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Original Articles
Psychometrics of Task Self-Efficacy Scale for Korean Elderly
Young Rhan Um, Rhayun Song, Yean Ok Suh, Kyung Ja June, Beverly L Roberts
Journal of Nurses Academic Society 1997;27(4):831-842.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.4.831
AbstractAbstract PDF

The purpose of the study was to test the reliability and validity of the Korean version of Task Self-Efficacy Scale for activities of daily living(ADL). The Task Self-Efficacy Scale was developed by Roberts(1996) for low-intensity exercise study with older people to predict their performance of ADL. The scale was translated and back translated by bilingual persons, and then was modified to resolve variations in the translations. The Korean version of Self-efficacy Scale of ADL was then administered to 193 elderly people including 95 hospitalized patients and 98 outpatients or healthy people. Face to face interview was used to fill out the structured questionnaire, and each interview took approximately 30 minutes. The subjects for the study were 80 women and 112 men with an age range of 65 to 95 years(M=71 years) of whom 82.6% classified themselves as moderate or quite active. Most subjects(80.2%) had an education level of elementary school or less. The Self-Efficacy Scale for ADL is measured on a 0 to 10 VAS, assessing three areas of ADL : self care activities, household tasks, and motor tasks. The higher the score is the higher person's confidence in performing ADL. Psychometric testing revealed that the scale was found to be internally consistent, showing a Cronbach's alpha of .97. The scale was significantly correlated with subjects' level of activity and subjective assessment of their health status. Moderate correlation with health-related hardiness scale also supported the validity. Factor analysis was performed to confirm whether the scale represents the three sub-areas as suggested in the literature. The results of the factor analysis led to a three factor solution according to Kaiser's criterion, but the items were not strongly and cleanly loaded for the third factor. This can be explained in that, among the three sub-ADL ares of the self-efficacy scale, the areas of self care activities and household tasks seem to have similar levels of difficulty in performance with not enough differences for the self-efficacy scale to distinguish between the two areas. Therefore, one factor solution was suggested since ADL can be seen a unit of activities as similar level of difficulty in performance. One factor solution explained 68.1% of variance of the 19-item scale and all items all correlated over .6 with the factor, showing that the selected factor solution fits the model. The results indicated that the Korean version of Task Self-Efficacy Scale for ADL was reliable and valid in producing useful information to evaluate the effects of various interventions toward promoting health and quality of life for elderly people.

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Effects of Low-intensity Exercise on Functional Ability in Hospitalized Elderly
Rhayun Song, Yeon Ok Suh, Young Rhan Um, Kyung Ja June, Beverly L Roberts
Journal of Nurses Academic Society 1997;27(4):807-819.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.4.807
AbstractAbstract PDF

The purpose of the study was to identify the effects of 12-week low-intensity exercise program on muscle strength, flexibility, balance, and cognitive characteristics related to the performance of activity of daily living(ADL). A total of 16 patients who were admitted to the medical unit of a general hospital in ChoongChung province were recruited eight for the exercise group and eight for the comparison group. Four levels of low-intensity exercise from 'ROM on bed' to 'exercise while walking' were then applied to the exercise group according to their physical condition. During hospitalization, patients in the exercise group performed each level of the prescribed exercise with the researchers until they felt. comfortable doing it independently. The researchers also visited the patients' homes after discharge to make sure they could perform the exercise with Theraband in their living environment. The exercise group was contacted by phone once a week to assess the frequency and intensity in which they performed the exercise as well as their physical condition. The subjects in the comparison group participated in measurements for the study without performing the exercise and were contacted by phone after discharge, in a matched time frame with the exercise group, to assess physical condition. Muscle strength, flexibility, balance, cognitive characteristics, and performance of ADL for the two groups were compared at the pretest and the posttest after the low-intensity exercise program by utilizing SPSSWIN and the results are as follows : 1) At the posttest, measurments of muscle strengths showed that the strength of the dorsal flexor in the exercise group was significantly higher than in the comparison group. 2) Objective balance for the exercise group was significantly better than for the comparison group as measured by 'standing on one foot' and Tinetti gait and balance control. 3) The exercise group showed significantly higher task self-efficacy than the comparison group. 4) Perceived exertion for ADL for the exercise group was significantly lower than for the comparison group. 5) Improvement of performance of ADL without assistance was significantly for the exercise group than the comparison group. The findings suggest that a low-intensity exercise program would be useful for the elderly who show decline in their physical functioning due to hospitalization by partly improving physical strength, task self-efficacy, and performance of ADL. Directions for further research on issues of motivating people to exercise as well as of standardizing various types of exercise were discussed.

