BACKGROUND: Despite increasing the number of newly licensed nurses across Korea, shortages caused by geographical imbalances remains a significant concern. Therefore, understanding nursing students' attitudes to working and living, factors influencing where they first choose to work after graduation is useful in formulating appropriate interventions to retain nurses in regional areas. METHODS: A total of 329 senior nursing students from areas outside Metropolitan Seoul completed self-report questionnaires. Data were analyzed using t-test, chi-square test and multiple logistic regression analysis. RESULTS: Of the respondents, 57.8% reported that they planned to work in the region in which their school was located. The three factors ranked as having the greatest influence on their decision to work in non-metropolitan regions were: the cost of living, housing costs, and the proximity to family. Enjoyable aspects of rural life contributed positively to students' intentions to work in non-metropolitan regions, whereas isolation and socialization problems negatively affected their intentions to work in such areas. CONCLUSIONS: Greater consideration should be given to improving working conditions and housing environments in non-metropolitan regions.
Employment ; Hospitals, Rural ; Housing ; Humans ; Intention ; Korea ; Logistic Models ; Nursing ; Seoul ; Socialization ; Students, Nursing ; Surveys and Questionnaires

PURPOSE: Health care delivery systems in rural areas face numerous challenges in meeting the community's needs. There is a lack of adequate attention for this problem. This study aims to explore the challenges of the health care process in rural Iran according to health care providers' experiences. METHODS: This was a qualitative study that used the content analysis method. We selected a total of 21 health care providers based on purposive sampling. Data collection consisted of semi-structured individual interviews that were analyzed by qualitative content analysis. RESULTS: Data analysis led to the formation of one main category, the challenges of process of health care in rural society. Within this main category, we created the following subcategories: change in characteristics of the rural society, increase in complexity of the health care process, decrease in workforce efficiency, and decrease in propensity of people's care. CONCLUSION: The findings of this study indicate that the process of health care in Iranian rural society is changing rapidly with community health workers encountering new challenges. There is diminished efficiency in responding to the changing care process in Iran's rural society. Considering this change in process of care, therefore, the health care system should respond to these new challenges by establishing new health care models.
Community Health Workers ; Data Collection ; Delivery of Health Care ; Health Personnel ; Humans ; Iran ; Nursing Care ; Rural Health ; Rural Population ; Statistics as Topic

PURPOSE: The purpose of this study was to describe how the rural elderly cope with experiences in multiple chronic diseases. METHOD: Data were collected through participant observation and in-depth interview using ethnography. The participants were 9 women and 2 men who aged over 65, were living in rural community, and had experienced two or more chronic diseases. RESULTS: According to the results of this study, those who had experienced multiple chronic diseases went through the stages of 'recognizing of revealed symptoms', 'discovering of disease', 'overcoming', 'neglecting', 'discovering another disease', 'being frustrated' and 'living with suffering'. CONCLUSION: The results of this study are expected to be utilized as basic materials to develop a nursing intervention program for effective management of chronic diseases.
Aged* ; Anthropology, Cultural ; Chronic Disease* ; Female ; Humans ; Male ; Nursing ; Rural Population

BACKGROUND: This study was done to delineate the incidence and socioeconomic cost of fall-related injuries in the rural elderly population. METHODS: From February 1, 2010 to March 31, 2010, a questionnaire-based interview survey was conducted on 2,295 persons 65 years or older living in rural communities (1 Myoen and 1 Eup of Gyoengsangnam-do). The socioeconomic cost due to falls in the elderly in 2009 was estimated using direct and indirect costs. The direct costs included medical costs covered by health insurance and those not covered by insurance. The indirect costs included nursing care, diapers, transportation, health function foods, medical assistance device, and productivity loss. RESULTS: Of the 2,295 subjects, 735 (32.0%) had suffered from fall-related injuries during the previous year. The direct costs of these injuries calculated to be 596,466,000 Won (56.6%). The indirect costs was 458,081,000 Won (43.4%). Of the indirect cost, loss of productivity was 274,993,000 Won, health function foods was 65,531,100 Won, nursing care was 48,755,000 Won, and transportation was 43,122,000 Won. The total socioeconomic costs (direct costs+indirect costs) of the study subjects was 1,054,547,000 Won. The socioeconomic costs per person was 459,500 Won for the total number of study subjects and 1,435,000 Won for the 735 subjects. CONCLUSION: When the above calculated socioeconomic cost for the 2,295 subjects is applied to the 1,067,262 Korean rural elderly population in 2009, the socioeconomic costs owing to fall-related injuries can be estimated to as much as 343,614,988,000 Won. In the future, the socioeconomic costs due to injuries such as falls is expected to increase as the elderly population increases. Therefore, injury prevention programs and studies for reducing the socioeconomic costs in the elderly community are needed.
Aged ; Efficiency ; Humans ; Incidence ; Insurance ; Insurance, Health ; Medical Assistance ; Nursing Care ; Rural Population ; Transportation

