March 31st 2021. The collected data were analyzed using SPSS 26 and AMOS 26 programs.
Results
The hypothetical path model was suitable for explaining the health-related quality of life in long-term care insurance in-home service users and has an explanatory power of 39.8%. Long-term care grade, depression, perceived health status, social support, age and living arrangement had a significant total effect on the quality of life in long-term care insurance in-home service users.
Conclusion
Long-term care insurance in-home service policies need to be expanded, such as screening and relieving depression, strengthening social support, and fostering a positive perception of health to improve the quality of life of the elderly.

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Prediction model of health-related quality of life in older adults according to gender using a decision tree model: a study based on the Korea National Health and Nutrition Examination Survey
Hee Sun Kim, Seok Hee Jeong
Journal of Korean Biological Nursing Science.2024; 26(1): 26. CrossRef

The Effect of Stress and Anxiety Caused by COVID-19 on the Quality of Life of Small Business Owners in an Area: Hae Ok Kim, Hyoen Jeong Kim, Hye Ji Jo; J Korean Acad Community Health Nurs. 2022;33(3):279-289. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.279

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Purpose
This is a descriptive correlation study to confirm the effect of stress and anxiety caused by COVID-19 on the quality of life of small business owners in an area under environment of COVID-19. Methods: The participants were 150 small business owners in an area. The collected data were analyzed by descriptive statistics, an independent t-test, a one-way ANOVA, Pearson's correlation coefficients, and multiple regression with the SPSS 25.0 Program. Results: The stress of small business owners averaged 3.67±0.65 out of 4 points, anxiety of COVID-19 was 2.65±0.52, and quality of life was 75.61±20.26 out of 130 points. The quality of life showed a significant negative correlation with ‘fear of infection’ (r=-.42, p<.001), ‘difficulties caused by social distancing’ (r=-.49, p<.001) in the stress subdomain, and anxiety (r=-.61, p<.001). On the other hand, stress, ‘fear of infection’ (r=.50, p<.001), ‘difficulties caused by social distancing’ (r=.60 p<.001), ‘anger against others’ (r=.35, p<.001) and anxiety showed positive correlation. Factors affecting the quality of life of the subjects were ‘fear of infection’ in the stress subdomain (β=-.23, p=.003), anxiety (β=-.45, p<.001), and residential area (J zone) (β=-.16, p=.030). These factors explained 47.0% of the variance. Conclusion: In order to enhance the quality of life of small business owners in an area, it is required to reduce stress and anxiety. In addition, it is necessary to prepare an intervention program that can reduce stress and anxiety of small business owners.

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Mediating effect of social support between COVID-19 stress on the mental health of older adults using customized care services: A cross-sectional study
Yujin Suh, YoungSun Park, Eun-Kyoung Han
Journal of Korean Gerontological Nursing.2023; 25(4): 410. CrossRef

Influencing Factors on Health-related Quality of Life among Japanese Middle-aged Marriage-based Immigrant Women in South Korea: A Cross-Sectional Study: Keiko Asami, Duck Hee Chae; J Korean Acad Community Health Nurs. 2022;33(2):188-195. Published online June 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.2.188

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Purpose
With the first generation of marriage-based immigrant women in East Asia now reaching their middle or old age, the need to focus investigations on their health-related quality of life has arisen. This study aimed to examine the extent to which physical and mental health, and psychosocial variables can predict health-related quality of life among Japanese middle-aged immigrant women. Methods This study has a descriptive cross-sectional design. A convenience sample of 197 Japanese middle-aged marriage-based immigrant women from two regions of South Korea were recruited between December 2017 and March 2018. Participants completed self-administered questionnaires on health-related quality of life, menopausal symptoms, depression, perceived health status, disease morbidity, social support, and acculturation. The data were analyzed using hierarchical multiple regression. Results Depression was the strongest predictor of health-related quality of life, followed by perceived health status, social support, and household income. Menopausal symptoms, presence of disease, and acculturation appeared to have no additional impact on participant’s health-related quality of life. Conclusion In times of rapid growth of global migration and the aging of immigrants in new destination countries, nursing interventions and public health policies for aging marriage-based immigrant women should be prioritized to improve their mental health by facilitating social support and disease management. In addition, social and employment policies that can help immigrant women transition to a healthy midlife are needed.

