Effects of e-Health Literacy, Parenting Stress, and Maternal Role Confidence on Children’s Health-Promoting Behaviors in Mothers of Infants and Toddlers

Purpose@#This study aimed to evaluate the effects of e-health literacy, parenting stress, maternal role confidence on children’s health-promoting behaviors in mothers of infants and toddlers. @*Methods@#The participants were 175 mothers of infants and toddlers. Data were collected from August 30 to September 24, 2022. The effects of e-health literacy, parenting stress, and maternal role confidence on children’s health-promoting behaviors in mothers of infants and toddlers were analyzed using multiple regression using IBM SPSS Statistics ver. 27.0. @*Results@#Children’s health-promoting behaviors showed a significant positive relationship with e-health literacy and maternal role confidence, and negative relationship with children’s age and parenting stress. The factors affecting children’s health-promoting behaviors were e-health literacy, maternal role confidence, and children’s age, which explained 30.7% of the total variance in children’s health-promoting behaviors. @*Conclusion@#This study suggests including e-health literacy and maternal role confidence for improving children’s health-promoting behaviors in mothers of infants and toddlers.

Parenting Experience of Shift Nurses With Elementary School-Aged Children During the COVID-19 Pandemic: A Phenomenological Study

Purpose@#This phenomenological study aimed to comprehend the altered parenting experience of nurses during the coronavirus disease 2019 (COVID-19) pandemic.Method: Using a qualitative approach, the research design employed a phenomenological methodology. The participants were 6 nurses with elementary school-aged children. The nurses were employed in tertiary general hospitals, working on rotating shifts during the COVID-19 pandemic. In-depth interviews were conducted to collect individual data, which were then analyzed using Colaizzi phenomenological method. @*Results@#Analyzing the collected data led to 178 significant results, from which 13 themes were derived. These 13 themes were further integrated into 5 distinct theme clusters: (1) struggling as a nurse-mom, (2) providing a supportive presence, (3) facing challenges in facilitating children's learning activities, (4) navigating parental roles in a chaotic situation, and (5) pursuing physical safety. These clusters were subsequently categorized into four overarching categories: “suffering,” which encompassed the themes of pressure of infection and providing a supportive presence, as well as “controlling,” “parenting,” and “seeking,” representing the remaining clusters, respectively. @*Conclusion@#The parenting experiences of shift nurses during the COVID-19 pandemic encompassed various aspects, including the challenges posed by the pressure of infection, the importance of providing a supportive presence, difficulties in managing children’s learning activities, navigating parental roles amid chaotic circumstances, and the pursuit of physical safety. These experiences significantly impact the stability of shift nurses’ caregiving abilities for both their patients and their children. Therefore, it is crucial to establish a comprehensive nationallevel care support system in times of disaster situations like the COVID-19 pandemic.

Development Process for Preterm Birth Risk Assessment Scale in High-Risk Pregnancy: 1st Phase of Preliminary Scale Development

Purpose@#To pool preliminary items based on nine domains as the first phase of developing a preterm birth risk assessment scale (PBRAS). @*Methods@#Item generation was performed using deductive methods, such as literature review and related scales, and inductive methods through in-depth interviews with 11 preterm birth (PTB) women, and ex­perts validated the content. The experts were clinical nurses who worked in delivery rooms, and professors who taught on the subject of women's health nursing. Preliminary survey for 32-item was conducted among 27 women with PTB. @*Results@#After item generation and pooling for the PBRAS, a total of 84 items were developed. A 32-item questionnaire was integrated with rigorous review by experts. Internal consistency of the 32-item PBRAS had a Cronbach alpha of 0.90. The PBRAS was significantly correlated with pregnancy stress (r= 0.77, p<0.001), somatic awareness scale (r=0.72, p<0.001), and risk scoring for PTB (r=0.44, p<0.001). @*Conclusion@#The 32-item PBRAS has content validity, but exploratory and confirmatory factor analyses for the 2nd phase of scale development needs to be performed.