PURPOSE: This study was to investigate the factors influencing quality of life of middle-aged women in rural area, to provide the basic data for health promoting intervention in order to improve quality of life. METHOD: The subjects were 469 middle-aged women by 40-64 from 7 rural areas in Gyeonggi-do, Jeolla-do and Gyeongsang-do. Data collection was conducted by using 6 questionnaires. RESULT: There were significant differences in the quality of life by age, educational level, marital status, religion, family pattern, and economic level. There were positive relationships between quality of life and health perception, social support, and negative relationships between quality of life and depression and stress. Stepwise Multiple Regression Analysis for quality of life revealed that the most powerful predictor was depression. Depression, health perception, social support, stress and economic level explained 51.5% of the variance. CONCLUSION: Depression, health perception, social support, stress and economic level were related with quality of life of middle-aged women in rural area. Therefore, it is necessary to develop the nursing intervention these psycho-social aspects to increase the quality of life.
Data Collection ; Depression ; Female ; Gyeonggi-do ; Humans ; Marital Status ; Methods ; Nursing ; Quality of Life* ; Rural Health ; Social Perception

PURPOSE: The purpose of this study was to identify community health nursing activities that community health practitioners perceive and their achievements in community by reviewing the community health nursing activities that community health practitioners have done for the last 30 years. METHODS: This study was a qualitative study. Thirty one community health practitioners were interviewed using the focus group interview method and data were analyzed using content analysis. Data were collected from April to June in 2011. RESULTS: Community health practitioners perceived themselves as "Community Vitalizers" and 9 categories were identified. They were 'ground to explore new nursing areas', 'assimilation to community', 'ground to establish community diagnosis', 'everyday life health management in the community', 'increased accessibility to medical services for the residents', 'enforced health practices for the residents', 'reinforced self-reliance of community', 'commitment to making a happy village' and 'mental fence of the community.' CONCLUSION: This study was meaningful in that it explained the unique identity of the community health practitionersand could be used as important basic materials in the process of re-establishment of the roles of Health Offices. Hereafter in-depth study on community competence reinforcement should be made to identify the roles of community health nurses.
Achievement ; Community Health Nursing ; Focus Groups ; Korea ; Mental Competency ; Nurse's Role ; Primary Health Care ; Reinforcement (Psychology) ; Rural Health

This survey was done to construct a nursing theory according to Korean culture and to identify the Korean traditional view. From ancient time until now, shamanism has played an important role as determinant of Korean culture and of the personality formation of Korean people. The subjects are 321 patients and member of their families who were over 18 years old, and who are living in five large cities and two rural communities on Korea. Data collection was done from March, 8th to April, 29th in 1999. The tool developed by the investigator through literature review was used to measure the perception and the attitude of patients and their families to Korean shamanism. Collected data were analyzed by frequency, percent and test with SPSS program. The results are summarized as follows : 1) While 35% of respondents answered that the destiny or fate was only relied on the abilities and endeavor of individual, 65% of respondents were fatalists or eclectic are compromised between the fate and endeavor. 2) While half of the respondents belief in divination to some degree, the rest of them reported hardly any belief in divination. 3) There were almost twice as many respondents who directly consulted fortunetellers were as respondents who did not consult fortunetellers. 4) The reasons for consulting fortunetellers were job problems, home problems, health problems by in that order. 5) The respondents almost always interpreted the cause of physical disease and mental disease as being psycho-sociological, but 1% of them explained mental disease as a shamanistic manifestation. 6) In case of disease, the reasons for consulting a fortuneteller was a) no hope of recovery from the sickness in any other way, b) the chronic disease in that order. 7) Of the respondents, 65% answered that disease could not be cured by a 'Gut'(the performance done by the shaman), but 27% of respondents thought that disease could be cured by a 'Gut' in the case of mental disease. 8) Sixty six percent of the respondents answered that they have experienced praying for their wishes with clean water. 9) While 54% of the respondents answered that they have seen or heard the 'Beung Gut'(the performance to pray for recovery of sickness done by the shaman), 46% responded that they have they have never seen or heard it. 10) To the question, "do you intend to have a 'Beung Gut'", 51.7% of respondents answer "no" stongly, but 48% of them say "yes" or took a compromising attitude. 11) Generally the respondents differed in perception and attitude to shamanism. In short, females more than males, old aged more than younger aged, lower educated more than higher educated, believers in Buddhism more than believers in any other religion, and blue color more than white color have more positive attitudes to shamanism. Also men living in rural communities have more positive attitude to shamanism than men living in the large cities. Consequently, Shamanism can be understood as an anxiety relieving cultural system even though Shamanism itself looks like a cultural complex.
Adolescent ; Anxiety ; Buddhism ; Chronic Disease ; Surveys and Questionnaires ; Female ; Hope ; Humans ; Korea ; Male ; Nursing Theory ; Research Personnel ; Rural Population ; Shamanism* ; Water

