The Attitude, Use and Adverse Effects of Complementary and Alternative Medicine (CAM) Therapies among Vulnerable, Community Dwelling Old Adults

PURPOSE: The purpose of this study is to obtain information of use of complementary and alternative medicines (CAMs) and any reported adverse effects of them on vulnerable elders in a community. METHODS: 1,837 elderly subjects aged 65 or higher with health problems were selected from those who were enrolled in a public health care center and received visiting health management services. A proportional stratified sampling method was used. Data collection was completed by face to face interviews using a structured questionnaire. The descriptive statistics and chi2-test were used to analyze the data. RESULTS: The prevalence of CAM use last year was 57.5%, and 10.4% of the subjects reported adverse effects of the therapies. The mean score of the subjects' attitudes towards CAM was 4.1+/-3.44 (range 1~10). The major sources of advice and exposure to CAM therapies were most likely to be from family and friends (72.5%). The primary reason for choosing CAM was to manage symptoms and relieve pain (86.6%). CONCLUSION: These findings suggest the need to develop nursing strategies for reducing and preventing adverse effects of CAM use by promoting awareness of using safe and appropriate CAM therapies.

The Factors Affecting Cultural Competency of Visiting Nurses and Community Health Practitioners

PURPOSE: The purpose of this study was to investigate the level of cultural competency of visiting nurses and community health practitioners and explore factors that are related with their cultural competency. METHODS: The subjects of this study were 113 visiting nurses and 103 community health practitioners working in Gangwon-do. Data were collected using a structured questionnaire on May 24, 2011. The SPSS/WIN 17.0 program was used for data analysis. RESULTS: The average score for cultural competency of visiting nurses was 2.76+/-0.60 and that of community health practitioners 2.91+/-0.51. Most of subjects received no multicultural education (78.0% for nurses, 85.7% for community health nurses). Factors influencing cultural competency were number of service experience for multicultural clients and participation of multicultural education. CONCLUSION: It is necessary to develop systematic educational programs to enhance the cultural competency of nurses.

Perception of Child Day Care Center Teachers on Issues and Needs in Child Health Management

PURPOSE: The purpose of this study was to investigate issues and needs related to child health management as recognized by teachers in day care centers. METHODS: Data were collected from 130 teachers from 20 day care centers. Each teacher was interviewed in depth and the data were examined through content analysis. RESULTS: For issues on child health management, the analysis scheme consisted of 10 categories and 36 subcategories. For needs on child health management, the analysis scheme consisted of 10 categories and 37 subcategories. Teachers indicated that tools for physical examination and playgrounds were insufficient and they had difficulty in controlling attendance of infectious children. They also indicated the lack of a linkage between day care centers and hospitals, lack of knowledge of health management, high teacher versus child ratio, and lack of help and budget needed for health care. CONCLUSION: The results of this study suggest the need to develop a linkage between day care centers and medical institutions. Also there is a need to provide support from health care personnel, health education for teacher, health management manuals for teachers, and financial aid to satisfy the needs for health management in day care center for children.

The Effects of a Case Management Program of Customized Home Visiting Health Service for Clients with Arthritis

PURPOSE: The purpose of this study was to analyze the effects of a case management program on range of motion, pain, depression and self efficacy in community-dwelling older women with knee arthritis. METHODS: The research design was one-group pre and post-test design with 40 participants with knee arthritis who agreed to participate in the 12-week case management program. Data were collected four times, before and after 4, 8 and 12 weeks. RESULTS: Repeated measures ANOVA revealed significant differences between before and after the service in range of motion, pain, depression and self efficacy. Significant improvements from the baseline to 4 weeks after the service were observed in the measurements of range of motion, pain, depression and self efficacy. There were no significant differences in range of motion, pain and depression between 4 and 12 weeks after the services. CONCLUSION: This study represents the first effort showing that a case management program can have positive outcomes on range of motion, pain, depression and self efficacy for older women with knee arthritis. More research using a control group pre-post test design considering time lapse is needed in order to examine more accurately the effects of case management programs for knee arthritis.