Information and General Guidance for Healthcare Professionals in the Fourth Wave of COVID-19

The COVID-19 curve seesawed and reached the fourth pandemic in July 2021. Since the first three waves, the focus has been on achieving herd immunity through vaccination while a lot of manpower is used for quarantine. However, we have not been able to prevent the fourth wave. The causes are thought to be related to people who doubt the safety of the vaccine and refuse it or violate quarantine guidelines such as social distancing. This study examined guidelines for preventing and controlling COVID-19, the accuracy of vaccination-related information, and described quarantine measures including for those who completed vaccination. In conclusion, prevention and vaccination are the most effective countermeasures against COVID-19. We recommend people vaccination with self-quarantine. Also, it is necessary to make large investments to protect and support nurses in future pandemics.

Information and General Guidance for Healthcare Professionals in the Fourth Wave of COVID-19

The COVID-19 curve seesawed and reached the fourth pandemic in July 2021. Since the first three waves, the focus has been on achieving herd immunity through vaccination while a lot of manpower is used for quarantine. However, we have not been able to prevent the fourth wave. The causes are thought to be related to people who doubt the safety of the vaccine and refuse it or violate quarantine guidelines such as social distancing. This study examined guidelines for preventing and controlling COVID-19, the accuracy of vaccination-related information, and described quarantine measures including for those who completed vaccination. In conclusion, prevention and vaccination are the most effective countermeasures against COVID-19. We recommend people vaccination with self-quarantine. Also, it is necessary to make large investments to protect and support nurses in future pandemics.

Development and Validation of the Happiness Scale for Middle-Aged Women Based on Existence, Relation, and Growth Theory

Purpose@#This study aimed at developing a happiness assessment scale for middle-aged women (HAS-MW) in Korea. @*Methods@#Preliminary items for the scale were drafted from the results of literature review and personal interviews and open-ended questions with women in the community. The interviews were based on the theory of existence, relatedness, and growth. After validating a preliminary scale, we analyzed the validity and reliability of the new scale items, and model fit. We surveyed 600 women aged 40 years to 64 years for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Valid data were divided into 352 for EFA and 174 for CFA by multiplies of number 1 to 3. @*Results@#Using exploratory and confirmatory factor analyses, we extracted four primary factors—self-value, positive thinking, self-care, and family relationship—and with a total of 24 items for HAS-MW. The fit of the final model was evaluated as good showing χ2/df = 2.10, goodness of fit index = .80, comparative fit index = .85, root mean square error of approximation = .08, standardized root mean residual = .05. The HAS-MW had a significant positive correlation with the Oxford Happiness scale and showed a significant negative correlation with the Hwa-Byeong Scale. Cronbach's α for the new scale was .91, and the Spearman-Brown half coefficient was .93. The new scale used a five-point Likert scale with higher scores indicating greater happiness. @*Conclusion@#The HAS-MW is a reliable and valid one. It can be used to measure the level of happiness for middle-aged women. In addition, it might be applied to find low women and to evaluate the effect of intervention program related to happiness in woman of middle age.

Development and Validation of the Happiness Scale for Middle-Aged Women Based on Existence, Relation, and Growth Theory

Purpose@#This study aimed at developing a happiness assessment scale for middle-aged women (HAS-MW) in Korea. @*Methods@#Preliminary items for the scale were drafted from the results of literature review and personal interviews and open-ended questions with women in the community. The interviews were based on the theory of existence, relatedness, and growth. After validating a preliminary scale, we analyzed the validity and reliability of the new scale items, and model fit. We surveyed 600 women aged 40 years to 64 years for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Valid data were divided into 352 for EFA and 174 for CFA by multiplies of number 1 to 3. @*Results@#Using exploratory and confirmatory factor analyses, we extracted four primary factors—self-value, positive thinking, self-care, and family relationship—and with a total of 24 items for HAS-MW. The fit of the final model was evaluated as good showing χ2/df = 2.10, goodness of fit index = .80, comparative fit index = .85, root mean square error of approximation = .08, standardized root mean residual = .05. The HAS-MW had a significant positive correlation with the Oxford Happiness scale and showed a significant negative correlation with the Hwa-Byeong Scale. Cronbach's α for the new scale was .91, and the Spearman-Brown half coefficient was .93. The new scale used a five-point Likert scale with higher scores indicating greater happiness. @*Conclusion@#The HAS-MW is a reliable and valid one. It can be used to measure the level of happiness for middle-aged women. In addition, it might be applied to find low women and to evaluate the effect of intervention program related to happiness in woman of middle age.