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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
Research in Community and Public Health Nursing.2024; 35: 10. CrossRef

The Effect of Instrumental Activities of Daily Living and Depression on the Life Satisfaction of the Elderly Living Together during the Daytime in the Rural Areas: Jin Kim, Jeong In Bae, Nam Hyun Cha; J Korean Acad Community Health Nurs. 2022;33(1):96-104. Published online March 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.1.96

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Abstract PDF

Purpose
The purpose of this study is to identify the factors affecting the life satisfaction during the communal life of the elderly in rural areas.
Methods
A total of 143 subjects were selected through convenient sampling. Data were collected in self-reporting questionnaires from 1 August to 30 August 2019. The data were analyzed with SPSS/WIN 23.0.
Results
The Instrumental Activities of Daily Living (IADL) was significantly different according to age, education, and cohabitation. Depression was significantly different according to gender, age, education, and cohabitation. Life satisfaction was significantly different according to age, education, religion, and cohabitation. There was a positive correlation between Instrumental Activities of Daily Living and depression, except for life satisfaction. 41.0% of life satisfaction was explained by depression, religion, and IADL.
Conclusion
The results of this study may be useful in understanding the life satisfaction level of elderly communal life and developing more specific programs for mental activity programs, and depression management strategies are required.

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Dual Mediating Effect of Electronic Device Utilization and Life Satisfaction on the Relationship between Instrumental Activities of Daily Living and Depression in Older Adults
Hwa-Soo Koong, Mihye Lim, Kawoun Seo
International Journal of Environmental Research and Public Health.2022; 19(17): 10617. CrossRef

Identifying Trajectories of Health-related Quality of Life in Mid-life Transition Women: Secondary Data Analysis of Korean Longitudinal Survey of Women & Families: Mi Seon Son; J Korean Acad Community Health Nurs. 2022;33(1):74-83. Published online March 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.1.74

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Abstract PDF

Purpose
The purpose of this study was to identify latent classes of health-related quality of life trajectories in middle-aged women and investigate predictors for latent classes.
Methods
This study utilized data from the 2^nd, the 4^the to the 7^the Korean Longitudinal Survey of Women & Families. The subjects included 1,351 women aged 40~45 years. The data was analyzed using latent class growth analysis and logistic regression.
Results
Two trajectories were identified for health-related quality of life in middle-aged women; ‘persistently good’ and ‘increasing’ groups. Predictors for the ‘increasing’ group were lower economic status, higher depression, and lower perceived health status.
Conclusion
This study showed that characteristics of the individual, symptom status, and health perceptions were associated with health-related quality of life in middle-aged women. It is necessary to provide effective intervention for latent classes of health-related quality of life trajectories based on physical, mental, and social factors.

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The moderated mediating effect of physical activity restriction in the relationship between chronic disease, depression, and quality of life in middle age
Sumi Choi, Inwha Yoo, Sohyun An, Ahyoung Cho
Journal of Affective Disorders Reports.2024; 16: 100746. CrossRef
Influence of body image on quality of life in breast cancer patients undergoing breast reconstruction: Mediating of self‐esteem
Yunhee Jang, Mihyeon Seong, Sohyune Sok
Journal of Clinical Nursing.2023; 32(17-18): 6366. CrossRef

Development and Evaluation of a Self-management Mobile App for Adults with Osteoarthritis: Ju Young Park, Jung Tae Son; J Korean Acad Community Health Nurs. 2022;33(1):114-127. Published online March 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.1.114

