Motherhood as Experienced by Women in a Prenatal and Early-Childhood Home Visitation Program, and Associated Factors

Purpose@#This study is intended to examine the difficulties facing mothers of young children (early childhood) and to understand the associated factors.Method: We analyzed 1,003 data items of women with children under age 2 who participated in a prenatal and early-childhood home visitation program in Seoul from 2016 to 2019. For our research, we used self-administered registration and service monitoring data. The difficulties the women faced as mothers were measured using the “Being a Mother Scale” (BaM-13). This analysis considered covariates including maternal and infant ages, their number of children, economic conditions, presence of disabilities, single motherhood, multicultural migration background, employment status, unintended pregnancy, instrumental and emotional support, and depression scores. @*Results@#The average score for being a mother was 14.45 (standard deviation=6.61), and higher scores were recorded for women with spouses, Korean women (as opposed to multicultural immigrant women), women whose pregnancies were unplanned, women without instrumental support, and severely depressed women. @*Conclusion@#Motherhood poses great difficulties to women with children under age two. To help women transition from motherhood, it is important to understand their situations in relation to their social and psychological characteristics, as well as the cultural, social, and contextual perspectives they bring to motherhood.

A Scoping Review on the Clinical Supervision and Mentoring for Nurses in Maternal and Child Health

Purpose@#This scoping review aimed to identify application methods, effectiveness, facilitating factors, and obstacles to clinical supervision for nurses in maternal and child health and to understand its discriminatory characteristics compared to mentoring. @*Methods@#This study was based on the scoping review methodology and consisted of six stages: (1) identifying research questions; (2) identifying relevant studies (search strategy); (3) study selection; (4) charting of the data; (5) collating, summarizing, and reporting the results; and (6) consultation. From April to July 2022, 1,323 studies were searched in PubMed, CINAHL, Cochrane, and Open Gray, and finally eleven studies were selected through the literature selection process. @*Results@#Because clinical supervision aimed to strengthen the professional capabilities of nurses, reflective practice was applied. However, mentoring was designed to acquire knowledge or skills that can be applied directly in practice. Therefore, indicators to measure the effects of clinical supervision consisted of psychosocial factors, such as job satisfaction and exhaustion, but the effects of mentoring were evaluated primarily using knowledge levels and skills. The model, which is applied mainly in clinical supervision, reflects the restorative function. When applying clinical supervision and mentoring, listening, supportive environment, and accessibility were identified as facilitating factors, while criticism, lack of time and space, and excessive workload were identified as obstacles. @*Conclusions@#Time and space must be secured to provide effective clinical supervision. The confidentiality of the supervisee must be guaranteed, and sufficient information must be provided in advance so that nurses can accurately recognize the clinical supervision process. Finally, a policy for institutionalizing clinical supervision should be supported to ensure its applicability and sustainability.

A Study on the Gongjungwisaeng Kanhohak, the First Korean Textbook for Public Health Nursing

Purpose@#The purpose of this study is to extend the knowledge about the textbook, Public Health Nursing Textbook (in Korean, Gongjungwisaeng Kanhohak) which is published in 1933 by the Nurses' Association of Korea. @*Methods@#Public Health Nursing Textbook was investigated from the cover page to the last page and compared with two original books and other nursing books published in modern Korea. @*Results@#Public Health Nursing Textbook was the forth published Korean nursing textbook and the first published Korean public health nursing textbook. Rosenberger, a missionary nurse from USA, Lee Keumjeon, Korean public health nurse who studied in Canada, and other Koreans were in charge of translation, etc. It is a user‐friendly book written mainly in Korean (Hangul) with Chinese characters and included the English table of contents, preface and back cover. Most of its contents were extracted and translated from two original books, one is Public Health Nursing by Mary Gardner and the other is Personal Hygiene Applied by Jesse Williams. It is worth noting that the book not only introduced the public health nurses’s activities across the country, but also focused on the information necessary for common health problems at that time. @*Conclusion@#From the Public Hygiene and Nursing, it can be seen that public health nurses had been independently educated since Imperial Japan’s colonial period, and public health nursing was growing as a independent field in Korea.