Healthcare Considerations for Special Populations during the COVID-19 Pandemic: A Review

The coronavirus disease 2019 (COVID-19) has emerged as a threat to human health and public safety. People of all ages are susceptible to severe acute respiratory syndrome coronavirus 2 infection. However, the clinical manifestations of this infection differ by age. This study purposes to describe healthcare considerations for special populations, such as children, pregnant and lactating women, and older adults, who may have unique healthcare needs, in the pandemic situation. To realize the research purpose, we conducted a review of the practice guidelines of public documents and qualified studies that were published online/offline during a specific period. The review identified current knowledge on care for newborns, children in schools, pregnant women (from antenatal to postpartum care), and older adults suffering from high-risk conditions. Subsequently, we summarize vaccination guidance for special populations and, finally, discuss the issues currently affecting special populations. Therefore, this current knowledge on care for special populations helps nurses to provide accurate information on vaccinations aimed at preventing COVID-19 and protecting the masses from infection. Currently, the scarcity of information on COVID-19 variants necessitates further research on measures to reduce pandemic spread.

Visualization of unstructured personal narratives of perterm birth using text network analysis

Purpose@#This study aimed to identify the components of preterm birth (PTB) through women’s personal narratives and to visualize clinical symptom expressions (CSEs). @*Methods@#The participants were 11 women who gave birth before 37 weeks of gestational age. Personal narratives were collected by interactive unstructured storytelling via individual interviews, from August 8 to December 4, 2019 after receiving approval of the Institutional Review Board. The textual data were converted to PDF and analyzed using the MAXQDA program (VERBI Software). @*Results@#The participants’ mean age was 34.6 (±2.98) years, and five participants had a spontaneous vaginal birth. The following nine components of PTB were identified: obstetric condition, emotional condition, physical condition, medical conditions, hospital environment, life-related stress, pregnancy-related stress, spousal support, and informational support. The top three codes were preterm labor, personal characteristics, and premature rupture of membrane, and the codes found for more than half of the participants were short cervix, fear of PTB, concern about fetal well-being, sleep difficulty, insufficient spousal and informational support, and physical difficulties. The top six CSEs were stress, hydramnios, false labor, concern about fetal wellbeing, true labor pain, and uterine contraction. “Stress” was ranked first in terms of frequency and “uterine contraction” had individual attributes. @*Conclusion@#The text network analysis of narratives from women who gave birth preterm yielded nine PTB components and six CSEs. These nine components should be included when developing a reliable and valid scale for PTB risk and stress. The CSEs can be applied for assessing preterm labor, as well as considered as strategies for students in women health nursing practicum.

Analysis of Research Topics and Trends in the Journal of Korean Academy of Nursing to Improve Its International Influence

Purpose@#The purpose of this study was to analyze articles published in the Journal of the Korean Academy of Nursing (JKAN) between 2010 and 2019, along with those published in three international nursing journals, to improve JKAN’s international reputation. @*Methods@#The overall characteristics of JKAN’s published papers and keywords, study participants, types of nursing interventions and dependent variables, citations, and cited journals were analyzed. Additionally, the keywords and study designs, publication-related characteristics, journal impact factors (JIF), and Eigenfactor scores of International Journal of Nursing Studies (IJNS), International Nursing Review (INR), Nursing & Health Sciences (NHS), and JKAN were analyzed and compared. @*Results@#Among the four journals, JKAN’s score was the lowest in both the journal impact factor and Eigenfactor score. In particular, while the JIF of INR and NHS has been continuously increasing; JKAN’s JIF has remained static for almost 10 years. The journals which had cited JKAN and those which JKAN had cited were mainly published in Korean. @*Conclusion@#JKAN still has a low IF and a low ranking among Social Citation Index (E) journals during the past 10 years, as compared to that of four international journals. To enhance JKAN’s status as an international journal, it is necessary to consider publishing it in English and to continuously improve the conditions of other publications.

