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Research Papers
Determinants of Problem Drinking by Regional Variation among Adult Males in Single-Person Households: Geographically Weighted Regression Model Analysis
Ahn, Junggeun , Choi, Heeseung , Kim, Jiu
J Korean Acad Nurs 2023;53(1):101-114.   Published online February 28, 2023
DOI: https://doi.org/10.4040/jkan.22131
AbstractAbstract PDF
Purpose
This study aimed to identify regional differences in problem drinking among adult males in single-person households and predict the determinants.
Methods
This study used data from the 2019 Community Health Survey. Geographically weighted regression analysis was performed on 8,625 adult males in single-person households who had been consuming alcohol for the past year. The Si-Gun-Gu was selected as the spatial unit.
Results
The top 10 regions for problem drinking among adult males in single-person households were located in the Jeju-do and Jeollanam-do areas near the southern coast, whereas the bottom 10 regions were located in the Incheon and northern Gyeonggi-do areas. Smoking, economic activity, and educational level were common factors affecting problem drinking among this population. Among the determinants of regional disparities in problem drinking among adult males in single-person households, personal factors included age, smoking, depression level, economic activity, educational level, and leisure activity, while regional factors included population and karaoke venue ratio.
Conclusion
Problem drinking among adult males in single-person households varies by region, and the variables affecting each particular area differ. Therefore, it is necessary to develop interventions tailored to individuals and regions that reflect the characteristics of each region by prioritizing smoking, economic activity, and educational level as the common factors.
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Effectiveness of Drinking Reduction Program Focused on Self-Determination Enhancement for College Students with Problematic Drinking
Ma, Jin-Kyoung , Yoo, Moon-Sook
J Korean Acad Nurs 2021;51(3):265-279.   Published online June 30, 2021
DOI: https://doi.org/10.4040/jkan.20247
AbstractAbstract PDF
Purpose
This study examined the impact of a drinking reduction program on drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors in college students with problematic drinking habits.
Methods
This study incorporated a non-equivalent control group prepost-test design. Study participants included 58 college students who scored 12 or more in the AUDIT-K test (Alcohol Use Disorders Identification Test-Korean version) (experimental group: 30; control group: 28). The intervention consisted of eight sessions and was conducted once a week. It was designed to promote autonomy, competence, and relatedness-the three elements of basic psychological needs in self-determination theory. The participants were assessed before the intervention, immediately after, and four weeks post intervention. Data were collected from October 12 to December 31, 2017. The analysis employed the chi-square test, Fisher’s exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 22.0.
Results
The mean age of participants was 21.8 years. There were 30 men (51.7%) and 28 women (48.3%). The differences in drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors were statistically significant for the group by time interaction (F = 42.56, p < .001; F = 54.96, p < .001; F = 39.90, p < .001, respectively). Conclusion: The findings indicate that the intervention effectively decreases drinking motivation, increases drinking refusal self-efficacy, and decreases problematic drinking behaviors. It can be an efficient strategy for college students with problematic drinking habits to enhance their self-determination ability.
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Original Articles
Development of a Scale for Alcohol Drinking Prevention Behavior in Early Elementary School Based on Ajzen’s Theory of Planned Behavior
Kim, Younkyoung , Lee, Chong Mi , Kang, Seo Young
J Korean Acad Nurs 2020;50(2):210-227.   Published online April 30, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.2.210
AbstractAbstract PDF
Purpose
This study aimed to develop a scale to measure variables related to alcohol drinking prevention behavior in early elementary school, based on the theory of planned behavior.
Methods
A scale was developed to measure variables related to alcohol drinking prevention behavior. Initial items for direct evaluation were constructed through a literature review, and those for belief-based indirect measure were generated through interviews with 30 second- and third-grade elementary school students. The collected data from 286 third-grade elementary school students were then subjected to item analysis, exploratory and confirmative factor analysis, criterion-related validity testing, and internal consistency assessment.
Results
The final scale consisted of 35 items. Intention, attitudes, subjective norms, and perceived behavioral control explained 82.7% of the variance; behavioral beliefs, normative beliefs, and control beliefs explained 65.6% of the variance; and evaluation of outcome, motivation to comply, and power of control beliefs explained 72.8% of the variance. The confirmatory factor analysis indicated that the theoretical models had a satisfactory goodness of fit. Criterion-related validity was confirmed between the direct evaluation variables and the indirect measure variables (attitudes r=.64, p <.001; subjective norms r=.39, p <.001; perceived behavioral control r=.62, p <.001). Cronbach’s a was .89 for the direct evaluation variables and .93 for the indirect measure variables.
Conclusion
The scale developed in this study is valid and reliable. It could be used to measure and explain variables related to alcohol drinking prevention behavior in early elementary school.
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Incidence of Colon Cancer Related to Cigarette Smoking and Alcohol Consumption in Adults with Metabolic Syndrome: Prospective Cohort Study
Ahra Jo, Heeyoung Oh
J Korean Acad Nurs 2019;49(6):713-723.   Published online December 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.6.713
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the impact of cigarette smoking and alcohol consumption on the incidence of colon cancer in adults with metabolic syndrome.