Development and Evaluation of the Parenting Support Group Program for Mothers with Infants

Purpose@#The purpose of this study is to evaluate the changes in parenting competency, parenting environment, and parenting stress by developing and applying parenting support group program based on the social support intervention model for mothers with infants. @*Methods@#In this experimental study, mothers with infants of 8~12 weeks old were recruited. 23 mothers were selected for analysis (11 in the experimental group and 12 in the control group).The parenting support group program was provided to the experimental group for seven sessions with 120 minutes per session. @*Results@#The experimental group showed that the parenting competency and parenting environment were significantly increased and the parenting stress was significantly decreased immediately after intervention. In the case of parenting environment, it was found to have a lasting effect until the point of further investigation. @*Conclusion@#The results indicate that the program as a social support intervention strategy for mothers rearing up infants is effective intervention in a universal context in the community.

Infant Mother’s Experiences with the Sustained Nurse Home-Visiting Program

Purpose@#The purpose of this study was to understand the experiences of mothers of infants who received sustained nurse home visiting services. The program of sustained home visit by nurses (Seoul Maternal Early Childhood Sustained Home-Visiting Program) is an intervention program. Its effectiveness has been verified in Australia, where services are provided to families in a vulnerable families during the period from prenatal period until the newborn is 2 years old. @*Methods@#The study protocol used qualitative approaches. Eleven mothers of infants who received nursing services in December 2015 were invited for an in-depth interview. The data collected were subjected to directed content analysis. @*Results@#The following 4 themes were identified from the analysis: (1) reduction in suspicion and increased feeling of benefit from the visiting service, (2) emotional support to the parents and use of community resources, (3) reliance on friendly nurses, and (4) gaining confidence about parenting and motherhood. @*Conclusion@#Sustained nursing home visiting services can be applied effectively in South Korea. The concrete narrations and descriptions of the experiences of mothers in this study can be used as a base for education, practice, and research.

Content Analysis of Mothers’ Questions Related to Parenting Young Children in Internet Parenting Community

Purpose@#This study aimed to investigate mothers’ questions related to parenting young children in the internet community. @*Methods@#One representative in the internet community was selected and parenting questions were collected over 2 weeks in October 2019. A total of 15,016 questions were analyzed by frequency and proportion after categorizing of 10 themes; health and daily care, connecting and communicating, play and learning, development and growth, poos and wees, sleep, feeding, solid foods, safety, behavior. @*Results@#The most frequently asked questions per age ranged from 1 to 3 months (32.2%). The most frequently asked questions by theme per age were about feeding newborn up to 6 months, solid foods from 7 to 12 months, health and daily care from 13 to 24 months, and play and learning from 25 to 71 months. @*Conclusion@#As these results reflect mother’s need for information and support, it is suggested that more specific and targeted online/offline support per age should be developed.

End of Life Care Competencies and Terminal Care Stress of Nurses in Long Term Care Hospitals / 한국호스피스완화의료학회지

PURPOSE: The purpose of this study was to investigate the relationship between end of life care competencies and terminal care stress of nurses in long term care hospitals. METHODS: For this study, 140 nurses were sampled among those that have over 6-month end of life care experience and were working at long term care hospitals located in A city and C city of Chungcheongnam-do. Using a questionnaire, data were collected from January 2018 through March 2018. Data were analyzed using the SPSS, Windows version 21.0, according to the purpose of the study and analyzed by descriptive statistics, t-test, one way ANOVA, Schéffe's test, and Pearson's correlation coefficient. RESULTS: The mean score on terminal care stress of nurses was above the normal level. The scores on end of life care competencies significantly varied by age, total career at hospitals, death/hospice and palliative care education, and bereavement experience. The mean score of end of life care competencies was negatively correlated with the mean score of lack of knowledge and skills among the sub-items of the terminal care stress category (r=−0.260, P=0.002). CONCLUSION: To decrease the terminal care stress of long term care hospital nurses, it is suggested to carry out end of life care education tailored to nurses' characteristics.

