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PURPOSE: This study evaluated a multifaceted intervention for osteoarthritis symptoms. METHODS: A cluster randomized controlled trial was conducted with a convenience sample of 90 patients aged between 45 and 82 years, who were recruited from three Community Health Posts (CHPs). The CHPs were randomized into two experimental groups (E1 and E2) and one control group (C). The intervention included health education and counseling combined with exercise classes based on the Interaction Model of Client Health Behavior. Trained community health nurse practitioners led the intervention. Stretching exercise (E1) and walking (E2) combined with muscle strengthening exercise were provided. The instruments included the Patient Activation Measure (PAM), Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index (K-WOMAC), Stanford Health Assessment Questionnaire Disability Scale (HAQDS), and Center for Epidemiologic Studies Depression Scale (CES-D). The HAQDS was measured using an ordinal scale, and Likert scales were used for the other instruments. Chi-square test and analysis of covariance were used; P values <.05 were considered significant. The study was conducted in 2014. RESULTS: The groups were similar at the baseline (P > .05) except for joint pain and patient activation (P < .05). At post-test, the changes in the mean scores were significant for joint pain and stiffness, and physical functioning. E2 with walking exercise showed better improvements in joint pain and physical functioning than the other groups (P < .01). CONCLUSIONS: Eight sessions of multifaceted intervention improved the osteoarthritis symptoms. Follow-up studies will be needed to determine the intermediate and long-term effects of the multifaceted intervention.
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Conductas Relacionadas con la Salud , Modelos Psicológicos , Anciano , Anciano de 80 o más Años , Artralgia , Ejercicio Físico , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla , Participación del PacienteRESUMEN
BACKGROUND: Nursing students' incivility experiences not only cause stress and burnout but also have other negative effects on general clinical training, hindering their learning or even affecting their career decisions. OBJECTIVES: This study aimed to comprehensively and thoroughly examine the specific phenomena and implications of incivility experienced by nursing students during clinical practicum. DESIGN: Based on the hermeneutical philosophy, this study utilizes an exploratory and qualitative design to describe the incivility experiences among nursing students undertaking clinical practicum. SETTING: This study was conducted at Y nursing college located in W city of South Korea. PARTICIPANTS: The participants were nursing students attending nursing colleges who were able to describe, in detail, their incivility experiences in clinical practice. These 32 senior-year students completed an entire course of clinical practice. METHODS: Data were collected through focus group interviews from September to November 2017. The focus group comprised 6 subgroups, with four to seven individuals each. For data analysis, the research manager compared the transcriptions with the recordings to confirm their accuracy. Qualitative content analysis methods were used to analyze the transcription contents. RESULTS: Based on the data analysis, 5 themes and 12 subheadings were derived from 131 significant statements. The derived themes included lack of respect, lack of role models, excessive demands, hostile behavior, and mean behavior. CONCLUSIONS: Nursing students felt neglected and disrespected during clinical practicum, and clinical practice guides made unreasonable demands rather than presenting examples as role models during the learning process. The students also experienced mean behaviors such as refusal and hostile acts. The findings of this study imply the necessity to promote clinical practicum environments that can reduce incivility experiences and empower nursing students undertaking clinical practicum education.
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Incivilidad , Relaciones Interprofesionales , Preceptoría , Estudiantes de Enfermería/psicología , Actitud del Personal de Salud , Bachillerato en Enfermería , Femenino , Grupos Focales , Hostilidad , Humanos , Masculino , República de Corea , Adulto JovenRESUMEN
The purpose was to examine factors associated with medication adherence among medical-aid beneficiaries with hypertension using the Expanded Behavioral Model of Health Services Utilization. A cross-sectional study was conducted with a convenient sample of 289 patients. The instruments included scales to measure medication adherence, health literacy, general self-efficacy, and pros and cons of chronic disease management. Data collection was performed between February and March 2011. A hierarchical regression analysis was performed. The study found that 25.6% to 34.6% had low motivation and low knowledge regarding medication adherence. Those with higher health literacy and higher self-efficacy scores were more likely to have higher medication adherence, whereas widowed and those who perceived more cons of chronic disease management were more likely to have lower medication adherence than their counterparts (p < .05). Interventions incorporating significant factors associated with medication adherence are required to enhance medication adherence and to prevent complications associated with medication non-adherence.