The purpose of this study was to collect the informations on the current status and the needs of the physically disabled elderlies in the rural community along with the prevalence rate of these population. One study group for the study of disability status evaluation was 139 physically disabled elderlies living in the main island of Kangwha, and the other group for the study on prevalence of disability was 542 elderlies living in Songhae myun. The prevalence of physical disability was 6.5% in Songhae myun. The neurologic disorder was the most frequent diagnosis among the physically disabled elderlies followed by the musculoskeletal disorder. The time for the medical service delivery was delayed; 45.3% of the subjects received medical service more than one month after the onset of disability. Only 18.0% of the disabled elderlies received the public disability service, and 15.8% of the subjects was waiting for further service. The most common need from the subjects was the medical service, followed by the service from the institution such as a nursing home and the financial support. Registration rate of the disabled was very low(7.7%). There were only three physical therapists for the rehabilitation services in studies areas. This study revealed that the public concepts for the disability and the rehabiltation service were inadequate. We hope that this basic data can be used for the planning of rehabilitation services in this community.
Aged ; Diagnosis ; Disabled Persons* ; Financial Support ; Hope ; Humans ; Nervous System Diseases ; Nursing Homes ; Physical Therapists ; Prevalence ; Rehabilitation ; Rural Population

PURPOSE: To examine geographical imbalances by analyzing new graduate nurses' migration patterns among regions where they grew up, attended nursing school, and had their first employment and to identify factors related to working in non-metropolitan areas. METHODS: The sample consisted of 507 new graduates working in hospitals as full-time registered nurses in South Korea. Migration patterns were categorized into 5 patterns based on sequential transitions of "geographic origin-nursing school-hospital." Multiple logistic regression analysis was conducted to identify factors associated with working in non-metropolitan hospitals. RESULTS: Nurses who grew up, graduated, and worked in the same region accounted for the greatest proportion (54%). Sixty-five percent had their first employment in the region where they graduated. Nurses tended to move from poor to rich regions and from non-metropolitan to metropolitan areas. Working in non-metropolitan hospitals was related to older age, the father having completed less than 4 years of college education, non-metropolitan origin, non-capital city school graduation, and a diploma (vs. baccalaureate) degree. CONCLUSION: Admitting students with rural backgrounds, increasing rural nursing school admission capacities, and providing service-requiring scholarships, particularly for students from low-income families, are recommended to address geographical imbalances.
Adult ; Attitude of Health Personnel ; Education, Nursing, Baccalaureate ; Employment ; Female ; Hospitals, Rural ; Hospitals, Urban ; Humans ; Logistic Models ; Male ; Nursing Staff, Hospital/*psychology ; Poverty ; Professional Practice Location

Breast feeding can play a very important role in the development of strong, healthy children. Many studies over the years have shown that breast milk provides defense against common ailments of childhood such as otitis media, gastrointestinal distress, and atopic diseases (allergies). For these reasons the American Academy of Pediatrics recommends breast feeding for at least the first twelve months of an infant's life. Goals of the Health People 2010 Initiative include that at least 75% of mothers will be breast feeding upon discharge from the hospital and at least 50% will be still nursing at six months post-partum. Currently, about 60% of new mothers initiate breast feeding and about 26% are still breast feeding at six months. However, research has shown that breast feeding trends are below these averages in rural areas of the United States. This may be due in part to lack of breast feeding knowledge and teaching in rural areas. Rural hospitals and birthing centers have not initiated many of the breast feeding promotional programs, such as the Baby Friendly Hospital Initiative and Best Start, that have been successful in improving breast feeding trends in urban areas. Often new mothers who live in rural areas do not have access to a lactation consultant to help them with proper follow up. This paper will examine these concerns and propose recommendations to improve breast feeding in rural areas.
Americas* ; Birthing Centers ; Breast Feeding* ; Breast* ; Child ; Consultants ; Female ; Follow-Up Studies ; Hospitals, Rural ; Humans ; Lactation ; Milk, Human ; Mothers ; Nursing ; Otitis Media ; Pediatrics ; United States