PURPOSE: This study aimed to identify variables influencing the psychosocial adjustment of North Korean adolescent refugees in order to establish a structural equation model and design an intervention strategy to improve psychosocial adjustment. METHODS: The subjects included 290 North Korean adolescent refugees aged 16~24 years who were enrolled in alternative schools or regional adaptation centers. They were surveyed using a structured questionnaire. RESULTS: The goodness of fit measures of the model were as follows: x²=131.20 (p < .001), GFI=.93, CFI=.91, TLI=.86, RMSEA=.08, and SRMR=.07. The results estimated from the structural equation model indicated a good fit of data to the hypothesized model, which proposed that stress and emotional intelligence are associated with psychosocial adjustment. The major variables influencing psychosocial adjustment were stress, emotional intelligence, which was a significant direct effect, whereas attitude of parenting showed an indirect effect on psychosocial adjustment through emotional intelligence. These variables account for 50.0% of psychosocial adjustment. CONCLUSION: It is necessary to develop a program and intervention plan that can enhance emotional intelligence and thereby relieve the stress of North Korean adolescent refugees. The program should also include parenting education so that parents have positive attitude of parenting.
Adolescent* ; Democratic People's Republic of Korea ; Education, Nonprofessional ; Emotional Intelligence ; Humans ; Intelligence ; Parenting ; Parents ; Refugees* ; Stress, Psychological

Purpose: This study aimed to investigate nursing students’ learning agility and confirm the mediating effect of self-leadership in the relationship between achievement motivation and learning agility. Methods: The study design was a descriptive survey design. The subjects were third- and fourth-year nursing students attending three universities in one region. Data were collected from November 28, 2019, to May 25, 2020, and a total of 202 data were collected using the scale of achievement motivation, self-leadership, and learning agility. Data analysis included frequency analysis, descriptive statistics, and Pearson's correlation coefficient using SPSS 25.0 statistics 25.0 software. The mediating effect of self-leadership was analyzed through regression analysis and bootstrapping using process macro ver. 3.4.1. Results: Self-leadership’s partial mediating effect was confirmed in achievement motivation and learning agility. Achievement motivation was found to affect directly learning agility, with an indirect effect through self-leadership. Conclusion The study results showed that nursing students could increase their learning agility through self-leadership improvement. Future research should focus on identifying the factors influencing nursing students’ learning agility and develop and apply programs to improve learning agility.

PURPOSE: This concept analysis was done to clarify ‘uncertainty in epilepsy’. METHODS: Walker and Avant's methodology guided the analysis. In addition, the concept was compared with uncertainty in other health problems. RESULTS: ‘Uncertainty in epilepsy’ was defined as being in the condition as seen from the epilepsy experience where cues were difficult to understand because they changed, were in discord with past ones, or they had two or more contradictory values at the same time. Uncertainty in epilepsy is evolved from appraisal of the epilepsy experience. As a result, uncertainty leads epilepsy patients, their family or health care providers to impaired functioning and proactive/passive coping behavior. CONCLUSION: Epilepsy patients with uncertainty need to be supported by nursing strategies for proactive, rational coping behavior. This achievement has implications for interventions aimed at changing perception of epilepsy patients, their families or health care providers who must deal with uncertainty.
Adaptation, Psychological ; Cues ; Epilepsy* ; Health Personnel ; Humans ; Nursing ; Uncertainty* ; Walkers

PURPOSE: This study examined the characteristics differences associated with 1-year continuous smoking abstinence in Korean young adult and middle-aged male workers. METHODS: 'Korea National Health and Nutrition Examination Survey (KNHANES)' is an ongoing surveillance system that assesses the health and nutritional status of Koreans. For a secondary analysis of cross-sectional data from KNHANES VI-1, this study selected 683 Korean male workers as a subpopulation, who were young adult or middle-aged. The subpopulation was composed of success or failure group of 1-year continuous smoking abstinence. Binomial logistic regression analysis was performed. RESULTS: Success group was more likely to be older, live in urban areas, rate their health status as excellent or good, and have ever been diagnosed with hypertension than failure group. Additionally, Success group was less likely to have used electronic cigarettes (e-cigarettes), drink more than once a month, and have been exposed to secondhand smoking in workplace within a week. CONCLUSION: Developing smoking cessation programs requires consideration of resources in rural areas, promoting self-efficacy, restricting e-cigarettes and drinking, and promoting a smoke-free workplace.
Cross-Sectional Studies* ; Drinking ; Electronic Cigarettes ; Employment ; Humans ; Hypertension ; Logistic Models ; Male* ; Middle Aged ; Nutrition Surveys ; Nutritional Status ; Smoke* ; Smoking Cessation ; Smoking* ; Tobacco Smoke Pollution ; Young Adult*