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Purpose
This study aimed to develop a self-management mobile app for adults with osteoarthritis based on a selfdetermination theory to use it as a nursing intervention tool, and to evaluate the effects of the developed mobile app on adults' basic psychological needs, indexes of osteoarthritis, self-management and quality of life.
Methods
The 56 participants were randomly assigned to either the experimental group (n=28) or the control group (n=28). The participants of the experimental group used a self-management mobile app for 12 weeks after the pretest, and two posttests were taken at the end of every 6 weeks. The data were analyzed using IBM SPSS/WIN 25.0 for Chi-square test, Fisher's exact test, independent t-test, and repeated measures ANOVA.
Results
Basic psychological needs, indexes of osteoarthritis, self-management, and quality of life score of the experimental group were significantly higher than those of the control group.
Conclusion
Our findings suggest that mobile app intervention can support improvements in psychological needs, symptoms of osteoarthritis and quality of life in adults with osteoarthritis. It is recommended that the developed mobile app be used as a nursing intervention tool for adults with osteoarthritis in the community.

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Development and effectiveness of a mobile-based autonomy support program for the prevention of metabolic syndrome in middle-aged women
Miseon Seo, Eun-Young Jun, Hyunjin Oh
Frontiers in Public Health.2024;[Epub] CrossRef

The Effect of Depression on Quality of Life in Patients with Parkinson's Disease: Mediating Effect of Family Function: Eun Sook Bae, Hye Seung Kang; J Korean Acad Community Health Nurs. 2022;33(1):105-113. Published online March 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.1.105

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Abstract PDF

Purpose
The purpose of this study is to explore the roles and function of family in mediating the relationship between depression and quality of life of patients with Parkinson’s disease (PD). Most studies have found that depression is particularly common in patients with PD and further associated with poor quality of life. Family function, as a mediator, is based on a strength orientation perspective that emphasizes not only their responsibilities and risks but also recuperative powers and growth potential.
Methods
Overall 157 adults with idiopathic Parkinson’s disease were enrolled in this study via outpatient clinic and completed a set of assessment to measure depression using BDI, family APGAR questionnaire, and patients’ quality of life using PDQ-8. Hierarchical multiple regression analysis was conducted to examine the mediating role of family APGAR score in the relationship between BDI and PDQ-8.
Results
Patients' depression, gait disturbance, duration of illness, and family function were statistically significant on quality of life. These factors accounted for 60% of the variance in quality of life. Family function has a partial mediating effect on the relationship between depression and quality of life.
Conclusion
Findings from the study suggest that although PD patients' depression impacts their quality of life, by having strong family function, the extent to which depression impacts the quality of life can be favorably mitigated. Additionally, these outcomes have important implications for future model development regarding PD patients.

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Factors Influencing Suicidal Ideation in Middle Aged Adults: Focused on Gender Differences
Jaerin Kim, Kuem Sun Han
Journal of Korean Academy of psychiatric and Mental Health Nursing.2023; 32(1): 45. CrossRef

The Effects of ICT Enhanced Home-visit Nursing in Long-Term Care Insurance on Health-related Quality of Life among Community-Dwelling Older Adults: Keun Joo Yoo, Jin Hee Shin, Eun Hee Cho, Seok Won Hong; J Korean Acad Community Health Nurs. 2022;33(1):1-12. Published online March 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.1.1

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Abstract PDF

Purpose
This secondary data analysis study evaluated the effects of ICT enhanced home-visit nursing in long-term care insurance on health-related quality of life among community-dwelling older adults.
Methods
This study included data of 131 older adults who had experienced a pilot service for ICT enhanced home-visit nursing. ICT enhanced home-visit nursing refers to a method of sharing health records and teleconference between a visiting nurse and a doctor during the home-visit nursing services to community-dwelling older adults. Health-related quality of life and influencing factors were analyzed by t-tests, logistic regression analysis using the Stata 17/SE program.
Results
After a pilot service for ICT enhanced home-visit nursing, their health-related quality of life increased. The teleconferencing method had a significant effect on the increase in health-related quality of life.
Conclusion
The findings indicate a pilot service for ICT enhanced home-visit nursing can be applied to the domestic community-based healthcare service model in terms of health management. In the future, the advanced service model of a pilot service for ICT enhanced home-visit nursing in which subjects conduct detailed for each health problem, and a well-designed evaluation system should be developed.