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Conocimientos, Actitudes y Práctica en Salud , Hipertensión/tratamiento farmacológico , Cumplimiento de la Medicación/estadística & datos numéricos , Anciano , Enfermedad Crónica , Estudios Transversales , Manejo de la Enfermedad , Femenino , Alfabetización en Salud/estadística & datos numéricos , Humanos , Hipertensión/economía , Masculino , Autoeficacia , Encuestas y CuestionariosRESUMEN
The purpose of this study was to examine a staged theoretical model to explain cultural knowledge-based multidimensional burden of women family caregivers caring for community-dwelling older adults using a modified Poulshock and Deimling model. In the model, the antecedents included elders' impairment in activities of daily living (ADL), elders' cognitive impairment, caregivers' self-efficacy, and caregivers' familism. The perception contained the disruptive behavior burden and social functioning burden of caregivers. The consequence variable included social activity restriction and negative changes in family relationships. The total sample was 157 primary women caregivers caring for community-dwelling older adults aged 65 and older. Instruments were General Self-Efficacy Scale, Family Scale, and Burden Scale. Path analysis was done to analyze the model using multiple linear regression methods. This study showed that impairments of older adults (impairment in ADL, cognitive impairment) and caregiver beliefs (strong familism, low self-efficacy) had an indirect influence on negative changes in family relationship and social activity restriction through the perceived emotional distress.
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Adaptación Psicológica , Cuidadores/psicología , Estrés Psicológico , Actividades Cotidianas , Disfunción Cognitiva , Femenino , Humanos , Vida Independiente , Modelos Teóricos , República de Corea , AutoeficaciaRESUMEN
BACKGROUND: Understanding the phenomenon of nursing student empowerment in clinical practice is important. Investigating the cognition of empowerment and identifying predictors are necessary to enhance nursing student empowerment in clinical practice. OBJECTIVES: To identify empowerment predictors for Korean nursing students in clinical practice based on studies by Bradbury-Jones et al. and Spreitzer. DESIGN: A cross-sectional design was used for this study. SETTING: This study was performed in three nursing colleges in Korea, all of which had similar baccalaureate nursing curricula. PARTICIPANTS: Three hundred seven junior or senior nursing students completed a survey designed to measure factors that were hypothesized to influence nursing student empowerment in clinical practice. METHODS: Data were collected from November to December 2011. Study variables included self-esteem, clinical decision making, being valued as a learner, satisfaction regarding practice with a team member, perception on professor/instructor/clinical preceptor attitude, and total number of clinical practice fields. Data were analyzed using stepwise multiple regression analyses. RESULTS: All of the hypothesized study variables were significantly correlated to nursing student empowerment. Stepwise multiple regression analysis revealed that clinical decision making in nursing (t=7.59, p<0.001), being valued as a learner (t=6.24, p<0.001), self-esteem (t=3.62, p<0.001), and total number of clinical practice fields (t=2.06, p=0.040). The explanatory power of these predictors was 35% (F=40.71, p<0.001). CONCLUSION: Enhancing nursing student empowerment in clinical practice will be possible by using educational strategies to improve nursing student clinical decision making. Simultaneously, attitudes of nurse educators are also important to ensure that nursing students are treated as valued learners and to increase student self-esteem in clinical practice. Finally, diverse clinical practice field environments should be considered to enhance experience.
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Competencia Clínica , Poder Psicológico , Estudiantes de Enfermería/psicología , Adulto , Actitud del Personal de Salud , Estudios Transversales , Curriculum , Toma de Decisiones , Bachillerato en Enfermería , Docentes de Enfermería , Femenino , Humanos , Masculino , Investigación en Educación de Enfermería , República de Corea , Autoeficacia , Adulto JovenRESUMEN
This study investigated the psychometric properties of the Korean version of the Patient Activation Measure 13 (PAM13) using Rasch analysis. The sample consisted of 270 Korean patients with osteoarthritis. The PAM13 was translated into Korean using a standardized forward-backward translation approach. In this study, the Cronbach's α coefficient was .88, the average interitem correlation was .34, and the average item-rest correlation was .55. The difficulty ranking of the item in this study differed from that in the original version. We did not need to collapse response categories. A total of 57.5% of the variance was explained by the residuals, indicating unidimensionality. The results suggest that the PAM13-K is a reliable and valid measure of activation. Further research is needed to validate item responsiveness and intervention effects.