Development of Caring as a Human Science: 50 Years of History of the Korean Society of Nursing Science

Purpose@#This year 2020 marks the 50th anniversary of the founding of the Korean Society of Nursing Science (KSNS). This study wasaimed to explore development of caring and describe the 50 years of history of KSNS within the sociocultural context of Korea regardingacademic footsteps, meanings, and implications for the future. @*Methods@#This study used a historical research methodology using a literaturereview and bibliometric analysis. Relevant literature was reviewed and the published abstracts in the Journal of Korean Academy ofNursing (JKAN) were analyzed using VOSviewer. @*Results@#Birth control and family planning in the 1970s was the main research topic. In the1980s, the development of nursing concepts, theories, and philosophies was the mission of KSNS to extend the disciplinary boundary. In the1990s, the progress of KSNS to become one of the woman-dominant healthcare professionals was the mission in the given period. Expandingthe frontiers of KSNS to the extent of global standards was the undertaking of the nursing scholars in the 2000s. Lastly, in the 2010s,the quality and quantity improvement of KSNS and JKAN is expected to make our future even prosperous. The map visualization of the 50years of research accumulation showed the comparable opposition of quantitative vs. qualitative research methodologies, equation modeling,and instrument development. @*Conclusion@#These clusters of research demonstrates the efforts to make nursing evidence by Koreannursing scholars for the last five decades. The growth in the slope of KSNS and outcomes of JKAN are to carry on to an unimaginable extentin the future.

A Survey on the Educational Needs and Competence of Nurses in Maternal Fetal Intensive Care Unit / 여성건강간호학회지

PURPOSE: Maternal Fetal Intensive Care Unit (MFICU), which provides intensive care to high-risk mothers with increasing maternal age and high-risk newborns, has become a new field of nursing work in South Korea. The present study was conducted to identify the educational needs and self-assessing clinical competence of nurses in MFICU. METHODS: The education needs and competencies of MFICU nurses were measured through prepared questionnaires by researchers based on the previous studies on job analysis of nurses in MFICU. Data were collected from January 2019 to March 2019. The study involved 168 nurses working in MFICUs at 12 hospitals nationwide as study subjects. The data were analyzed using the SPSS WIN 23.0 program. RESULTS: The education needs of nurses in MFICU had an average of 4.21 points (±0.50) and their nursing competence was average 3.38 points (±0.60). The items reported as high education needs but low competency by nurses in MFICU were as following: ‘postpartum hemorrhage and shock,’ ‘cardiopulmonary resuscitation (CPR) for neonate,’ ‘CPR during pregnancy,’ ‘disseminated intravascular coagulation,’ ‘sepsis,’ and ‘mechanical ventilation during pregnancy.’ CONCLUSION: Based on these results, it is proposed that a comprehensive education program for nurses in MFICU should be developed by considering low capabilities among MFICU nurses as a priority factor.

Development and Evaluation of Empowering Education Program for Maternal Fetal Intensive Care Unit (MFICU) Nurses / 여성건강간호학회지

PURPOSE: This study was conducted to develop an empowering education program for Maternal-Fetal Intensive Care Unit (MFICU) nurses who provide intensive care to high-risk mother and fetus at hospitals, to test effects of the education program on nursing care confidence and nursing knowledge, and to examine program satisfaction. METHODS: This study comprised of 2 phases: program development and evaluation. First, we have followed a process of program development to develop and refine an empowering education program for MFICU nurses through collaborative works among clinical obstetrics and gynecology doctors and nurses and academic nursing professors. Second, the empowering education program was provided to 49 nurses and evaluated from July 5 to 6, 2019. Levels of MFICU nursing care confidence and knowledge were measured. RESULTS: The empowering education program included 18 hours of lectures, discussion, and Q & A, which continued for 2 days. This program significantly improved high-risk maternal-fetal nursing care confidence and knowledge of nurses. The program was well met with nurses' education need and goals, and found to be highly satisfactory. CONCLUSION: The empowering education program was observed to be effective in terms of improve nursing care confidence and knowledge of nurses in MFICU. It is proposed that this program should be open regularly for nurses to obtain and improve their clinical knowledge, confidence, and competency. Further study is needed to develop and run 2-levels of education such as basic and advanced levels based on nurses' clinical background and competency.

