Effects of Health Education Using Virtual Reality for Adolescents: A Systematic Review and MetaAnalysis

Purpose@#This study aimed to evaluate the effects of health interventions using virtual reality (VR) on improving knowledge, attitudes, and skills; and inducing behavioral change among adolescents. @*Methods@#This study is a systematic review and meta-analysis following PRISMA guidelines. We searched Cochrane, MEDLINE, Embase, CINAHL, Scopus, Web of Science, and Korean databases between database inception and April 10, 2021. Based on heterogeneity, a random- or fixed-effects model was used, as appropriate, to calculate effect sizes in terms of the standardized mean difference (SMD) and odds ratio (OR). Studies were selected if they verified the effects of health education using VR on adolescents; there was an appropriate control group; and if the effects of education were reported in terms of changes in knowledge, attitudes, skills, or behaviors. @*Results@#This analysis included six studies (n = 1,086). The intervention groups showed greater responses in knowledge and attitudes (SMD = 0.57, 95% confidence interval (CI) [0.12 to 1.02]), skills related to health behavior (SMD = -0.45, 95% CI [-0.71 to -0.19]), and behavioral change after 12 months (OR = 2.36, 95% CI [1.03 to 5.41]). @*Conclusion@#The results confirm the effectiveness of health interventions using virtual reality (VR). Although the analysis include a small number of studies, a case can be made for health interventions using VR to be utilized as educational methods and strategies to prevent risky behaviors among adolescents.

Determinants of Protective Behaviors Against Endocrine Disruptors in Young Korean Women

Purpose@#A convenience-oriented lifestyle in young people is accompanied by greater consumption ofand exposure to endocrine disruptors, which can affect reproductive health, especially in women. Weaimed to identify factors that influence protective behaviors against endocrine disruptors among femalecollege students in South Korea. @*Methods@#Using a cross-sectional survey design, we recruited 199 female college students. A selfadministeredquestionnaire was used, and data were collected at the site. @*Results@#A healthy lifestyle, information utilization, receiving peer advice on avoiding exposure toendocrine disruptors, and a history of environmental illnesses were found to be significant factors,explaining 42.0% of the variance in protective behaviors against endocrine disruptors. @*Conclusion@#Health consequences of environmental hazards and importance of maintaining a healthylifestyle need to be emphasized in young women's healthcare. Health professionals should advocate forand empower women to protect themselves against endocrine disruptors.

Prevalence of Menstrual Disorders according to Body Mass Index and Lifestyle Factors: The National Health Insurance Service-National Health Screening Cohort in Korea, 2009~2016

Purpose@#This study was performed to identify the prevalence of menstrual disorders in Korean women based on body mass index (BMI)and lifestyle factors, by utilizing the Korean National Health Insurance Database. @*Methods@#A retrospective observational study designwas used for the secondary data analysis. Data of women aged 15 to 49 years who were diagnosed with menstrual disorders were extractedfrom The National Health Insurance Service-National Health Screening Cohort in Korea from 2009 to 2016. The age-standardizedprevalence rate of menstrual disorders was calculated using SAS version 9.4, and a Chi-square test and Cochran-Armitage test were performed. @*Results@#In total, 2,219,445 cases were extracted from the database. The prevalence of menstrual disorders significantly increasedfrom 8.6% to 11.6% (Z=135.16, p for trend <.001) over the past eight years. In particular, it was higher in underweight womenthan in women with normal weight across all years (Z=-4.18~-14.72, p <.001). Moreover, statistically significant differences in the prevalenceof menstrual disorders were found to be associated with drinking and smoking in all years and with physical activity levels in part(p <.05~.001). @*Conclusion@#These findings present compelling evidence on the prevalence of menstrual disorders based on a national database.Since the prevalence of menstrual disorders has steadily increased and differs based on BMI and lifestyle factors, educational andclinical interventions are necessary to promote risk awareness and appropriate behavioral changes among Korean women.