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Osteoartritis/psicología , Psicometría/métodos , Psicometría/normas , Anciano , Anciano de 80 o más Años , Estudios Transversales , Competencia Cultural , Femenino , Conocimientos, Actitudes y Práctica en Salud , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , República de Corea , Autocuidado/psicología , TraducciónRESUMEN
PURPOSE: The purpose of this study was to validate the Needs Assessment Tool for Case Management (NATCM) for use with Korean medical aid beneficiaries. METHODS: Psychometric testing was performed with a sample of 645 Korean medical aid beneficiaries, which included 41 beneficiaries who were selected using proportional sampling method, to examine intraclass correlation coefficients (ICC). Data were evaluated using item analyses, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach's alpha, and ICC. RESULTS: Through psychometric testing the final version of NATCM was found to consist of two subscales: 1) Appropriateness of Health Care Utilization (5 items) and 2) Self Care Ability (6 items). The two subscale model was validated by CFA (RMSEA=.08, GFI=.97, and CFI=.93). Internal consistency measured by Cronbach's alpha was .82, and subscale reliability ranged from .79 to .84. The ICC of the NATCM between case managers was .73 and between case managers and health care professionals. .82. CONCLUSION: This study suggests that the final version of NATCM is a brief, reliable, and valid instrument to measure needs of Korean medical aid beneficiaries. Therefore, the NATCM can be effectively utilized as an important needs assessment as well as outcome evaluation tool for case management programs in Korea.
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Evaluación de Necesidades , Actividades Cotidianas , Adulto , Anciano , Anciano de 80 o más Años , Pueblo Asiatico , Manejo de Caso , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Manejo del Dolor , Psicometría , República de Corea , Apoyo Social , Encuestas y CuestionariosRESUMEN
PURPOSE: The current study was done to identify individual- and group-level factors associated with health care service utilization among Korean medical aid beneficiaries by applying multilevel modeling. METHODS: Secondary data analysis was performed using data on health care service reimbursement and medical aid case management progress from 15,948 beneficiaries, and data from 229 regions were included in the analysis. RESULTS: Results of multilevel analysis showed an estimated intraclass correlation coefficient (ICC) of 18.1%, indicating that the group level accounted for 18.1% of the total variance in health care service utilization, and that beneficiaries within the region are more likely to share common features with regard to health care service utilization. At the individual level, existence of disability and types of medical aid beneficiaries showed a significant association, while, at the group level, social deprivation index, and the number of beneficiaries and case managers within the region showed a significant association with health care service utilization. CONCLUSION: The significant influence of group level variables in health care service utilization found in this study indicate a need for group level approaches, such as policy change and/or promotion of community awareness.
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Servicios de Salud/estadística & datos numéricos , Asistencia Médica/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Manejo de Caso , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos de Enfermería , Análisis Multinivel , República de Corea , Adulto JovenRESUMEN
AIMS: This article is a report on an international study of the quality of nursing doctoral education; herein, we report findings for Korea. Specific aims were to: examine the validity and reliability of the quality of nursing doctoral education questionnaire; and identify contributing factors and domain(s) for improvement. BACKGROUND: The quality of nursing doctoral education has been a worldwide concern with the recent rapid increase in number of nursing doctoral programmes around the world, and comprehensive evaluation is needed for policy recommendations. METHODS: A cross-sectional descriptive study, conducted from October 2006 to January 2007, used an online questionnaire evaluating four domains: programme, faculty, resources and evaluation. Seven deans, 48 faculty, 52 graduates and 87 students from 14 nursing schools participated. RESULTS: Content and construct validity, and construct reliability of the questionnaire were established. Overall, participants reported that the perceived quality of private universities/schools was significantly higher than that of public/national universities. A higher ratio of doctoral to non-doctoral students was significantly associated with higher quality. The domains of programme, faculty and resources were highly correlated. The programme was the most important domain; availability of sufficient materials and information for students most needed improvement. Overall, faculty perceived the quality of the programme, faculty and resources as more positively than did the graduates and students. CONCLUSION: This study provides useful policy guidance for nurse educators worldwide for improving doctoral programmes and faculty's role in educating students. Further study is recommended that examines contributing factors to quality doctoral education.