Meaning of Happiness Based on ERG Theory in Middle-Aged Korean Women / 여성건강간호학회지

PURPOSE: The purpose of this study was to explore the components and nature of happiness in middle-aged women in Korea. METHODS: Thirty middle-aged women living in metropolitan Seoul and Gyeonggi and Chungcheong provinces agreed to participate in this study. The data were collected through in-depth interviews with the participants in one-on-one settings. The data were analyzed qualitative using Colaizzi's method of phenomenology. RESULTS: The three theme clusters were extracted from the raw data, along with 13 themes and 138 meaningful sentences and phrases. The three happiness theme clusters in middle-aged women were “live healthy for stability,” “rule one's mind for harmony,” and “activate hopes for self-esteem.” The first theme cluster included healthy life, economic stability, physical youth, and positive thought. The second theme cluster included that harmonious family, ruling of mind, my position as invisible person in social relationships, and precious relationships to support. The last theme included the center of one's life is oneself, a sense of accomplishment, self-improvement, recognition of one's worth and rest for one self. The three theme clusters were associated with the existence, relatedness, and growth (ERG) of ERG areas, respectively. CONCLUSIONS: We conclude that the core components of happiness in middle-aged women are to live healthy and mind-ruled and activate hope. The nature of happiness is egocentric stability in middle-aged women. The results suggest that theme clusters might be used to develop a scale for measuring happiness in middle-aged women. This will be helpful to assess the psychosocial status of middle-aged women in Korea.

Experience of Conflict in Three Shift Nurses Rearing more than Two Kids: Phenomenological Study

PURPOSE: To understand the essentials of rearing conflict experience by three shift nurses in advanced general hospitals. METHODS: The design was a qualitative research of phenomenology. Participants were 7 shift nurses working in advanced general hospitals who were rearing young children. Data were collected individually through in-depth interview on their life experiences. Data were analyzed by Colaizzi's phenomenological methodology. RESULTS: Eighteen themes were drawn from 256 meaningful experiences and these themes were integrated to six theme clusters. The most influencing themes were ‘Regret that I cannot satisfy even the slightest wish’, ‘Fail to care for kids’, and ‘Mutual feeling to care giver between appreciation and inconvenience’. Other themes were as follows: ‘Body and mind are broken’, ‘The need for a three-shift system to support nurses who are rearing children’, ‘Doing my best for work and child rearing’. CONCLUSION: The nature of three-shift nurses working in advanced hospital and caring kids is explained as ‘lives with conflict’ between work and home. This study suggests it is necessary to establish a 24-hour care center for 3-shift nurses to keep working while rearing their children.

Preterm Labor and Birth: Definition, Assessment, and Management

No abstract available.

Job Analysis of Maternal Fetal Intensive Care Unit Nurses Using DACUM Technique / 임상간호연구

PURPOSE: This study was performed to establish the role and to analyze the job of MFICU (Maternal Fetal Intensive Care Unit) nurses using DACUM (Developing a curriculum). METHODS: A DACUM workshop was held to define MFICU nurses' role and identify their duties and tasks. A DACUM committee was consisted of 7 nurses, 2 nursing professors and 1 medical doctor and as a result, a survey was developed which contained duties and tasks of MFICU nurse. Pre-test was carried out for the validity, finally collected the data from 97 nurses who worked at 7 MFICU and 10 delivery room. RESULTS: A total of 60 duties, 115 tasks and 822 elements of tasks were defined on the DACUM chart and survey. The importance, frequency and difficulty of the tasks were presented the determinant coefficient (DC), the highest DC duty was ‘Manage maternal ventilator’ (15.09) and the lowest DC was ‘Provide nursing care for leisure to gestation extension mother’ (6.52). Twenty-eight tasks were differentiated between MFICU and delivery nurses significantly. And the most important, frequently, difficulty task perceived by MFICU nurse was ‘Check fetal heartbeat with electronic fetal heart monitor’. CONCLUSION: The organized educational program and policy was needed to develop for MFICU nurses.