Determinants of Protective Behaviors Against Endocrine Disruptors in Young Korean Women

Purpose@#A convenience-oriented lifestyle in young people is accompanied by greater consumption ofand exposure to endocrine disruptors, which can affect reproductive health, especially in women. Weaimed to identify factors that influence protective behaviors against endocrine disruptors among femalecollege students in South Korea. @*Methods@#Using a cross-sectional survey design, we recruited 199 female college students. A selfadministeredquestionnaire was used, and data were collected at the site. @*Results@#A healthy lifestyle, information utilization, receiving peer advice on avoiding exposure toendocrine disruptors, and a history of environmental illnesses were found to be significant factors,explaining 42.0% of the variance in protective behaviors against endocrine disruptors. @*Conclusion@#Health consequences of environmental hazards and importance of maintaining a healthylifestyle need to be emphasized in young women's healthcare. Health professionals should advocate forand empower women to protect themselves against endocrine disruptors.

Effects of exposure to endocrine disruptors, burnout, and social support from peers on premenstrual syndrome in nurses

Purpose@#This study aimed to investigate the effects of exposure to endocrine disruptors, burnout, and social support from peers on premenstrual syndrome (PMS) in nurses. @*Methods@#This descriptive correlational study was conducted among 122 nurses under the age of 49 working at a university hospital. The participants answered self-report questionnaires. The data were analyzed using the t-test, analysis of variance, Pearson or Spearman correlation coefficients, and hierarchical multiple regression in IBM SPSS version 23.0. @*Results@#The mean age of the nurses was 28.9 years. Of these nurses, 49.2% were working in a general ward, 24.6% in the intensive care unit, 14.8% in the emergency room, and 11.4% in an outpatient department. The explanatory power of the model was 38.3%, and it was statistically significant (F=11.74, p≤.001). Exposure to endocrine disruptors (β=0.32, p<.001) was the most powerful variable affecting PMS, followed by burnout (β=0.27, p=.001), working in the intensive care unit or emergency room (β=0.22, p=.003), family history of PMS (β=0.19, p=.009), and support from coworkers (β=–0.15, p=.043). @*Conclusion@#Based on these findings, it is necessary to develop an intervention program to reduce the symptoms of PMS. Additionally, further studies are needed to develop and evaluate measures to minimize exposure to endocrine disruptors and burnout in order to alleviate PMS among nurses.

Relationship between Menstrual Distress and Sleep Disturbance in Middle-school Girls

PURPOSE: To identify factors associated with menstrual distress and characterize the relationship between menstrual distress and sleep disturbance in middle-school girls. METHODS: Participants in this correlational study were 117 middle-school girls who were recruited through convenience sampling. Data were collected from March 2018 to April 2018 using self-reported structured questionnaires and analyzed using IBM SPSS Statistics 23.0. Factors associated with menstrual distress included physiological, psychological, and situational factors based on the theory of unpleasant symptoms. RESULTS: Age of menarche (β=−.28, p < .001), amount of menstruation (β=.23, p=.004), lifestyle-related exposure to endocrine-disrupting chemicals (β=.21, p=.027), and academic and peer-relationship stress (β=.19, p=.025) influenced menstrual distress, explaining 47.4% of the variance in this regression model. The relationship between menstrual distress and sleep disturbance was statistically significant. Sleep disturbance was increased 1.26 folds when dysmenorrhea score increased by one unit (OR=1.26, 95% CI: 1.01~1.58). However, parental support was not a significant moderating factor of sleep disturbance. CONCLUSION: This study provides basis to develop an intervention strategy to alleviate menstrual discomfort in adolescents and improve their quality of sleep.

Development and Testing of a Mastery Learning Program of Nursing Skills for Undergraduate Nursing Students

PURPOSE: This study was undertaken to develop and test a mastery learning program of nursing skills for undergraduate nursing students. METHODS: In this methodological study, first, the preliminary draft of a mastery learning program to provide training for nursing skills was developed based on Bloom's framework for mastery learning. Second, to test the developed program, a single-blinded, nonequivalent control group nonsynchronized study was conducted on 50 senior nursing students in a University selected by convenient sampling. Thirteen students were assigned to a control group; 13, 12, and 13 of them were assigned to intravenous therapy, transfusion, and patient transfer groups, respectively. The achievement levels and performance scores of the selected nursing skills were measured before and after the completion of the program in all the groups. Lastly, the final program was confirmed based on the results of the program testing. RESULTS: Intravenous therapy, transfusion, and patient transfer were selected as essential nursing skills for the program based on the priorities rated by clinical instructors and staff nurses. The achievement levels of selected nursing skills were determined by Angoff scores. After participating in the program, the proportion of passers and performance scores of the nursing skills in the experimental groups were significantly higher than those in the control group. The final program was confirmed which included a diagnostic test, enrichment activities for the passers and three repetitions of corrective activities and formative assessments for non-passers. CONCLUSION: The results suggest that a mastery learning program for undergraduate students can lead to better improvement and performance of essential nursing skills.