Effects of a Group-based Parenting Support Program for Infant and Toddler Parents: A Systematic Review of Randomized Controlled Trials

PURPOSE: Group-based interventions help the members of the parent group work together to share their parenting stress, provide opportunities for them to support each other emotionally and informatively, and allow them to achieve what they want to accomplish. The purpose of this study is to investigate and synthesize the outcome of a parenting support program for infant and toddler parents. METHODS: Published randomized control trials were identified through Ovid-Medline, Embase and CINAHL DB. Eligible studies include articles published between 2008 and 2018 in English in the randomized controlled trial design in which parenting support programs were implemented for infant and toddler parents group. RESULTS: A total of 11 studies was selected for this review. These programs reported large level of effect size for parenting, and middle level effect size for parent's psycho-social outcomes and child development. There were many programs conducted for parents with infants between 13 and 24 months, and the frequency of programs provided for 2 hours a week was high with 9 to 12 sessions. Most programs were facilitated by trained professionals including nurses and social workers except two programs led by lay persons. CONCLUSION: This review demonstrates that group-based parenting support programs have positive effects on parenting, parent's psychosocial health and infant development. To disseminate the effective group-based parenting support programs, further research is needed to confirm the long term effect and develop nurse's role as a group facilitator.

The Seoul Healthy First Step Project: Introduction and Expansion, Program Content and Performance, and Future Challenges

With the motto ‘Equity from the Start for a Healthy Future’, the Seoul Healthy First Step Project (SHFSP) was launched in 2013 in an attempt to support women with young children, to improve the health and development of babies, and eventually to close the gap in child development. The SHFSP contains both universal components (universal risk assessment of mothers and universal home visitation after birth) and selective components (prenatal and postnatal sustained home visits, mothers' groups, and community service linkage), thereby taking a proportionate universality approach. For sustained home visits, the SHFSP introduced the Maternal and Early Childhood Sustained Home-visiting (MECSH) program from Australia, which has been proven to be effective in improving maternal and childhood outcomes. Between 2013~2017, the SHFSP has paid 58,327 visits to roughly 38 thousand families with babies. In 2017, the SHFSP covered 19.6% of families with newborn babies in Seoul. The SHFSP conducted internal satisfaction surveys of universal and sustained visitation service recipients, in which an overwhelming majority of mothers provided positive feedback. A performance assessment conducted in 2016 by an external organization showed that 93% of SHFSP service recipients were satisfied with the home visitations. Considering the popular support for the program from mothers and families in Seoul (the most affluent area in Korea) and the lack of a national home visiting program to promote early childhood health and development, this program should be expanded nationally in the near future.

Competencies of Nurses in a Maternal Early Childhood Sustained Home-Visiting Program

PURPOSE: Competency is a key foundation of the nursing education curriculum and a baseline element of nursing practice. The purpose of this study was to explore the competencies of community health nurses in a maternal early childhood sustained home-visiting program based on nurses' field experiences. METHODS: The participants were 21 nurses who had more than 1 year of experience in this program. Reflective interviews were performed; lasting 1 hour per nurse, on August 18, 2016, and the collected data were analyzed using qualitative directed content analysis. RESULTS: Twenty-four themes were extracted for 9 competencies. The major themes included implementing a long-term relationship-based approach, providing client-led service rather than expert-led service, helping mothers with psychosocial difficulties, and applying skills in a practical manner in the home environment. CONCLUSION: In order to develop a home-visiting program as part of maternal-early childhood nursing practice, nurses should develop competencies that help them make significant and positive interventions. Results indicate that the curriculum for community health nurses should be changed to improve competencies in building relationships with clients and to focus on the application of skills in specific cases and in clinical practice.