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Effects of Motivation-Enhancing Program on Health Behaviors, Cardiovascular Risk factors, and Functional status for Institutionalized Elderly Women
Rhayun Song, Kyung Ja June, You Ja Ro, Chun Gill Kim
Journal of Korean Academy of Nursing 2001;31(5):858-870.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.5.858
AbstractAbstract PDF

This study was to compare changes in health behaviors, motivational factors, cardiovascular risk factors, and functional status (SIP) after implementing the 6-month motivation-enhancing program to institutionalized elderly women.
METHODS
Sixty-four elderly women participated. Face to face interviews with blood sampling and anthropometric assessment were conducted at the pretest, 10 weeks and 6 months during the program.
RESULTS
1. The program participants showed significantly better health behaviors over 6 months. The mean motivational level was also significantly improved, especially for perceived benefits, perceived barriers, and emotional salience. 2. The mean of cardiovascular risk factors for the participants was 21.8 at the level of low to moderate risk. After completing the program, total risk score was significantly decreased to 18.7 at 10 weeks, and further to 17.7 at 6 months. A significant reduction was also found in HDL and LDL-cholesterol levels, blood pressure, obesity, inactivity, and stress. 3. The functional status (SIP) was 11% at the baseline and significantly changed in positive direction at 10 weeks (M=9.3) and at 6 month (M=6.3). The significant improvement was also found in physical and psychosocial dimensions and sleep/rest dimension.
CONCLUSION
The motivation enhancing program was effective to reduce cardiovascular risks and to improve the functional status of institutionalized elderly women by motivating them to perform better health behaviors.

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A Survey on Functional Status among Low-Income Older Adults Living at Home
Kyung Ja June, Yoon Mi Cho
Journal of Korean Academy of Nursing 2001;31(5):749-758.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.5.749
AbstractAbstract PDF

PURPOSE: The purpose of the study was to analyze the functional status of low income elderly living at home according to their socio-economic factors, sensory function, health status, medical service utilization, commodity and types of chronic disease.
METHOD
Functional status was defined by the level of mobility, ADL and IADL categorized as independently functional, mildly impaired, moderately disabled, and severely disabled. The data was collected by home-visit interviews with 567 community dwelling adults who were 65 years of age or more with low a income status subsidized by government in ChonAn.
RESULTS
9.9% of community dwelling older adults were severely disabled, and 44.4% were moderately disabled in their functional status. There were significant differences in the functional status by age, education, religion, and types of family structure. The older adults with hearing impairment or dental problems had a significantly higher rate of severe disability. Self-rated health status and medical service utilization were also significant factors to the differences in functional status. The functional status of older adults was also significantly related to the presence of chronic health problems such as chronic back pain, stroke, and Alzheimer-dementia.
CONCLUSION
The results confirmed that community dwelling older adults with low income status were more functionally disabled in comparison to general older adults at national level, while the relating factors to their functional status seemed similar to other studies on older adults. Further studies were suggested to look into functional status longitudinally and focus on the changes of functional status by managing modifiable influencing factors.

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The Influencing Factors on the Quality of Job Role of Married, Working Women in Korea
Eun Ok Park, Kyung Ja June
Journal of Korean Academy of Nursing 2000;30(7):1697-1708.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.7.1697
AbstractAbstract PDF

The labor participation rate of women are increasing, especially for married and 30 and over aged women in Korea. The employment of married women occurs dual-role problems. But recent empirical evidences suggest that employment yields a net gain of benefits over costs with respect to both physical and mental health for women as well as men. Previous researches suggested that the quality of the role or role satisfaction, not the occupancy of the role, is one of the predictors of psychological health. The purpose of this study is to investigate influencing factors on quality of job role for Korean women with children and husband. Data were collected from 323 mothers of students at 3 kindergartens, 2 elementary schools, 3 middle schools, 4 high schools in metropolitan area, during 1998.8 - 1998.12. they were dual-earner couples, and were employed over one year. Response rate is 62.3%. Quality of role was measured using Role Quality Scale developed by Park, June & Kim(1999). This instrument is based on Role Rewards and Concerns Scale of Barnett et al.(1993) for quality of job role. Quality of job role is made of 27 items and the subfactors are interpersonal relationship, job stress, pride, payment, and autonomy. Scales have good internal consistency(Cronbach ??= 0.86). The findings of this study show that personal income, occupation, husband's attitude for wife's employment, and the perceived equity for labor division between couples are significant variables for quality of job role. But age, education, career years, working hours per week are not significant. 24.83% of the variance in quality of job role were accounted for by these variables.