Factors related to Endocrine Disruptors Exposing Behaviors in Mothers of Infants

PURPOSE: The purpose of this study was to examine factors associated with behaviors of mothers that expose their infants to endocrine disruptors. The PROCEED model was used as a theoretical basis for the study. METHODS: This correlational study included 120 mothers with infants between the ages of 1 month to 36 months. Participants were recruited through the maternal community web-site of mothers of infants in W city. RESULTS: There was a significant negative correlation among experience of mothers who had participated in environmentally friendly activities, the health status of the infants perceived by the mother, and behaviors of mothers that exposed infants to endocrine disruptors. The factors based on PROCEED model explained 15.3% of the behaviors by mothers that exposed infants to endocrine disruptors. CONCLUSION: It is necessary to develop and provide educational programs that include detailed information on relationship of endocrine disruptors to children's health.

Effects of Preoperative Dehydration on Postoperative Nausea and Vomiting in Gynecological Surgery Patients

PURPOSE: The purpose of this study was to investigate the effect of dehydration from preoperative fasting on postoperative nausea and vomiting in patients who underwent gynecologic surgeries. METHODS: Study design was a prospective descriptive study. A total of 75 patients in a university hospital were selected. Data were collected from March 17 to May 16, 2014 using self-report questionnaires and clinical electronic chart. RESULTS: Factors influencing the development of postoperative nausea and vomiting were type of surgery (t=3.44, p=.001), use of PCA (t=-2.16, p=.034), and preoperative dehydration level (t=5.93, p<.001), and these variables accounted for 51.7% of postoperative nausea and vomiting. Among these variables, preoperative dehydration amount (beta=.56) showed the largest influence in the difference in postoperative nausea and vomiting. CONCLUSION: Reducing dehydration during preoperative fasting can prevent occurrence of postoperative nausea and vomiting. Development of a clinical guideline is necessary to give directions for the prevention of dehydration during preoperative fasting and to ensure the proper duration of fasting according to patient characteristics, type of surgery and time of surgery.

Current Status of Women's Health Nursing Practicum and Direction

PURPOSE: This study was done to examine current status of women's health nursing practicum and identify necessary core nursing skills in this practicum area. Moreover, one syllabus and evaluation sheets for women's health nursing clinical practicum at one university were reviewed. METHODS: A survey design was used with 81 educators who were teaching maternity or women's health nursing and its practicum. RESULTS: Most clinical sites for practicum were university hospitals (43.0%), women's hospitals (32.7%), or general hospitals (17.3%); but the majority (77.8%) of educators expressed difficulty in finding appropriate practicum places. Common teaching and learning methods were clinical guides for practicum (44.6%), e-learning content (30.2%), and simulation (23.6%). Core nursing skills for this practicum included assessment of stages of labor, preparation of uterine-fetal monitoring devices and interpretation of results, monitoring uterus and fetal activity, and performing Leopold's maneuver. For postpartum care, the following were included; postpartum fundal massage, assessment of breast engorgement, fundus height, and episiotomy sites, inserting urinary catheter, and teaching the use of patient-controlled analgesia. CONCLUSION: To improve the quality of clinical practicum, development of a clear course syllabus, standardized clinical guidebook, and core nursing skills is required and should be shared with all relevant nurse educators.