Infection Control of Hospital Nurses: Cases of Middle East Respiratory Syndrome / 한국직업건강간호학회지

PURPOSE: The 2015 Korean Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreaks resulted in 186 cases, with 8% (15 persons) of these being nurses. This study aimed to examine MERS-CoV infection status of clinical nurses and to evaluate perception for infection control. METHODS: We investigated the MERS-CoV infection status of nurses using MERS-CoV press release data. We examined and analysed perception for Infection control of 121 nurses of the three MERS intensive therapeutic hospitals in July 2015. RESULTS: One to six nurses per hospital in total 8 health care facilities were infected with MERS-CoV. They mainly had short clinical careers and were unaware of infection possibility. The personal and organizational infection control levels that nurses perceive were low and the relationship between two levels was statistically significant. CONCLUSION: For promoting health protection and infectious disease management competency of nurses, it is necessary to prepare institutional system for controlling infectious disease.

Home-Based Hospice Care Provided by a Free-Standing Hospice Center: Patients' Characteristics and Service Conditions / 한국호스피스완화의료학회지

PURPOSE: This study was conducted to investigate patients' characteristics and actual conditions of home-based services offered by a free-standing hospice center. METHODS: A retrospective review was performed with the medical records of 75 patients who received home-based hospice care from a free-standing hospice center from January 2014 through December 2014. RESULTS: Most patients (54.7%) were enrolled via self-directed referral. The reason for the service termination was death at home 25.3%, admission to a hospice ward 50.7%, hospitalization 22.6% and patients' refusal 2.7%. Seventy three patients had cancer, and two patients had ALS. Among all, 58.7% were in a dying phase, and 34.7% were almost completely bedfast at the time of their enrollment in this study. When they enrolled, the patients' physical symptoms were characterized as pain (89.4%), sleep disturbance (71.2%), urinary difficulties (35.8%) and defecation difficulties (47.8%). Among all, 77.4% terminated the home visit service within one month. The mean frequency of the home visits was 3.25 (±3.98), and less than five in 82.7% of patients. The mean frequency of the phone service was 3.40 (±3.12). The frequency of doctor's home visits was 1.21±0.79 on average, and the figure increased when patients' conditions turned unstable. CONCLUSION: It is necessary to develop a home-based hospice care model with consideration of patients' characteristics and the actual service conditions delivered by free-standing hospice facilities.

Prevalence and Related Factors of Clonorchiasis among Five Major Riverside Residents in South Korea

PURPOSE: This study attempted to investigate the prevalence and related factors of Clonorchiasis among five major riverside residents in South Korea. METHODS: This study is descriptive research, nationwide survey, and the subjects are 23,492 residents selected by convenience sampling. Data collection was conducted between March 1 and June 30, 2011, and stool collection and questionnaire survey were conducted by affiliated public health centers in 38 cities and Gun's. RESULTS: The prevalence rates of Clonorchiasis in the five major riversides were as follows: the Guem River 15.2%; the Nakdong River 11.9%; the Seomjin River 10.9%; the Han River 5.7%; and the Yeongsan River 3.9%. The prevalence rates were shown to be significantly high among people who had highly frequent experiences of eating and cooking freshwater raw fish, were diagnosed with liver and/or biliary tract diseases, and drank less than once a month. CONCLUSION: These results suggest that it is necessary to improve awareness of Clonorchiasis and provide intensive public health education for the riverside residents. And the target groups should be set up by reflecting the characteristics of at-risk groups, and it is necessary to prepare customized strategies for prevention and management of Clonorchiasis.

Nurse Staffing Levels and Proportion of Hospitals and Clinics Meeting the Legal Standard for Nurse Staffing for 1996~2013 / 간호행정학회지