Purpose: The purpose of this study is to determine the influence of the learning environment on nursing students' clinical practice education and the violence experienced during clinical practice on vocational identity. Methods: The design of the study was a descriptive survey, and data were collected from November 15 to November 27, 2019. The data of the study were obtained from 515 nursing students attending three universities using self-administered questionnaires. Data were analyzed using the SPSS 25.0 program. Results: For the experience of violence, verbal violence (98.3%) was the type most commonly experienced, and patients (97.7%) were the most frequent perpetrators. The clinical learning environment was perceived differently according to gender, personality, interpersonal relationship, satisfaction with nursing, clinical practice satisfaction, violence prevention education, the need for violence prevention education, sexual violence experiences, and violent perpetrators. The most influential factor on vocational identity was satisfaction with the nursing major (β=0.24, p<.001), followed by extroverted personality (β=0.18, p<.001), clinical learning environment (β=0.15, p=.001), satisfaction with clinical practice (β =0.15, p=.002), and the experience of violence by patients (β=-0.10, p=.016), which together explained 24.1% of the variance in the model. Conclusion It is necessary to make efforts to ensure that students do not experience violence during clinical practice, to maintain a close cooperative relationship between university and clinical institutions to improve the learning environment for clinical practice, and to make the clinical field an educational learning environment.

Purpose: This study aimed to identify the modifiable factors affecting breastfeeding planning and duration among healthy mothers and their use of breastfeeding information resources. Methods: A cross-sectional survey was conducted in a community setting. Four hundreds participants were recruited at five pediatric clinics and three community health centers located in Paju-si and Goyang-si, Gyeonggi-do, between January and May 2019. Based on the breastfeeding decision-making model, driven by Martens and Young’s work, the survey items consisted of demographics, childbirth and breastfeeding characteristics, and breastfeeding information resources. In the analysis, 389 responses were used in the t-test, ANOVA, and logistic regression. Information resource networks were compared before and after childbirth including a subgroup analysis depending on the breastfeeding duration. Results: The modifiable factors affecting breastfeeding planning and duration were antenatal and postpartum breastfeeding education and the provision of information in the hospital.The frequency of Internet use and websites visited were notable and potentially modifiable factors, which were also observed in the networks showing different relationship patterns according to participant subgroups and times. The childbirth event increased the centralization of the network in the planned group, while the network of the non-planned group was more diffused after childbirth. The network of the short-term breastfeeding group was characterized by a more centralized pattern and the resources of high betweenness centrality than the long-term group. Conclusion Breastfeeding education is a consistent factor that affects breastfeeding behavior. A well-designed internet-based approach would be an effective nursing intervention to meet the needs of women seeking breastfeeding information and changing their behaviors.

Purpose: The purpose of this study is to determine the influence of the learning environment on nursing students' clinical practice education and the violence experienced during clinical practice on vocational identity. Methods: The design of the study was a descriptive survey, and data were collected from November 15 to November 27, 2019. The data of the study were obtained from 515 nursing students attending three universities using self-administered questionnaires. Data were analyzed using the SPSS 25.0 program. Results: For the experience of violence, verbal violence (98.3%) was the type most commonly experienced, and patients (97.7%) were the most frequent perpetrators. The clinical learning environment was perceived differently according to gender, personality, interpersonal relationship, satisfaction with nursing, clinical practice satisfaction, violence prevention education, the need for violence prevention education, sexual violence experiences, and violent perpetrators. The most influential factor on vocational identity was satisfaction with the nursing major (β=0.24, p<.001), followed by extroverted personality (β=0.18, p<.001), clinical learning environment (β=0.15, p=.001), satisfaction with clinical practice (β =0.15, p=.002), and the experience of violence by patients (β=-0.10, p=.016), which together explained 24.1% of the variance in the model. Conclusion It is necessary to make efforts to ensure that students do not experience violence during clinical practice, to maintain a close cooperative relationship between university and clinical institutions to improve the learning environment for clinical practice, and to make the clinical field an educational learning environment.