Lifestyle Risk Factors and Awareness of Stroke among Adults in Urban Areas

BACKGROUND: Modifying risk factors and improving stroke awareness in the general community have been emphasized for preventing stroke. This study aimed to explore modifiable lifestyle risk factors and the awareness of stroke and to compare scores for stroke knowledge according to lifestyle risk factors and recognition of important indicators among adults in urban areas. METHODS: A cross-sectional study was conducted with a total of 196 participants aged 40 to 65 selected by a convenient sampling of community cultural centers, churches, and recreational groups. Participants completed a structured questionnaire including general characteristics, risk factors of stroke, and awareness of stroke including general knowledge, risk factors, reactions to warning symptoms, and knowledge on personal risk factors of stroke such as body weight, blood pressure, blood sugar, and cholesterol level. RESULTS: Less than 30% of the participants engaged in regular physical activity and low fat diet and 33% of the participants were classified as having 'higher' level of knowledge on stroke. Knowledge on their personal risk factors of stroke were generally poor. Scores for knowledge on stroke were not different for lifestyle risk factors and knowing whether their body weight and blood pressure level were within normal limits. Meanwhile, scores for knowledge on stroke were significantly higher among those knowing whether their blood sugar and cholesterol level were within normal limits. CONCLUSIONS: There is a need to improve stroke awareness among community adults by providing more targeted information on warning symptoms, risk factors of stroke, and important indicators of major conditions related to stroke and their contribution to stroke prevention.

Analysis on Reports of Statistical Testings for Correlation and Regression / 여성건강간호학회지

PURPOSE: This study aimed to examine the accuracy and adequacy of research papers reporting statistical testings for correlation and regression. METHOD: Original research articles utilized correlation and regression analysis were reviewed from the Korean Journal of Women Health Nursing published from the year 2004 to 2006. Thirty-six papers were evaluated in accordance with formatted criteria in respect to an inclusiveness of research title, accuracy of statistical methods and presentation styles, and errors in reporting statistical outcomes. RESULT: Thirty articles (83.3%) utilized Pearson's correlational analysis, and ten articles did regression analysis. Lack of accurate understanding and interpretation of the statistical method was a main fault. Basic assumptions and diagnostic testings for each statistical method were not performed or described in most of the studies. Some points like consistency of research questions with statistical methods and criteria for sample size were still left out in part. Details of the presentation in the reporting of outcomes were not complied with the guidelines, which need careful concerns of the writers. Errors in English of result tables were found in more than one third of the tables. CONCLUSION: The outcome would be reflected in the submission guidelines for future writers. To reach the level comparable with internationally recognized nursing journals, concrete knowledge to apply statistical methods should be ensured in the processes of submission, reviews, and editing.

Analysis on Reports of Statistical Testings for Mean Differences / 여성건강간호학회지

PURPOSE: This study aimed to evaluate the accuracy and adequacy of research papers reporting statistical testings for mean differences. METHODS: Original research articles utilized t-test, Chi-square test, and ANOVA were reviewed from Korean Journal of Women Health Nursing published from the year 2004 to 2006. Seventy-six papers were evaluated in accordance with formatted criteria in respect to an inclusiveness of research title, accuracy of statistical methods and presentation styles, and errors in reporting statistical outcomes. RESULTS: Research titles were quite comprehensive, however overall accuracy of statistical values and basic formats reached only 60 to 80% by items. Details of the presentation in the reporting of outcomes were not complied with the guidelines, which need careful concerns of the writers. Errors of English in table presentation were found in more than 30% of the papers. CONCLUSION: The outcome would be reflected in the submission guidelines for future writers. To reach the level comparable with internationally recognized nursing journals, concrete knowledge to apply statistical methods should be ensured in the processes of submission, reviews, and editing.

Effect of Taegyo-focused Prenatal Education on Maternal-fetal Attachment and Self-efficacy Related to Childbirth / 간호학회지

PURPOSE: To examine the effect of Taegyo-focused prenatal classes on maternal-fetal attachment and self-efficacy related to childbirth. METHODS: Over 4 weeks, 49 women, 20 to 36 weeks of gestation participated in a prenatal program led by the nurse who developed it. In addition to Lamaze content it included; understanding ability of fetus to respond, sharing motivation, purpose of pregnancy, and preconceptions of experiencing childbirth, training in maternal- fetal interaction, writing letters and making a declaration of love to unborn baby. Using a pre- experimental design, data were collected by self-report, before and after program, using Cranley's Maternal-Fetal Attachment Scale (1981), and Shin's (1997) Labor Self-Efficacy Measurement. RESULTS AND CONCLUSION: Paired t-test showed significant changes in scores of maternal-fetal attachment (t=6.91. p<.001) and self-efficacy related to childbirth (t=10.19, p<.001). Taegyo opens the possibility of integrating Western ideas with Korean traditional health behavior. Incorporation of Taegyo into existing prenatal classes is recommended.