A Survey on the Use of Visiting Nurses in Child Day Care Centers

PURPOSE: The purpose of this study was to contribute children's health care and health promotion by surveying the use of visiting nurses in child day care centers. METHODS: This study is a descriptive study, and the study period covers July to September, 2010. The research subjects were 27 public health center managers, 166 visiting nurses and 137 child care teachers. RESULTS: Teachers' need of visiting health care services and visiting nurses' work performance of were statistically significantly different. The teachers' need of visiting health care was higher in all areas (health examination, health life practice, infectious disease control, safety accidents and disaster management, emergency measures and linkage, nutrition, parent education) but the visiting nurses had a low level of work performance. CONCLUSION: Child care teachers are not health professionals for child health care, and therefore they are in need of professional help. Thus, for the current public health centers in need of customized visit health care, new visiting nurses in charge of professional child health care need to be developed. Also, new models need to be developed for visiting nurses and child care teachers through the connection of community child health care.

Development and Evaluation of a Child Health Care Protocol for Child Day Care Center Teachers

PURPOSE: The purpose of this study was to develop a child health care protocol for teachers in child day care centers. METHODS: The ADDIE model with 10 Kid Keys was applied to develop this child health care protocol. All contents were developed through content validity test by 7 professionals and need assessment and evaluation by child day care center teachers. RESULTS: This protocol consisted of 10 keys, as follows: Health Examination/Growth & Development, Practice of Health Life, Management of Communicable Disease, Negligent Accident, Coping with Emergency and Transference, Child Abuse, Nutrition/Obesity, Quality Assurance of Staff, Parent Education, Guidance & Supervision of Child Day Care Centers. The contents contained goals, objectives, teaching content, suggested activities for children, writing forms related to each subject, and self-evaluation sheet. CONCLUSION: This protocol can be practical and effective for child health care in child day care centers and it is hoped that it will be utilized in more child day care centers.

The Effects of Chronic Musculoskeletal Pain and Depression on Health-related Quality of Life by Gender in Community-dwelling Older Adults

PURPOSE: The aim of this study was to investigate the effects of chronic musculoskeletal pain and depression on health-related quality of life (HRQoL) according to gender in community-dwelling older adults. METHODS: The subjects of this study were 209 elderly individuals who were receiving visiting nursing services from a public health center located in Gangwon-do. Data were collected using a structured questionnaire from March to April, 2008. SPSS/WIN 13.0 was used for data analysis. RESULTS: Depression and HRQoL showed a significant difference between male and female subjects. There was a negative correlation between chronic musculoskeletal pain, depression, and HRQoL. In the male elderly, depression was the most significant predictor of HRQoL, while in the female elderly, chronic musculoskeletal pain was the most significant predictor of HRQoL. CONCLUSION: The study showed that chronic musculoskeletal pain was the variable with the highest explanatory power for HRQoL in the female elderly. Therefore, chronic musculoskeletal pain needs to be assessed and managed first in nursing interventions to improve HRQoL of the female elderly.

A Survey on the Customized Visiting Nurse's Assessment and Management of Chronic Musculoskeletal Pain in Older Adults

PURPOSE: The aim of this study was to investigate the status of visiting nurse's assessment and management of chronic musculoskeletal pain in older adults. METHODS: The subjects of this study were 285 visiting nurses working at 24 public health centers located in Seoul, Gyeonggi-do, and Gangwon-do. Data were collected using a structured questionnaire from June to July, 2008. The SPSS/WIN 13.0 program was used for data analysis. RESULTS: Of the visiting nurses, 195 (77.4%) reported lack of pain education for nurses. The education of exercise (83.3%) was used most frequently by nurses as a pain intervention. Barriers to effective pain management were inadequate pain management guidelines and lack of pain education for nurses. CONCLUSION: It is necessary to develop evidence-based nursing interventions for pain management and to develop systematic educational programs for visiting nurses management of chronic musculoskeletal pain.