Subjective Health and Factors of Health-related Quality of Life in Elderly Haenyo

PURPOSE: To investigate the subjective health and health-related quality of life (HRQoL) in Haenyo. METHODS: Subjects were 100 elderly Haenyo in Jeju island who belonged to a fishing-village society. Main variables were activities of daily living (ADL), instrumental ADL (IADL), the HRQoL, subjective health, and depression. Subjective health and differences of HRQoL by variables were analyzed by t-test or ANOVA using IBM SPSS Statistics 23. Hierarchical multiple regression was executed to examine the effects of the major factors on the quality of life. RESULTS: The mean age was 69.9 years, the mean period for diving career was 51.5 years, and work hours per month were 37.8. Comorbidity of diseases was 2.74, and the common health problems were osteoporosis and headache/dizziness. HRQoL was significantly different by age (F=4.52, p=.013), education (F=6.10, p=.003), muljil work years (F=3.93, p=.050), depression (t=-3.04, p=.030), subjective health state (F=30.62, p < .01), and degenerative arthritis (F=-2.38, p=.019). In the final model by hierarchical multiple regression, ADL/IADL (β=.41, p < .001), depression (β=-.29, p < .001), and subjective health (β=.43~.51, p < .001) were significant and explained 63.5% of the total variance of HRQoL. CONCLUSION: Haenyo have specific health problems different from those of elderly women in general. ADL/IADL, depression and subjective health affected their HRQoL. It is clear that Haenyos' health problems need further study to improve their health.

Bladder Symptoms, Fatigue and Physical Activity in Postpartum Women

PURPOSE: Physical activity is important for postpartum women. The objective of this study was to evaluate bladder symptoms, fatigue, and physical activity according to time after birth and birth modes. METHODS: This was a cross-sectional study using web-based questionnaire or one-to-one contact. A total of 290 women after giving birth responded to self-administered questionnaires. Multivariate analysis of variance determined the differences in variables. RESULTS: Bladder symptoms were significantly different by time after birth and birth mode; they were the highest in the first week after birth and in Cesarean birth. Postpartum fatigue showed a significant tendency by birth mode, but not by time after birth. Physical activity was significantly different by birth mode. The lowest level of physical activity was found for women who gave Cesarean birth. Moderate physical activity was also significantly different by time after birth, but vigorous physical activity was not significantly different. CONCLUSION: In conclusion, bladder symptoms and physical activity are different by time after birth and birth mode in postpartum women. The first week after giving birth is an important period for postpartum women whose bladder symptoms and physical activity should be of concern.

Multiple Factors in the Second Trimester of Pregnancy on Preterm Labor Symptoms and Preterm Birth

PURPOSE: The aim of this study was to determine the influence of various factors on preterm labor symptoms (PLS) and preterm birth (PB). METHODS: This prospective cohort study included 193 women in the second stage of pregnancy. Multiple characteristics including body mass index (BMI), smoking, and pregnancy complications were collected through a self-report questionnaire. Pregnancy stress and PLS were each measured with a related scale. Cervical length and birth outcome were evaluated from medical charts. Multiple regression was used to predict PLS and logistic regression was used to predict PB. RESULTS: Multiple regression showed smoking experience, pregnancy complications and pregnancy specific stress were predictors of PLS and accounted for 19.2% of the total variation. Logistic regression showed predictors of PB to be twins (OR=13.68, CI=3.72~50.33, p25 (kg/m²) (OR=3.50, CI=1.35~9.04, p<.01) and a previous PB (OR=4.15, CI=1.07~16.03, p<.05). CONCLUSION: The results of this study show that the multiple factors affect stage II pregnant women can result in PLS or PB. And preterm labor may predict PB. These findings highlight differences in predicting variables for pretrm labor and for PB. Future research is needed to develop a screening tool to predict the risk of preterm birth in pregnant women.