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Educación de Postgrado en Enfermería/normas , Formulación de Políticas , Evaluación de Programas y Proyectos de Salud/normas , Encuestas y Cuestionarios/normas , Adulto , Estudios Transversales , Curriculum/normas , Docentes de Enfermería , Femenino , Humanos , Persona de Mediana Edad , Investigación en Educación de Enfermería , Investigación en Evaluación de Enfermería , Análisis de Regresión , Reproducibilidad de los Resultados , República de Corea , Estudiantes de EnfermeríaRESUMEN
PURPOSE: To compare and contrast demographic characteristics and health care service utilization between overusers and underusers of health care services and to identify factors associated with the overuse or underuse of health care services among the medical aid beneficiaries in Korea. METHODS: Secondary data analysis was performed using health care costs and medical aid case management progress data. Data on demographic characteristics, health-related quality of life (HRQoL), and inappropriate health care service user category (overuse or underuse) were provided by the Medical-Aid Case Management Center of Korea, and heath care service reimbursement data were provided by the Korea National Health Insurance Corporation (NHIC). Data on 22,697 beneficiaries were used for analysis, and logistic regression analysis was conducted to examine factors that are associated with overuse and underuse of health care services. RESULTS: The study results revealed that older individuals, women, unemployed individuals, type 1 medical aid beneficiaries, and those with higher education and disabilities were more likely to belong to the overuse group, but urban residents, compared to metropolitan residents, and those with higher HRQoL were more likely to belong to the underuse group (p < .05). CONCLUSIONS: Understanding factors associated with the overuse or underuse of health care services may help to provide tailored case management services to improve the HRQoL of the beneficiaries and optimize their use of health care services. CLINICAL RELEVANCE: Promoting appropriate use of health care services may enhance clients' quality of life and preserve resources for other essential services for medical aid beneficiaries.
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Mal Uso de los Servicios de Salud/estadística & datos numéricos , Servicios de Salud/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Estado de Salud , Humanos , Reembolso de Seguro de Salud/estadística & datos numéricos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Calidad de Vida , República de Corea , Factores SexualesRESUMEN
The purpose of this study was to describe outcome indicators of nursing education including critical thinking, professionalism, leadership, and communication and to evaluate differences among nursing programs and academic years. A descriptive research design was employed. A total of 454 students from four year baccalaureate (BS) nursing programs and two three-year associate degree (AD) programs consented to complete self-administered questionnaires. The variables were critical thinking, professionalism, leadership and communication. Descriptive statistics, χ(2)-test, t-tests, ANOVA, and the Tukey test were utilized for the data analysis. All the mean scores of the variables were above average for the test instruments utilized. Among the BS students, those in the upper classes tended to attain higher scores, but this tendency was not identified in AD students. There were significant differences between BS students and AD students for the mean scores of leadership and communication. These findings suggested the need for further research to define properties of nursing educational outcomes, and to develop standardized instruments for research replication and verification.
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AIM: This paper is a report of a comparison of advice on lifestyle given by healthcare providers and subsequent action by recipients between Korean Americans and native Koreans with hypertension. BACKGROUND: High blood pressure is controllable by having a healthy lifestyle, such as weight control, dietary change, exercise, low-sodium diet, alcohol restriction and smoking cessation, and by taking medication. Healthcare providers play an important role in teaching individuals with hypertension on healthy lifestyles. METHOD: This descriptive comparative study was conducted with a convenience sample of 100 Korean Americans and 100 native Koreans with hypertension. They were interviewed between May 2003 and June 2004 on the advice they received from healthcare providers on lifestyle and their subsequent action in terms of taking medication, weight control, dietary change, exercise, low-sodium diet, smoking cessation, alcohol restriction and tension reduction. Nutrient profiles were examined using the 24-hour dietary recall method. FINDINGS: Korean Americans received advice on lifestyle less than did native Koreans, but more Korean Americans followed healthy lifestyle advice on dietary change and exercise than did native Koreans (P<0.001). Weight control was the least adhered to behaviour among the Korean Americans, although almost two-thirds of them were overweight or obese. Both groups exceeded the Dietary Reference Intakes of sodium, but perceived their sodium consumption as low. CONCLUSION: Native Korean participants need to pay closer attention to carrying out the advice, whereas healthcare providers to Korean Americans need to give more advice on culturally acceptable healthy lifestyles, particularly on dietary changes and weight control. Both groups need to monitor their sodium intake more realistically. It is not only advice from healthcare providers that is integral to control of hypertension, but also that patients should follow that advice.