Purpose: This study aimed to identify the modifiable factors affecting breastfeeding planning and duration among healthy mothers and their use of breastfeeding information resources. Methods: A cross-sectional survey was conducted in a community setting. Four hundreds participants were recruited at five pediatric clinics and three community health centers located in Paju-si and Goyang-si, Gyeonggi-do, between January and May 2019. Based on the breastfeeding decision-making model, driven by Martens and Young’s work, the survey items consisted of demographics, childbirth and breastfeeding characteristics, and breastfeeding information resources. In the analysis, 389 responses were used in the t-test, ANOVA, and logistic regression. Information resource networks were compared before and after childbirth including a subgroup analysis depending on the breastfeeding duration. Results: The modifiable factors affecting breastfeeding planning and duration were antenatal and postpartum breastfeeding education and the provision of information in the hospital.The frequency of Internet use and websites visited were notable and potentially modifiable factors, which were also observed in the networks showing different relationship patterns according to participant subgroups and times. The childbirth event increased the centralization of the network in the planned group, while the network of the non-planned group was more diffused after childbirth. The network of the short-term breastfeeding group was characterized by a more centralized pattern and the resources of high betweenness centrality than the long-term group. Conclusion Breastfeeding education is a consistent factor that affects breastfeeding behavior. A well-designed internet-based approach would be an effective nursing intervention to meet the needs of women seeking breastfeeding information and changing their behaviors.

Purpose: This study aimed to explore nursing students’ experience with community-linked nursing education programs. Methods: This study utilized a qualitative content analysis. Participants were 55 sophomore nursing students. The community-linked nursing education program was conducted for eight weeks using the Analysis, Design, Development, Implementation, Evolution (ADDIE) model. Data were collected from 55 reflection records and five individual interviews and then analyzed through the three steps of qualitative content analysis, coding, condensing, and categorizing. Results: Twelve categories, 26 subcategories, and six topics emerged. The themes of impression and lesson from the community-linked nursing education programs were “recognizing the importance of professional competence in performing the role of nurse,” “recognizing the need for leadership and cooperation in nursing practice,” and “increased awareness of the role as a nursing professional for community residents.” The themes of the strategies used were “looking at the goal and moving forward,” and “aligning differences and working together with team/community members.” The theme of strategies for the advancement of community-linked nursing education programs was “establishing a sustainable student-participating community-linked education program.” Conclusion The community-linked nursing education programs made students aware of the necessary competencies as professionals. In particular, they gave them hope for their role as professional nurses in the community. It could also be seen that they developed the ability to engage in team activities for community activities. Community-linked nursing education programs will need to be developed into continuous programs with community residents.

PURPOSE: The purpose of this study was to evaluate the nutritional status of low-income urban elders by diversified ways, and to analyze the risk factors for malnutrition. METHODS: The participants in this study were 183 low-income elders registered at a visiting healthcare facility in a public health center. Data were collected using anthropometric measurements, and a questionnaire survey. For data analysis, descriptive statistics, chi2-test, t-test, Fisher's exact test, multiple logistic regression analysis were performed using SPSS 20.0. RESULTS: Regarding the nutritional status of low-income elders as measured by the Mini Nutritional Assessment (MNA), 10.4% of the elders were classified as malnourished; 57.4% as at high risk for malnutrition; and 32.2% as having normal nutrition levels. The main factors affecting malnutrition for low-income elders were loss of appetite (OR=3.34, 95% CI: 1.16~9.56) and difficulties in meal preparation (OR=2.35, 95% CI: 1.13~4.88). CONCLUSION: In order to effectively improve nutrition in low-income urban elders, it is necessary to develop individual intervention strategies to manage factors that increase the risk of malnutrition and to use systematic approach strategies in local communities in terms of a nutrition support system.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Depression/pathology ; Female ; Health Behavior ; Health Status ; Humans ; Male ; *Malnutrition ; *Nutritional Status ; Oral Health ; Poverty ; Questionnaires ; Risk Factors ; Severity of Illness Index ; Urban Population