A Study on the Awareness of Importance, Performance Level, and Perceived Competence Level of School Health Promotion Programs

PURPOSE: The purpose of this study was to provide fundamental materials for improving school health promotion programs by investigating school nurses' awareness of the importance, performance level, and perceived competence level of school health promotion programs in Gangwon-do. METHODS: The subjects of this study were 173 school nurses who were working in Gangwon-do. The instrument for this study was a scale for awareness of importance, performance level, and perceived competence level. Data were collected on December 15, 2007 and analyzed using SPSS 13.0 for Windows. RESULTS: The mean score of awareness of importance was 3.51 (range: 1~4). The mean score of performance level and the mean score of perceived competence level were 3.35 (range: 1~4) and 3.29 (range: 1~4), respectively. The younger school nurses were (F=4.380, p=.014), the higher their awareness of importance was. The performance level was lowest in high school nurses (F=5.013, p=.008). There were significant correlations between awareness of importance, performance level, and perceived competence level in school nurses. CONCLUSION: In order to improve the effectiveness of school health promotion programs, training and education programs for school nurses' competencies and technical support systems for school nurses should be provided.

Experiences of Single Pregnant Mothers / 여성건강간호학회지

PURPOSE: This study was done to assess the personal experiences of the coping process during pregnancy for single mothers. METHODS: The participants were 17 single mothers who had stayed in a social welfare facility. Data was collected with an in-depth unstructured interview. Data analysis was done by the grounded theory method. RESULTS: One-hundred twelve concepts and 49 sub-categories were confirmed in the analysis. The sub-categories were grouped into 19 categories; escape from a miserable family, wrong meeting, openness of sex, defenseless state of pregnancy, inevitable result of pregnancy, heartbreak by herself, closure, isolation, difficult situation of being alone, stigma, supporting & protecting, helplessness, seeking, empowering, feeling of loss, conflict, facing issues, assuring a fresh start and becoming-mature. "Being driven over the edge of a cliff" was the key phenomenon which the single mothers experienced during the process of pregnancy. CONCLUSION: The above results will help nurses assessing single pregnancy mothers' needs and developing a nursing intervention program for supporting them. Therefore, nurses will be able to stop them from "being driven over the edge of cliff". A more vigorous nursing intervention is suggested for the research of the vulnerable classes of medical health care including single pregnant mothers.

The Effects of Customized Home Visiting Health Service in Gangwon-do: Focused on Hypertension and DM Clients

PURPOSE: This study was to present the effects of home visiting health service on hypertension and DM clients. METHOD: The one-group pretest-posttest design was applied to 127 hypertension and 116 DM clients. To evaluate the effects of visiting nursing service, biological indexes and self-care abilities were measured from April to July, 2007. RESULT: Biological indexes and self-care abilities were improved in the hypertension and DM clients who received visiting nursing service. Especially, blood pressure and fasting blood sugar showed a dramatic decrease. CONCLUSION: Home visiting health service by public health centers is considered to be an effective nursing service in Gangwon-do. Therefore, case management is demanded not only for hypertension and DM but also for other chronic diseases.

The Effect of Tele-Health Service on Knowledge and Family support of Hypertension patients / 대한의료정보학회지

OBJECTIVE: The purpose of this study was to evaluate the effect of tele-health service on knowledge and family support of hypertension patients. METHODS: The subjects were two hundred thirty seven primary hypertension patients who were enrolled at health care center located at the cities of Chunchon, Wonju, and Kangreung, Kwangwon-Do. Tele-health system were located health care center of each cities and the service had been provided for three months. Tele-health system called patients every morning to remind them of taking the prescribed medicine by a 12.5 second pre-recorded message. In addition, tele-health system informed the patients of knowledges on hypertension(medication, exercise, nutrition, regular examination) by 18.4 through 25.3 second pre-recorded message during weekend. Data were collected using a questionnaire before and after the service. RESULTS: The differences of knowledge on hypertension before and after tele-health service was significant(t=-7.908, p=.000). Family support before and after the service was statistically significant as well(t=-7.550, p=.000). CONCLUSION: Tele-health service was effective to manage hypertension.