Methods

This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study (KoGES). The data of a sample of 2,327 adults with metabolic syndrome tracked every two years from 2001 to 2014 were used in this study. Statistical data analyses of the frequency, number of cases per 100,000 person-years, log-rank test, Kaplan-Meier curve, and Cox's proportional hazards regression were performed using IBM SPSS statistics version 24.

Results

During the observation period, the number of colon cancer cases was 46, and the total person-years were 252,444. The incidence of colon cancer was higher in current, over 10 pack-year smokers when compared to non-smokers (hazard ratio=3.38, 95% confidence interval=1.09~8.42).

Conclusion

Excessive and long-term smoking should be avoided to prevent colon cancer, especially in adults with metabolic syndrome, since it might exacerbate the risk factors of colon cancer. Particularly, health professionals need to provide individualized smoking cessation interventions to those at high risk of colon cancer.

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Patterns of Drinking Behaviors and Predictors of Class Membership among Adolescents in the Republic of Korea: A Latent Class Analysis
Haein Lee, Sunhee Park
J Korean Acad Nurs 2019;49(6):701-712.   Published online January 17, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.6.701
AbstractAbstract PDF
Abstract Purpose:

Despite the high drinking rates and the complexity of drinking behaviors in adolescents, insufficient attention has been paid to their drinking patterns. Therefore, we aimed to identify patterns of adolescent drinking behaviors and factors predicting the distinct subgroups of adolescent drinking behaviors.

Methods:

We analyzed nationally representative secondary data obtained in 2017. Our final sample included 24,417 Korean adolescents who had consumed at least one glass of alcohol in their lifetime. To investigate patterns of drinking behaviors, we conducted a latent class analysis using nine alcohol-related characteristics, including alcohol consumption levels, solitary drinking, timing of drinking initiation, and negative consequences of drinking. Furthermore, we investigated differences in demographics, mental health status, and characteristics of substance use across the latent classes identified in our study. To do so, we used the PROC LCA with COVARIATES statement in the SAS software.

Results:

We identified three latent classes of drinking behaviors: current non-drinkers (CND), binge drinkers (BD), and problem drinkers (PD). Compared to the CND class, both BD and PD classes were strongly associated with higher academic year, lower academic performance, higher levels of stress, suicidal ideation, lifetime conventional or electronic cigarette use, and lifetime use of other drugs.

Conclusion:

Health professionals should develop and implement intervention strategies targeting individual subgroups of drinking behaviors to obtain better outcomes. In particular, health professionals should consider different characteristics across subgroups of adolescent drinking behaviors when developing the interventions, such as poor mental health status and other substance use among binge and problem drinkers.

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Comparison of Awareness about Alcohol Use during Pregnancy among Female College Students by Drinking Levels: Using the Theory of Planned Behavior
Saem Yi Kang, Hae Won Kim
J Korean Acad Nurs 2019;49(6):690-700.   Published online January 17, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.6.690
AbstractAbstract PDF
Abstract Purpose:

The purpose of this study was to examine the awareness of alcohol use during pregnancy and factors influencing the intention to abstain from alcohol during pregnancy by drinking levels.

Methods:

Utilizing a comparative descriptive design, a total of 359 female college students were recruited. Measurements were Theory of Planned Behavior (TPB) variables related awareness of alcohol use during pregnancy, Korean Version of the Alcohol Use Disorders Identification Test, knowledge about alcohol use during pregnancy, and socio-demographic factors. Main variables were compared by drinking levels. The factors influencing the intention to abstain from alcohol during pregnancy were identified using hierarchical regression analysis.

Results:

Non-problematic alcohol behavior group (n=185) had higher the intention to abstain from alcohol during pregnancy than problematic alcohol behavior group (n=174) (t=3.13, p=.002). The significant TPB variables influencing the intention to abstain from alcohol during pregnancy were that attitudes (β =-.44, p<.001), subjective norms (β =.14, p=.026), and perceived behavior control (β =.19, p=.002) in non-problematic alcohol behavior group, whereas the corresponding variables in the problematic alcohol behavior group were attitudes (β =-.51, p<.001) and subjective norms (β =.21, p=.006).