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Asiático , Conductas Relacionadas con la Salud/etnología , Conocimientos, Actitudes y Práctica en Salud , Hipertensión/prevención & control , Estilo de Vida/etnología , Educación del Paciente como Asunto/métodos , Aculturación , Adulto , Asiático/estadística & datos numéricos , Pueblo Asiatico/estadística & datos numéricos , Dieta/etnología , Dieta Hiposódica/etnología , Emigrantes e Inmigrantes , Ejercicio Físico , Femenino , Humanos , Hipertensión/epidemiología , Hipertensión/etiología , Corea (Geográfico)/epidemiología , Masculino , Cumplimiento de la Medicación/etnología , Persona de Mediana Edad , Sobrepeso/epidemiología , Sobrepeso/prevención & control , Cese del Hábito de Fumar/etnología , Estados Unidos/epidemiologíaRESUMEN
BACKGROUND: Familism is an important and complex clinical issue because of its significant impact on family caregiving of elders. PURPOSE: The purpose of this study was to examine the psychometric properties of a Korean-translated version of the Family Scale (FS-K) among Korean adults. A descriptive, cross-sectional survey design was used. METHODS: A panel of experts completed the initial translation into Korean and back-translated the FS. Upon establishment of the content and translation equivalence between English and Korean versions of the FS, psychometric properties were evaluated for reliability and construct validity with a sample of 577 adults. RESULTS: The internal consistency of FS-K was found to be acceptable, and Cronbach's alpha coefficient was .75. For construct validity, the mean scores of the FS-K were significantly different for gender and marital status (p < .05). For the FS-K, six components were extracted, accounting for 53.9% of the variance. CONCLUSIONS: Results of this study suggest that the FS-K can be used as a reliable and valid measure of familism among Korean adults. The FS-K will contribute to the understanding of familism for family caregivers caring for elders in both research and clinical practices.
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Hijos Adultos , Actitud , Cuidadores/psicología , Relaciones Familiares/etnología , Encuestas y Cuestionarios , Adulto , Estudios Transversales , Análisis Factorial , Enfermería de la Familia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , República de CoreaRESUMEN
PURPOSE: The study was done to examine the effects of cognition-behavior integrated breast cancer prevention education, in which a breast model with interchangeable nodules was utilized, on the self-competency of nursing students in performing breast cancer education. METHODS: A nonequivalent control group non-synchronized design was used. A traditional lecture intervention was provided for 49 3rd year college of nursing students (control group) while the integrated breast cancer prevention education was given to 47 3rd year students in the same college one year later (experimental group). The integrated breast cancer prevention education was developed by the research team to strengthen the competency of cognitive and behavioral components in education on breast cancer. RESULTS: Effects of the intervention were found to be significant through all study variables: knowledge about breast cancer (t=7.79, p <.001), breast cancer risk awareness (t=2.05, p <.05), self-competency of breast self-exam (t=8.27, p <.001), and intention to teach breast self-exam (t=3.87, p <.001). CONCLUSION: The integrated breast cancer prevention education was useful to improve not only knowledge about breast cancer but competency in performing breast examination for nursing students who acquired technical skills from various simulation nodules. As the program helped the students to be prepared as confident educators, future application of the module is recommended for academic curricula.