Professional Self-Concept and Self-Efficacy according to the Need for Advanced Practice Nurse among Korean Nurses / 기본간호학회지

PURPOSE: The purpose of this study was to identify the need for advanced practice nurse and explain the relationship between self-efficacy and professional self-concept among Korean nurses. METHOD: The participants were 511 Korean nurses who were recruited in hospitals or public health centers in Korea. The instruments used in this study were Sherer et al's self-efficacy instrument, Arthur's professional self-concept instrument, and a structured questionnaire on the need for advanced nurse practitioners. Cronbach alpha, mean, SD, X2, t-tests, ANOVA, Pearson correlation coefficient were used to analyze the data using SPSS PC+ ver 12.0 for Windows. RESULTS: Of the nurses, 57.9% of wanted to be advanced practice nurses. The mean of professional self-concept and self-efficacy scores for the nurses were at the medium level. Professional self-concept and self-efficacy of nurses showed significant differences according to age, working location, marital status, level of education, and length of clinical experience. A significant positive correlation was found between professional self-concept and self-efficacy. CONCLUSION: Before planning to develop the role of Advanced practice nurse, there is a need to measure self-efficacy and professional self-concept among nurses. Politically, strategies to increase self-efficacy and professional self-concept among Korean nurses will be necessary in order to prepare good advanced practice nurse.

Teachers' Needs Analysis about Contents of Sexual Education for the Lower Grades of Primary School / 여성건강간호학회지

PURPOSE: This study was done to discover the contents needed for a sexual education program in the lower grades (the first to the third grade) by primary school teachers and to discover difficulties in confronting sexual education. METHOD: This was a descriptive study of 198 teachers for lower grade students in 15 primary schools. A questionnaire on sexual education was distributed and collected by mail. RESULT: The contents for sexual education that teachers felt were highly needed are as follows: sanitation of genitals, sexual violence, pregnancy & childbirth, family, self-assertion, and sexual self-determination. Teachers think prevention of sexual violence is the main reason for sexual education. Teachers indicated that sexual education considering the developmental stage was difficult. CONCLUSION: Development of a sexual education curriculum for lower grade primary school students is necessary for increasing the problem-solving ability of students focused on sexual violence, self-assertion and sexual self-determination, in addition to providing simple information.

The Effect of a Physical Exercise Program Using Elastic Bands in the Attitude of Physical Exercise and the Degree of Joint Pain

PURPOSE: The purpose of this study was to identify the effects of a physical exercise program using elastic bands in rural area women. METHOD: This study adopted a pre-post test design. The subjects were 89 rural area women who were selected from four community health care centers. The physical exercise program was executed 30 times for 10 weeks (3 times a week) from August 23 to October 31, 2003. RESULTS: There was a significant difference in the attitude of physical exercise (t=-5.517, p=.000). In the degree of joint pain, there were significant differences in the flextion and extension of the shoulder joint (t=2.557, p=.020; t=5.625, p=.000), and there was a significant difference in the flextion of the knee joint (t=4.747, 0=.000) but there was no significant difference in the extension of the knee joint (t=1.795, p=.083). CONCLUSION: Physical exercise programs need to be implemented and spread continuously.

Unmarried Mothers using Social Welfare Facilities / 아동간호학회지

PURPOSE: The purpose of this study was to provide basic data for the development of education programs for unmarried mothers. METHOD: From a group of unmarried mothers using social welfare facilities, 201 participated in this study. The study was done from October 2003 to April 2004 and self-efficacy, self-esteem, sexual knowledge, sexual attitude were measured. RESULTS: 1. On the basis of 100 points, self-efficacy averaged 62.76, self-esteem, 60.96, sexual knowledge, 58.75 and sexual attitude, 71.52. 2. According to the general characteristics of the women, there were significant differences in self-efficacy according to age (F=4.237, p=.006), schooling (F=5.071, p=.007), job prior to pregnancy (F=4.341, p=.002), and family income (F=6.183, p=.002). There was a significant difference in self-esteem according to family income (F=4.243, p=.016). There were significant differences in sexual knowledge according to age (F=3.950, p=.009), schooling (F=14.869, p=.000), family income (F=9.304, p=.001), number of pregnancies (t=-2.532, p=.012), and experience of abortion (t=2.775, p=.006), and, in sexual attitude according to schooling (F=7.356, p=.001) and family income (F=7.647, p=.001). 3. There were significant relationships between self-efficacy and self-esteem (r=.598, p=.000), and between sexual knowledge and sexual attitude (r=.569, p=.000). CONCLUSION: Pregnancy prevention programs should include sexual education and interventions designed to increase self-efficacy and self-esteem.