Conclusion:

It is necessary to increase the intention to abstain from alcohol during pregnancy for the female college students having problematic alcohol behavior. The following strategies are recommended for them; decreasing acceptable attitudes toward alcohol use during pregnancy and reinforcing the influence of social pressure toward to abstain from alcohol during pregnancy.

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Impact of Parents’ Problem Drinking on Suicidal Ideation of Their University Student Children : The Multiple Mediating Effects of Childhood Trauma, Experiential Avoidance and Depression
Eun Sook Lee, Eun Ju Bong
J Korean Acad Nurs 2018;48(5):565-577.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.5.565
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to construct and test a hypothetical model about impact of parents’ problem drinking on suicidal ideation of their children who are university students and the multiple mediating effects of childhood trauma, experiential avoidance, and depression based on stress-vulnerability model.

Methods

A purposive sample of 400 university students was recruited from three universities in provincial areas and the data were collected between October and November 2016. The collected data were then analyzed using SPSS 20.0 and AMOS 20.0 programs. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed. Multiple mediating effects analysis using phantom variable and bootstrapping were implemented to verify the mediating effect of the research model.

Results

We found no significant direct effect on depression and suicidal ideation of parents’ problem drinking, but multiple mediating effects of childhood trauma and experiential avoidance between parents’ problem drinking and depression (B=.38, p=.001). The path from parents’ problem drinking to suicidal ideation was significantly mediated by childhood trauma and depression (B=.02, p=.016) and by childhood trauma, experiential avoidance, and depression (B=.05, p=.011), but experiential avoidance did not have a significant direct effect on suicidal ideation (B=.02, p=.616). Conclusions: Based on the results of this study, it can be suggested that in order to decrease depression and prevent suicide of university students, considering of parents’ problem drinking and childhood trauma, intervention methods that decreased chronic use of experiential avoidance and strengthen acceptance should be developed and made available to them.

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The Effects of Loneliness on Alcohol Drinking, Smoking, and Health Perception in College Students
Ok Soo Kim
Journal of Korean Academy of Nursing 1999;29(1):107-116.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.1.107
AbstractAbstract PDF

The purpose of this study was to determine the effects of loneliness on drinking, smoking, and health perception(symptom pattern & subjective health) in college students. The convenience sample consisted of 417 college students attending four universities. The Revised UCLA Loneliness Scale(RULS) and the Symptom Pattern Scale were used to collect the data. In this study, 84.7% of the subjects used alcohol, with a mean of 5.52 drinks per week, and 32.9% of the subjects smoked for a mean of 5.08 cigarette packs per week during the previous month. The mean score loneliness measured by the RULS was 40.82, indicating that the subjects were moderately lonely. The majority of the subjects had a low level of symptom pattern and evaluated their health as either very good or good. The level of alcohol drinking and the smoking increased and symptom pattern decreased with age. Female students were lonelier than male students in this study. Also, the female students had a lower level of symptom pattern and evaluated their health worse than the male students. Male students consumed more alcohol and smoked more cigarette than female students. Living arrangement was significantly related to the level of loneliness. The subjects who lived with their parents and siblings were less lonely than those who lived with their friends, or relatives or who lived in a dormitory. Age and religion were not related to the level of loneliness. The level of loneliness influenced drinking, symptom pattern, and subjective health. The study found that subjects who were more lonely consumed alcohol less, had a higher level of symptom pattern, and perceived their health worse than those who were less lonely. Smoking was not influenced by loneliness in this study.

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A Study of Factors that Influence Internet Addiction, Smoking, and Drinking in High School Students
Kyung Ja June, Shin Young Sohn, Ae Young So, Ggod Me Yi, Sun Hee Park
Journal of Korean Academy of Nursing 2007;37(6):872-882.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.6.872
AbstractAbstract PDF

PURPOSE: This study aimed at exploring relationships among Internet addiction, smoking, and drinking and examining the effect factors on Internet addiction, smoking and drinking. METHODS: By using stratified sampling, 1,529 participants representing high school students in the Kangwon province were selected. Data was analyzed by SPSS 12.0. using chi-square, Pearson correlation coefficient and multiple regression. RESULTS: One-fifth of the total participants were at the mild or moderate stage of Internet addiction. Regarding smoking, 22.7% of male subjects and 4.5% of female subjects were current smokers. Regarding drinking, the percentages of subjects who drank alcohol once or twice per month were 53.5% of male students and 40.7% of female students. Internet addiction positively correlated with depression, novelty seeking, harm avoidance and reward dependence, Internet addiction negatively correlated with persistence, self-directness, cooperativeness, and self-transcendence. Significant factors affecting Internet addiction were depression, gender, novelty seeking, and self-transcendence. Important factors influencing smoking were drinking, gender, school type, satisfaction with school, novelty seeking, and reward dependence. Significant factors affecting drinking were smoking, novelty seeking, school type and ages. CONCLUSION: This study shows the necessity of developing and implementing effective intervention programs in order to prevent adolescents from experiencing Internet addiction and health risk behaviors.