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BACKGROUND: The rapidly increasing number of nursing doctoral programs has caused concern about the quality of nursing doctoral education, including in Korea. OBJECTIVES: To describe the perceived quality of Korean nursing doctoral education in faculty, student, curriculum and resources. DESIGN: Focus group. SETTINGS: Fourteen Korean nursing doctoral programs that are research focused and include coursework. PARTICIPANTS: Four groups of deans, faculty, students and graduates; students completed three semesters of doctoral program; and graduates completed doctoral programs within the most recent 3 years. METHODS: Focus groups examined the strengths and weaknesses of faculty, students, curriculum, and resources. RESULTS: Faculty strengths were universities' recognition of faculty research/scholarship and the ability of faculty to attract extramural funding. Faculty weaknesses were aging faculty; high faculty workload; insufficient number of faculty; and teaching without expertise in nursing theories. Student strengths were diverse student backgrounds; multidisciplinary dissertation committee members, and opportunities to socialize with peers and graduates/faculty. Students' weaknesses were overproduction of PhDs with low academic quality; a lower number and quality of doctoral applicants; and lack of full-time students. Curriculum strengths were focusing on specific research areas; emphasis on research ethics; and multidisciplinary courses. Curriculum weaknesses were insufficient time for curriculum development; inadequate courses for core research competencies; and a lack of linkage between theory and practice. Resources strengths were inter-institutional courses with credit transfer. Weaknesses were diminished university financial support for graduate students and limited access to school facilities. Variations in participant groups (providers [deans and faculty] vs. receivers [students and graduates]) and geographical location (capital city vs. regional) were noted on all the four components. CONCLUSIONS: The quality characteristics of faculty, students, curriculum, and resources identified in this first systematic evaluation of the quality of nursing doctoral education can inform nursing schools, universities, and policy-makers about areas for improvement in Korea and possibly in the world. Geographical variations found in these four components of doctoral education warrant attention by policy-makers in Korea.
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Actitud del Personal de Salud , Curriculum , Educación de Postgrado en Enfermería/organización & administración , Docentes de Enfermería , Enfermeras Administradoras/psicología , Estudiantes de Enfermería/psicología , Tesis Académicas como Asunto , Adulto , Factores de Edad , Curriculum/normas , Docentes de Enfermería/normas , Grupos Focales , Necesidades y Demandas de Servicios de Salud , Humanos , Corea (Geográfico) , Persona de Mediana Edad , Investigación en Educación de Enfermería , Investigación Metodológica en Enfermería , Competencia Profesional , Investigación Cualitativa , Apoyo a la Formación Profesional , Carga de TrabajoRESUMEN
The purpose of this paper is to propose new evaluation criteria and an analytic hierarchy process (AHP) model to assess the expanded national immunization programs (ENIPs) and to evaluate two alternative health care policies. One of the alternative policies is that private clinics and hospitals would offer free vaccination services to children and the other of them is that public health centers would offer these free vaccination services. Our model to evaluate the ENIPs was developed using brainstorming, Delphi techniques, and the AHP model. We first used the brainstorming and Delphi techniques, as well as literature reviews, to determine 25 criteria with which to evaluate the national immunization policy; we then proposed a hierarchical structure of the AHP model to assess ENIPs. By applying the proposed AHP model to the assessment of ENIPs for Korean immunization policies, we show that free vaccination services should be provided by private clinics and hospitals rather than public health centers.
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Control de Enfermedades Transmisibles , Investigación sobre Servicios de Salud , Vacunación/métodos , Política de Salud , Humanos , Corea (Geográfico)RESUMEN
PURPOSE: This study aimed to describe the range of participation of nursing faculty members and their collaborators in multidisciplinary primary health care in Korea and to analyze facilitators, benefits, barriers, and learned lessons. METHODS: An exploratory descriptive research design was utilized. A total of 13 nursing faculty members and 13 multidisciplinary collaborators were interviewed face to face using a brief questionnaire and semi-structured interview guide. Descriptive statistics, comparative analysis, and content analysis were used for data analysis. RESULTS: About 43% of the nursing faculty had multidisciplinary primary health care experience. Facilitators included a government-funded research/demonstration project, personal belief and expertise in primary health care, and well-delineated role boundaries. Benefits included improved quality of life, more convenient community life, meeting multifaceted needs of community residents, and enhanced research activities. Barriers were lack of teamwork; territoriality and self-protective behaviors; lack of insight into primary health care among stakeholders; nurses undervaluing their work; and the rigid bureaucratic system of public health centers. Learned lessons were the importance of teamwork and its synergistic benefits, the importance of conducting clinically relevant research, having the government's support in the improvement of public health, developing health policies through multidisciplinary primary health care (M-D PHC) work, and respecting each other's territory and expertise. CONCLUSION: Teamwork should be included in all health professions' curricula, and nursing clinical practicums should include primary health care in all specialty areas. More faculties should engage in multidisciplinary primary health care. The benefits of a multidisciplinary approach to primary health care outweigh the difficulties experienced by multidisciplinary team members. The findings of this study may be useful for future multidisciplinary primary health care work worldwide.