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Community Health Nursing During the COVID-19 Pandemic in Korea: Consequences, Challenges, and Directions
Eunjoo Kim, Ju Young Yoon, Hyori Kim
Journal of Community Health Nursing.2023; 40(2): 79. CrossRef

Factors Influencing Urinary Incontinence Quality of Life among Elderly Women in Home Visiting Healthcare Services: Ae Young So, Sun Ah Park; J Korean Acad Community Health Nurs. 2021;32(3):243-253. Published online September 30, 2021; DOI: https://doi.org/10.12799/jkachn.2021.32.3.243

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Abstract PDF

Purpose
The purpose of this study is to identify factors affecting the urinary incontinence (UI) prevalence and the quality of life among elderly adult women who are subject to home visiting healthcare services.
Methods
A cross-sectional study was conducted with 400 women aged 60 or over who were registered for home health care services at one health center in Gangwon-do. Data were collected using a structured questionnaire consisting of UI severity, UI type, and the quality of life. The UI severity was assessed using International Consultation of Incontinence Questionnaire-Short Form (ICIQ-SF), the quality of life using Incontinence Quality of Life (I-QOL), and type of UI using Questionnaire for Urinary Incontinence Diagnosis (QUID). The data were analyzed by using x² test, independent t-test, one-way ANOVA, Pearson’s Correlation, binary logistic, and multiple lineal regression.
Results
The prevalence of UI is 51.7%. The mean score of ICIQ-SF was 9.70±4.04 for women with UI and 0.04±0.51 for women without UI (t=-33.67, c<.001). As the frequency of day time urination (OR=1.34), the subjective health status (OR=1.45), and the educational status (OR=0.90) were higher, the risk of UI prevalence was the higher. The factors affecting I-QOL were ICIQ-SF score, mixed UI, subjective health status, and nighttime urination (adjusted R² =.61).
Conclusion
The results of this study showed that UI severity, mixed UI, subjective health status, and day time urination affected the quality of life. It suggests that the assessment for the severity and type of UI be needed to prevent UI or improve the quality of life of UI vulnerable elderly adult women.

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A Multisite Study on the Effect of a Urinary Incontinence Self-Management Program on Community-Dwelling Older Women in Korea
Sunah Park, Aeyoung So
Journal of Wound, Ostomy & Continence Nursing.2024; 51(1): 61. CrossRef

Development and Effect of the Integrated Health Promotion Program for Cancer Survivors Living at Home: Hee Sang Yoon, Eun A Hwang; J Korean Acad Community Health Nurs. 2021;32(1):51-63. Published online March 31, 2021; DOI: https://doi.org/10.12799/jkachn.2021.32.1.51

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Abstract PDF

Purpose
This study aimed to develop an integrated health promotion program for cancer survivors residing in the community based on the shared care model, and evaluate its effectiveness. Methods: A quasi-experimental trial was conducted. The participants consisted of 35 cancer survivors with completed intensive cancer therapy at the cancer hospital. The intervention group (n=20) and the control group (n=15) were recruited from among a district home cancer patient registrations. The intervention group participated in an integrated health promotion program based on the MAPP (Mobilizing for Action through Planning and Partnership) development process. The program consisted of physical, psycho-social and body image units. The participants were assessed before the program, and immediately after the program. Data were collected between July 1 and September 2, 2018 using FACT-G quality of life (QOL), distress thermometer (DT), and resilience. The data were analyzed by performing a x ² test, Fisher’s exact test, Mann-Whitney test, and ranked ANCOVA using SPSS. Results: The intervention group reported a higher QOL overall and significantly higher social/family well-being than the control group. Distress was significantly lower in intervention group than in the control group. Resilience had no significant difference between the two groups. Conclusion: These findings indicate that the integrated health promotion program base on the shared care model and MAPP development process could be effective intervention for improving social/family well-being and the QOL, and reducing distress of cancer survivors at home. Community health center nurses need to provide intervention to support self-care competency for cancer survivors’ comprehensive care with physical, psycho-social, and body image to help them adjust their life to a moderate risk group in the community.