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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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The Importance of Smoking Definitions for the Study of Adolescent Smoking Behavior
Sunhee Park, Kyung Ja June
Journal of Korean Academy of Nursing 2006;36(4):612-620.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2006.36.4.612
AbstractAbstract PDF
Purpose

Smoking is the leading cause of death and smoking initiation rarely occurs after adolescence. Thus research on adolescent smoking is crucial. A consistent definition of smoking is important because inconsistent definitions make comparisons across studies an arduous task. Thus, the aim of the study was to suggest future research directions for smoking definitions after examining pitfalls in the literature.

Methods

In this study the literature on adolescent smoking in the U.S. and South Korea was examined, and three types of smoking definitions were identified. Limitations in the studies are identified and future research directions are suggested.

Results

In the U.S. literature, smoking definitions can be categorized into three groups: definitions based on stage models, smoking trajectories, and definitions derived from specific data. In the South Korean literature, various levels of smoking have not been differentiated.

Conclusions

While the literature does not provide a definitive answer regarding the definition of smoking, it suggests three issues to consider for future research. First, multiple measures of smoking are more desirable than a one-time measure. Second, theory- or trajectory-based smoking definitions are more desirable than definitions derived from available data. Finally, regularity and amount of cigarette use should be incorporated in defining smoking behavior.

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Factors Related to Nurse Staffing Levels in Tertiary and General Hospitals
Yun Mi Kim, Kyung Ja June, Sung Hyun Cho
Journal of Korean Academy of Nursing 2005;35(8):1493-1499.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.8.1493
AbstractAbstract PDF
Background

Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services.

Purpose

To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics.

Methods

A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals.

Results

None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing.

Conclusions

The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.

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Effects of Hospital Nurse Staffing on in-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection in Surgical Patients
Yunmi Kim, Sung-Hyun Cho, Kyung Ja June, Soon Ae Shin, Jiyun Kim
J Korean Acad Nurs 2012;42(5):719-729.   Published online October 12, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.5.719
AbstractAbstract PDF
Purpose

This study was done to examine relationships between nurse staffing level and postsurgical patient outcomes using inpatient database from the National Health Insurance.

Methods

Records of 111,491 patients who received one of 12 types of surgery between January and December, 2009 were identified and analyzed in this study. Nurse staffing level was measured using adjusted nurse staffing grades from 0 to 7. Patient outcomes were defined as in-hospital mortality, or pneumonia, sepsis, or urinary tract infection after surgery. Logistic regression analyses estimated by Generalized Estimation Model, were used to analyze the association between nurse staffing level and patient outcomes.

Results

An inverse relationship was found between nurse staffing and patient mortality. Compared with patients who were cared for in hospitals with the highest nurse staffing (Grades 0-1), increases in the odds of dying were found in those with Grades 6-7 [OR (odds ratio)= 2.99, 95% CI (confidence interval)= 1.94-4.60], those with Grades 4-5 (OR= 1.78, 95% CI= 1.24-2.57) and those with Grades 2-3 (OR= 1.57, 95% CI= 1.25-1.98). Lower nurse staffing level was also associated with higher number of cases in pneumonia and sepsis.

Conclusion

Policies for providing adequate nurse staffing is required to enhance quality of care and lead to better perioperative patient outcomes.

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Effects of Case Management using Resident Assessment Instrument-Home Care (RAI-HC) in Home Health Services for Older People
Kyung Ja June, Ji Yun Lee, Jong Lull Yoon
J Korean Acad Nurs 2009;39(3):366-375.   Published online June 29, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.3.366
AbstractAbstract PDF
Purpose

To evaluate the effects of case management using Resident Assessment Instrument-Home Care (RAI-HC) in home health service for older people.

Methods

All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Cognitive Performance Scale (CPS), Depression Rating Scale (DRS), Pain and the number of Clinical Assessment Protocols (CAP).

Results

Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression (odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL (OR: 4.423, CI: 1.151-16.999) and the number of CAP (OR: 11.443, CI: 3.805-34.410).

Conclusion

Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

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