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PURPOSE: We compared the nutrient profiles of hypertensive Korean-Americans, non-Hispanic Whites and Blacks with those of normotensive Korean-Americans, Whites, and Blacks. METHODS: This study was a cross-sectional comparative design of nutrient profiles among three ethnic groups. Korean-Americans were interviewed at Korean-American health clinics and churches in Chicago and data were collected by the 24-hour dietary recall method. Age- and sex-matched data of non-Hispanic Whites and Blacks were selected from the Third National Health and Nutrition Examination Survey for comparison. Descriptive statistics, one way ANOVA with post hoc test, and the propensity score matching method within each hypertensive and normotensive group were used for data analysis. Subjects included 102 subjects with hypertension (Korean-Americans, n = 37; Whites, n = 37; Blacks, n = 28), and 149 subjects without hypertension (Korean-Americans, n = 55; Whites, n = 55; Blacks, n = 39) for final statistical analyses. RESULTS: Significant differences in nutrient profiles among the three groups were as follows. In both hypertensive and normotensive groups, Korean-Americans consumed less energy from fat and saturated fatty acids and more energy from carbohydrates than did Whites and Blacks. All three ethnic groups exceeded the dietary reference intakes of sodium, but did not meet those of calcium and potassium. CONCLUSION: The findings suggest that protein may be needed to replace excessive carbohydrate intake in Korean-Americans and to replace fat intake in Whites and Blacks. Health professionals need to emphasize the importance of increasing calcium and potassium intake and decreasing sodium intake in their nutrition education for these ethnic groups to help prevent and control hypertension.
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PURPOSE: The purpose of this study was to compare stress levels of elementary students according to three regional levels: a large city, a medium-sized city, and a rural area. METHODS: This was a descriptive comparative survey using a convenience sample of 1,161 5th-and 6th-grade students. The stress level was measured by a stress scale that consisted of 65 items regarding personal characteristics, family, school, and peer factors. The data were analyzed by chi2-test, t-test, ANOVA and multiple regression using the SPSS 10.0 statistical program. RESULTS: Overall, the mean stress scores reported by the participants were near the middle of a 5-point scale and the level of family-related stress was highest, followed by peer, school, and individual-related stress. Sixth-graders and female students showed higher stress levels than 5th-graders and male students, respectively. The participants reporting unsatisfaction with their lives and those living in large cities tended to have significantly higher stress levels. CONCLUSION: Grade, gender, life satisfaction, and regional levels were all significant factors associated with high stress levels among elementary students. Development of stress management programs for this specific population, especially targeting students who are female and living in large cities, is needed.
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Psicología Infantil , Estrés Psicológico/epidemiología , Estudiantes/psicología , Análisis de Varianza , Distribución de Chi-Cuadrado , Niño , Relaciones Familiares , Femenino , Humanos , Masculino , Población Rural , Factores Socioeconómicos , Población Suburbana , Encuestas y Cuestionarios , Población UrbanaRESUMEN
AIM: This paper is a report of a study to describe the dietary acculturation of hypertensive and normotensive Korean Americans and native Koreans by comparing dietary pattern and diet quality. BACKGROUND: Dietary acculturation is a major factor that influences the risks for cardiovascular disease in immigrants. Nurses play a key role in educating immigrants about dietary acculturation. Limited studies have examined dietary acculturation of Korean immigrants with hypertension. METHOD: A descriptive study of hypertensive and normotensive Korean Americans and native Koreans (n = 398) was conducted in 2003-04, using the 24-hour dietary recall method. Dietary pattern was measured by consumption frequency of Korean, American and common food, and eating outside the home. Diet quality was measured by the revised version of the Diet Quality Index. FINDINGS: Korean Americans showed greater consumption of American food, common food and fast food, and ate away from home more often than native Koreans. Overall Diet Quality Index scores were not statistically significantly different between the two groups after matching. Compared with native Koreans, Korean Americans consumed lower amounts of sodium, potassium, vegetables and fruits, and energy from carbohydrates. Hypertensive Korean Americans consumed fewer vegetables and fruits, and less sodium and potassium than hypertensive native Koreans. No statistically significant differences were found between hypertensive and normotensive Korean Americans in dietary acculturation. CONCLUSION: Dietary acculturation of immigrants is a common phenomenon regardless of the country from which they immigrate. Healthcare professionals should consider the advantages and disadvantages of dietary acculturation in health promotion for immigrants.