Citations

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Distress among Korean Cancer Survivors: A Latent Profile Analysis
Kwang-Hi Park, Min Kyung Song
International Journal of Environmental Research and Public Health.2022; 19(3): 1613. CrossRef
Introduction to methodology for the development of an integrative medical service model
Moon Joo Cheong, Myeung Su Lee, Min Cheol Joo, Sang-Yeol Lee, Jung-Han Lee, Jong-Min Yun, Yeonseok Kang, Myeong Soo Lee, Hyung Won Kang
Integrative Medicine Research.2022; 11(2): 100840. CrossRef
Community-Based Oncology Nursing: Status and Prospects
Jeong Sook Park
Asian Oncology Nursing.2022; 22(4): 203. CrossRef

Influence of Depression and Social Support on Health-related Quality of Life among Migrant Workers: The Mediating Effect of Health Promoting Behavior: Han Na Jung, Young Suk Kim; J Korean Acad Community Health Nurs. 2020;31(3):360-374. Published online September 30, 2020; DOI: https://doi.org/10.12799/jkachn.2020.31.3.360

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Abstract PDF

Purpose
This study aims to identify the mediating effect of health promoting behavior in the relationship between depression and health-related quality of life, and between social support and health-related quality of life among migrant workers.
Methods
Data were collected from 152 migrant workers working at companies in K and B metropolitan cities. The study conducted a survey from August 1 to September 30, 2019, and used self-report structured questionnaires that were translated into English and Korean. The data were analyzed using descriptive statistics, Pearson correlation coefficient, simple and multiple regression, Baron and Kenny’s method, and Sobel test.
Results
Depression was significantly negatively correlated with social support (r=-.29, p<.001), health promoting behavior (r=-.30, p<.001) and health-related quality of life (r=-.44, p<.001). And social support was significantly positively correlated with health promoting behavior (r=.50, p<.001) and health-related quality of life (r=.44, p<.001). And health promoting behavior was significantly positively correlated with health-related quality of life (r=.51, p<.001). Furthermore health promoting behavior showed partial mediating effects in the relationship between depression and health-related quality of life (Z=3.26, p<.001), and showed partial mediating effects in the relationship between the social support and health-related quality of life (Z=3.98, p<.001).
Conclusion
In this study, depression and social support were shown to mediate health promotion behavior to improve health-related quality of life. Therefore, in order to improve the health-related quality of life of migrant workers, it is necessary to focus on the health promotion behaviors, and effective strategies are needed to reduce depression, and support social support.