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Development and Effects of a Drinking Prevention Program for Preschool Children
Younkyoung Kim, Chong Mi Lee, Jong Park
J Korean Acad Nurs 2016;46(2):183-193.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.183
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the effects of the program to promote drinking knowledge, attitudes, and coping behavior in preschool children.

Methods

A quasi-experimental with non-equivalent control group pretest-posttest design was conducted. The participants were 123 five year old children from G city. They were assigned to the experimental group (n=77) or the control group (n=46). A pretest and posttest were conducted to measure main variables. For the experimental group, the drinking prevention program was given for 6 weeks. Data were analyzed using χ2-test, t-test, and ANCOVA.

Results

After the intervention, preschool children in the experimental group reported significant differences in drinking knowledge (F=9.25, p=.003), drinking attitudes (F=19.57, p<.001), and coping behavior (F=16.38, p<.001) compared to preschool children in the control group.

Conclusion

The results of this study indicate that a drinking prevention program for preschool children is effective in increasing drinking knowledge, attitudes, and coping behavior. This drinking prevention program is recommended as an effective intervention for preschool age children to postpone an early introduction to drinking.

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Factors Affecting Social Competence in School-aged Children according to Alcohol Consumption by Parents'
Jin-A Lee, Young-Ran Kweon
J Korean Acad Nurs 2014;44(5):495-503.   Published online October 31, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.5.495
AbstractAbstract PDF
Purpose

The purpose of this study was to identify factors affecting the social competence of school-aged children according alcohol consumption by their parents.

Methods

The participants were 558 5th grade elementary school students. Data were collected using structured questionnaires from September 17 to October 2 2013, and analyzed using descriptive statistics, χ2-test, t-test, ANOVA, Pearson correlation coefficients, and Stepwise multiple regression analysis with the SPSS PC+ 21.0 program.

Results

Participants were classified into three groups according to alcohol use; Non-use parent group (52.7%), social use parent group (31.0%), and problem use parent group (16.3%). Participants whose parents were problem users had significantly lower scores on emotional awareness and expression (F=14.45, p<.001), social support (F=5.82, p=.003), and social competence (F=16.33, p<.001) compared to students in the other two groups. In school-aged children with parents who were alcohol abusers, the variables that predicted social competence was friend support (66.0%).

Conclusion

These results emphasize the importance of focusing on the crucial role of peer support in the development of social competence in school-aged children of parents who abuse alcohol. Further, for these children, interventions aimed at improving social support and children's emotional awareness and expression may be most beneficial.

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The Reliability and Validity of a Drinking Refusal Self-Efficacy Questionnaire-Revised (DRSEQ-R) in Korean College Students
Young-Ran Tak, Ji-Yeon An, Hae-Young Woo
Journal of Korean Academy of Nursing 2008;38(2):344-352.   Published online April 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.2.344
AbstractAbstract PDF
Purpose

This study was to test the reliability and validity of a Drinking Refusal Self-Efficacy Questionnaire-Revised (DRSEQ-R) in Korean college students.

Methods

The DRSEQ-R was designed to assess an individual's belief in their ability to refuse drinking alcohol by Oei et al. (2005) and consisted of three factors (social pressure, opportunity, and emotional relief). A methodological study design with an exploratory factor analysis for validity and correlation coefficients for reliability was used. DRSEQ-R was translated into Korean and a translation equivalency was obtained. DRSEQ-R was tested with a sample of 201 college students in Korea. The subjects consisted of 106 males and 95 females. Principal component factor analysis was used for construct validity and Cronbach's alpha was used to evaluate for internal consistency of the instrument.

Results

The factor analysis showed three factors explaining 66.3% of total variance and the corresponding factors were emotional relief (48.01%), drinking contextual opportunity (11.18%), and social pressure (7.14%). The internal consistency was acceptable (Cronbach's alpha=.937). All three factors of DRSEQ-R negatively correlated with alcohol dependency and a heavy drinker showed a lower DRSEQ-R than a moderate drinker.

Conclusion

Based on the findings, DRSEQ-R is a reliable and valid instrument to measure for drinking refusal self-efficacy in Korean college students.

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