PURPOSE: To analyze the proportion of medical institutions meeting the legal standard for nurse staffing. METHODS: Data collected from 29,282 institutions between 1996 and 2013 were analyzed. Nurse staffing was measured as daily patient census per registered nurse (RN). The standard for general hospitals, hospitals, and clinics is 2.5 or less, and that for long-term care hospitals is 6.0 or less of the daily patient census per RN. Clinics may substitute nursing assistants for RNs by 50% or 100% depending on their daily inpatient census; long-term care hospitals may substitute nursing assistants for RNs by two thirds of the required number of RNs. RESULTS: The proportion of general hospitals, hospitals, clinics, and long-term care hospitals meeting the standards was 63%, 19%, 63%, and 94%, respectively, in 2013. While general hospitals had an increase in the proportion during the 1996-2013 period, small changes were found in hospitals and clinics. In 2013, nurses were estimated to care for 16 (interquartile range: 12~24) patients per shift in general hospitals. Three quarters of clinics had no RNs in 2013. CONCLUSION: Many medical institutions did not meet the legally mandated minimum staffing level. The government must implement policy actions for all medical institutions to meet the legal standards.

Direction of the Community Health Nursing Practice Education Focusing on the Nursing Education Accreditation Criteria

PURPOSE: The purpose of this study was to seek the direction of community health nursing practice education focus on the nursing education accreditation criteria. METHODS: We collected data through e-mail survey to all of 202 Korean nursing baccalaureate education institute in April, 2016. The 93 professors teaching community health nursing was responded about their affiliated institute (response rate 46.0%). RESULTS: The Korean nursing graduates in Feb. 2016 was practiced 3.01 credits, 131.6 hours in community health nursing course. Community health nursing practice agency was public health center (98.9%), Public health center post (43.0%), Public health center branch (32.3%) in order. The possibility to achieve the course objectives up to national examination was recognised Public health center (3.4), Public health center post (3.3), Public health center branch and school (3.2) from 5 score likert scale. A lot of nursing education institute have difficulty in clinical placement in community health nursing practice agency that meet eligibility of preceptor and space gaining for only nursing students. CONCLUSION: The nursing education accreditation criteria in 3rd cycle have to be considered real community health nursing practice situation and newly emerging community health nursing fields.

A Design for and Evaluation of a Critical Thinking Class for New Community Health Practitioners / 한국간호교육학회지

PURPOSE: This study was carried out to describe the process and evaluation of a critical thinking class for new community health practitioners. METHODS: The case study design was used to develop and evaluate a critical thinking class for 46 participants in the community health practitioners training program. The class was held two hours a week for 8 weeks. Critical thinking disposition was tested before and after the class and critical skill was graded according to the final test score. Data analysis was performed using descriptive statistics and paired t-tests using SPSS WIN 20.0. RESULTS: Clinical critical thinking competences were identified through the literature review. The case situations with questions guiding the problem-solving process were developed and used for group discussion. Critical thinking disposition of participants was determined to have increased slightly after having taken the class. 17.4% of the participants had a competency level high enough to solve a problem and half of them stayed at the level of understanding of critical thinking. Compared with the class's satisfaction with the relevance to their jobs, the satisfaction with the learning method and instructor was high. CONCLUSION: The findings of this research will serve as the basis for developing critical thinking classes for community health nurses in order to improve their critical thinking competence.

Prevalence and Risk Factors of Clonorchiasis among Residents of Riverside Areas in Muju-gun, Jeollabuk-do, Korea

We evaluated the status of Clonorchis sinensis infection and potential risk factors among residents of riverside areas (Geumgang) in Muju-gun, Jeollabuk-do (Province), Korea. From January to February 2010, a total of 349 (171 males, 178 females) stool samples were collected and examined by the formalin-ether concentration technique. Also, village residents were interviewed using questionnaires to obtain information about C. sinensis infection-related risk factors. Overall egg-positive rate of C. sinensis was 13.2%. Egg-positive rates were significantly higher in males, farmers, and residents who had lived there more than 20 years, and in residents who had eaten raw freshwater fish than in opposite groups, respectively. However, there was no significant difference between age groups, education levels, cigarette smoking, alcohol drinking, health status, past history of infection, and experience of clonorchiasis medication and examination. Logistic regression analysis was performed to determine risk factors for clonorchiasis. On univariate analysis, the odds ratios for males, farmers, those who had lived there more than 20 years, and who had eaten raw freshwater fish were 2.41, 4.44, 3.16, and 4.88 times higher than those of the opposites, respectively. On multivariate analysis, the odds ratio of residents who had eaten raw freshwater fish was 3.2-fold higher than that of those who had not. These results indicate that residents living in Muju-gun, along the Geum River, Korea, have relatively high C. sinensis egg-positive rates, and the habit of eating raw freshwater fish was the major factor for the maintenance of clonorchiasis.