Analysis of Sexuality Content in Textbooks for Students in Lower Grades of Elementary School / 아동간호학회지

PURPOSE: The purpose of this study was to develop a sexuality education course of study for students in the lower grades of elementary school. METHOD: On the basis of the sexuality education guidebook for elementary school students published by Korea Ministry of Education & Human Resources Development, the state-designated textbooks for first to third grade were analyzed. RESULTS: 1) In the category of physical and psychological development, physical development and psychosexual development content were covered, but not sexual health content. 2) In the category of understanding of human relationship, marriage and family, and the opposite sex and love were presented but self-determination and selection were only partially presented. 3) In the category of sexual culture and sexual ethics, sexual role in society was covered, but not social environment or equality of the sexes. CONCLUSION: These results suggest that content on sexuality which is not covered in textbooks for students in lower grades should be included in other school courses or activities in class.

Development of an Evaluation Tool for Middle School Student Sex Education / 아동간호학회지

PURPOSE: To develop a tool to evaluate middle school sex education programs. METHOD: An evaluation tool was developed in 4 stages: first, preliminary items were developed based on the sex education guidebook for teachers published by the Korean Ministry of Education and Human Resources Development; second, a panel of specialists reduced the number of preliminary items by 3 validity tests on the contents; third, final items were selected from the results of pre-test. Finally, reliability and validity were tested by a sample of 601 middle school students of both genders attending all three grades. RESULTS: The developed evaluation tool contained 31 items on the sexual knowledge and 22 items on the sexual attitude. The results of reliability tests were as follows: Cronbachs alpha for sexual knowledge was .84; and for sexual attitude was .88. CONCLUSION: This study suggested the developed evaluation tool for sex education programs for middle school students had a high degree of reliability and validity.Therefore, it can be utilized to effectively evaluate Korean middle school sex education programs.

Sexual Knowledge and Attitudes among Middle School Students / 아동간호학회지

PURPOSE: To suggest ideas that promote sexual health and useful in planning sex education programs for middle school students. METHOD: This study surveyed 661 middle school students from three schools in Seoul and Chunchon. RESULTS: The average degree of sexual knowledge was 31.5, while attitude was 32.5. There were statistically significant differences in sexual knowledge in relation to: coeducational environment (t=-5.776, p=.000), grade (F=36.351, p=.000), father's age (t=-2.510, p=.012), mother's age (t=-2.146, p=.032), economical status (F=3.264, p=.039), source of sexual knowledge (F=8.484, p=.000), the degree of interest in the opposite sex (F=16.871, p=.000), sexual discussions with parents (t=3.556, p=.000), sexual discussions with teachers (t=2.847, p=.005), and sex education (t=2.148, p=.032). Likewise, stastically significant differences in sexual attitudes were linked to: coeducational environment (t=-7.646, p=.000), subject's grade (F=32.743, p=.000), parental marriage status (t=2.338, p=.020), mother's age (t=-2.048, p=.041), source of sexual knowledge (F=6.917, p=.000), the degree of interest in the opposite sex (F=15.559, p=.000), sexual discussions with parents (t=3.908, p=.000), and sexual discussions with teachers (t=2.946, p=.003). The students level of sexual knowledge and attitude was significantly correlated (r=.686, p=.000). CONCLUSION: This study indicates a variety of systematic sexual education programs are needed for middle school student at home and school.

Development and Application of Sexual Health Education Program for Unmarried Mothers / 여성건강간호학회지

PURPOSE: This study was done to develop a sexual health education program for unmarried mothers that were intended to provide the correct sexual knowledge, to help them establish positive sexual perception and to improve sexual health. The program was applied and its effect was evaluated. METHOD: One group pretest-posttest quasi-experimental research design was applied to evaluate the effect of a sexual health education program unmarried mothers. The research team developed a 34 hour program of 16 units, where the basic schemes were human development, relationships, personal skills, sexual behavior, sexual health, and society & culture. We applied the program to 32 unmarried mothers in the Institute for unmarried mothers in Gangwon-do, Korea from April 19, 2004 to June 14, 2004. RESULT: After the application of an 8 week sexual health education program, the subjects significantly showed a better perception of self-efficiency, self-esteem, sexual knowledge and sexual behavior than before the program. CONCLUSION: The sexual health education program for unmarried mother in this study was effective on improving sexual perception and promoting sexual health behavior.