Citations

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Structural Equation Modeling of Health Promotion Behavior on Migrant Workers: A Multi-Group Analysis Based on the Period of Residence
Hanna Jeong, Youngsuk Kim
Journal of Korean Academy of Nursing.2024; 54(1): 73. CrossRef
Evaluation of bio-psycho-social and socio-cultural problems of Syrian elderly living in Turkey
Emrah Apak, Taner Artan, Dogac Niyazi Ozucelik
International Journal of Social Psychiatry.2023; 69(2): 454. CrossRef
The Moderating Effect of Mental Health on the Relationship Between Cardiovascular Disease Awareness and Health Behaviors of Middle-Aged Korean Chinese Workers With Cardiovascular Risk Factors in Korea
Yu Zhu Zhang, Seon Young Hwang
Journal of Transcultural Nursing.2023; 34(2): 131. CrossRef
Health-related quality of life of migrant workers: a systematic literature review
Hyun-Jin Cho, Kyoungrim Kang, Kyo-Yeon Park
BMC Public Health.2023;[Epub] CrossRef
What Determines the Health-related Quality of Life of Vietnamese Migrant Workers in Korea?
Jihyon Pahn, Heesuk Kim, Youngran Yang
Research in Community and Public Health Nursing.2023; 34: 147. CrossRef
Social Support for Acculturative Stress, Job Stress, and Perceived Discrimination Among Migrant Workers Moderates COVID-19 Pandemic Depression
Youlim Kim, Hyeonkyeong Lee, Mikyung Lee
International Journal of Public Health.2022;[Epub] CrossRef

Development and Effectiveness of the Interpersonal Caring Program for Young North Korean Defectors: Jeong Im Choi, Eun Joung Choi; J Korean Acad Community Health Nurs. 2020;31(3):310-321. Published online September 30, 2020; DOI: https://doi.org/10.12799/jkachn.2020.31.3.310

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Abstract PDF: Purpose
The purpose of this study is to evaluate the effectiveness of the interpersonal caring program for young North Korean defectors which we developed based on Kim's interpersonal caring technique.
Methods
This study employs a non-equivalent control group pretest-posttest design. The subjects of this study are 36 young North Korean defectors living in three areas. The participants are recruited through alternative schools, churches, and acquaintances. The experimental group consists of 20 participants and the control group consists of 16 participants. Experiments are conducted by four days. Specifically, the experiments are conducted eight times and each takes about 120 minutes. Furthermore, we run the camp for two nights and three days. We test our hypothesis by using Kolmogorov-Smirnov, Independent t-test, Paired t-test, and Independent t-test.
Results
All the test statistics support our hypotheses such as self-esteem (t=1.87, p=.035), mental health (t=-1.69, p=.049), interpersonal relationships (t=1.93, p=.031), and quality of life (t=1.88, p=.034).
Conclusion
We found that the interpersonal caring program developed in this study is effective in improving North Korean defectors’ self-esteem, mental health, interpersonal relationships, and quality of life.

The Health-related Quality of Life for Children with a Mentally Ill Parent: Eun Hye Kim, Sook Bin Im; J Korean Acad Community Health Nurs. 2020;31(3):234-243. Published online September 30, 2020; DOI: https://doi.org/10.12799/jkachn.2020.31.3.234

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Purpose
This study is aimed to identify the health-related quality of life for children with a mentally ill parent.
Methods
The 13 participants were school-aged children whose parents were registered at the D Regional Mental Health Welfare Center. Data were collected using one-on-one interview with illustration cards and analyzed by content analysis.
Results
The participants were living a difficult life in anxiety amid a reversal of parent-child role, such as doing housework and taking care of their parents. The study revealed a love-hate family relationship that the participants wanted parental recognition and attention but they were frustrated by insufficient parental care and sibling conflict. Nevertheless, they only had each other themselves to trust and rely on. Their mixed health awareness and negative emotions were influenced by parents. Some of participants were exposed to dangerous environment such as domestic violence, and they need support system for help in difficult situations. Sometimes they felt happy by satisfying physiological, social, and self-esteem needs. They also showed a positive potential that they were matured more than peers through the experience of overcoming difficulties.
Conclusion
Not only were there not enough attention and support for the children with mentally ill people, but they were also exposed to an environment that threatens their physical or mental health. Therefore, to improve their health-related quality of life, there should be some integrated support of the community health system to cope with the challenges they face.

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Children in the Blind Spot of Social Medical Concerns: Supporting Children with Mentally Ill Parents in Korea
Sookbin Im, Myoung Lyun Heo
Community Mental Health Journal.2021; 57(8): 1525. CrossRef

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