Job Competencies and Educational Needs Perceived by New Community Health Practitioners

PURPOSE: This study was performed to identify job competencies and needs for job education perceived by new community health practitioners. METHODS: This study used a qualitative research design. Eight new community health practitioners participated in this study. Data were collected through in-depth interviews and analyzed using content analysis. RESULTS: Five job competencies were identified in this study, including primary care, public health management, interpersonal relationship, teaching and counseling, and leadership. The contents of job education that they needed were management of major symptoms and chronic diseases, understanding and prescription of medications, emergency responses and care, management of endemic diseases, planning and management of public health programs, writing official documentsand computer works, and leadership training. The learning methods they preferred were connecting theory and practice, situation- or case-based learning, skill- or practice-based learning, and increased opportunities of clinical practice. CONCLUSION: The findings of this study provided the direction of job education for new community health practitioners. Job education for new community health practitioners needs to consider the job competencies and educational needs identified in this study.

Effects of a Clonorchiasis Prevention Education Program for Clonorchiasis Prevention Lecturers

PURPOSE: The study was conducted to clarify effects of a clonorchiasis prevention education program for clonorchiasis prevention lecturers. METHODS: The research adopted a single group pretest-posttest design to see effects of the educational program to prevent Clonorchis sinensis infection. The subjects of this study were 74 clonorchiasis prevention lecturers from primary health care facilities. The pretest was conducted before the clonorchiasis prevention education program and the post test was done after the 2-day program in August, 2011. Descriptive statistics, t-test, and ANOVA were conducted to analyze the data. RESULTS: The confidence level in Clonorchiasis management activities was improved significantly from 4.1+/-0.53 points before the education to 4.4+/-0.46 points after the education (t=-5.117, p<.001). The knowledge level about prevention of Clonorchis sinensis was improved significantly from 16.1+/-2.72 points before the education to 18.3+/-1.14 points after the education (t=-6.629, p<.001). CONCLUSION: The results suggest that the education program was effective in improving the confidence and knowledge levels in Clonorchiasis management activities for the clonorchiasis prevention lecturers. Based on the results of this study, continuous research on how the increased knowledge and confidence levels of Clonorchis sinensis prevention affect the prevalence of Clonorchis sinensis infection.

Reliability and Validity of the Korean Version of the Copenhagen Psyco-social Questionnaire Scale / 한국직업건강간호학회지

PURPOSE: This study aims to test the validity and criteria-related reliability of the Korean version of the Copenhagen Psyco-social Questionnaire version II (COPSOQ-K) assessing the psychosocial working environment. METHODS: The COPSOQ-K was developed through forward-backward translation techniques, and revision based on feedback from focus groups. Survey data were collected from 311 office workers who worked in one workplace. An internal consistency reliability was estimated by Cronbach's alpha. The impacts of the COPSOQ-K scales on job satisfaction, self-rated health, stress, sleeping troubles, burnout, and sickness absence were analyzed with multiple regression model or multiple logistic regression model, adjusted age and gender using SAS version 9.3. The Pearson correlation coefficients between the COPSOQ-K scales and Korean job stress and its subdomain were identified. RESULTS: Cronbach's alpha of COPSOQ-K scales was adequate or good (0.66~0.87). The major COPSOQ-K scales predict job satisfaction, self-rated health, stress, sleeping troubles burnout, and sickness absence. The major COPSOQ-K scales were correlated with Korean job stress and its subdomain. CONCLUSION: The COPSOQ-K scales have satisfactory reliability and criteria-related validity. The COPSOQ-K scales will be useful for the future studies and practices associated with psychosocial working environment.