BACKGROUND: This study analyzed the relationship between health behaviors and marital adjustment in multicultural couples to evaluate their health status. METHODS: Married couples (70 Korean men and their immigrant wives) completed a structured interview on health behaviors and sociodemographic factors, the Revised Dyadic Adjustment Scale (RDAS), and the Marital Intimacy Scale. Based on the cutoff value of the RDAS, respondents were classified into two groups: high or low dyadic adaptation groups. The collected data were compared with health behavior regarding smoking, alcohol consumption, exercise, and weight. RESULTS: The odds ratio (OR) (95% confidence interval [CI]) by logistic regression with adjustment for age, educational level, career, occupation, length of residence in Korea, nationality, religion, age difference between couple, number of children, monthly income, and proficiency in Korean was 1.279 (1.113–1.492) for unhealthy exercise and 1.732 (1.604–1.887) for unhealthy body weight in female immigrants with low marital adjustment. In Korean husbands with low marital adjustment, the OR (95% CI) was 1.625 (1.232–2.142) for smoking and 1.327 (1.174–1.585) for unhealthy exercise. No significant relationship was found between marital intimacy and health behaviors in female immigrants or Korean husbands. CONCLUSION: More desirable health behaviors were observed in highly adapted couples. Therefore, family physicians should be concerned with marital adjustment and other associative factors to evaluate and improve multicultural couples' health status.
Alcohol Drinking ; Body Weight ; Child ; Cultural Diversity ; Emigrants and Immigrants* ; Ethnic Groups ; Family Characteristics ; Female* ; Health Behavior* ; Humans ; Korea ; Logistic Models ; Male ; Marital Status ; Occupations ; Odds Ratio ; Physicians, Family ; Smoke ; Smoking ; Spouses ; Surveys and Questionnaires

PURPOSE: This study examined the mediating and moderating effects of multicultural efficacy in the relationship between cultural empathy and cultural competence in child care teachers. METHODS: A cross-sectional descriptive survey design was used. The participants were 277 child care teachers at private and public daycare centers in G and S districts of Seoul. The survey instruments included a cultural empathy questionnaire, a multicultural efficacy scale, and a cultural competence scale. Data were analyzed using the SPSS and AMOS programs. For data analysis, descriptive statistics, correlation, and mediating and moderating effect analyses were performed. Bootstrapping was implemented to verify the mediating effect of the model developed herein. RESULTS: Positive correlations among cultural empathy, multicultural efficacy, and cultural competence were noted. Multicultural efficacy showed a significant mediating effect on the relationships between cultural empathy and cultural competence. However, there was no moderating effect. CONCLUSION: In order to enhance the cultural competence of child care teachers, it is necessary to develop a strategy that can promote their cultural empathy and multicultural efficacy. Furthermore, these results will ultimately enhance the role of child care teachers, thus contributing to the normal growth and development of multicultural children.
Child ; Child Care ; Child ; Cultural Competency ; Cultural Diversity ; Empathy ; Growth and Development ; Humans ; Negotiating ; Self Efficacy ; Seoul ; Statistics as Topic

PURPOSE: The purpose of this study is to investigate how sexual experience associate with the suicide ideation, suicide plan and suicide attempt among culturally diverse adolescents compared with Korean adolescents. METHODS: This study used a secondary data analysis study with the data derived from the 10~12th (2014~2016) Korean Youth Risk Behavior Web-based Survey. Data of 2,201 culturally diverse adolescents and 189,278 Korean adolescents were analyzed. Descriptive statistics, χ² test, and hierarchical logistic regression were used for data analysis. RESULTS: After controlled for individual, family and social factors as compounding variables, the suicide ideation of culturally diverse adolescents with sexual experience was higher for 1.72 (95% CI: 1.24~2.38), suicide plan for 2.24 (95% CI: 1.58~3.17) and suicide attempt for 2.71 (95% CI: 1.87~3.93) compared to Korean adolescents without sexual experience. Regardless of cultural diversity, the risk of suicide ideation, suicide plan and suicide attempt of adolescents with sexual experience was higher than adolescents without sexual experience. CONCLUSION: Our study findings indicate the highest need to prevent suicide ideation, suicide plan and suicide attempt among culturally diversity adolescents with sexual experience among all the other adolescents' group.
Adolescent ; Cultural Diversity ; Humans ; Logistic Models ; Risk-Taking ; Sexual Behavior ; Statistics as Topic ; Suicide

No abstract available.
Cultural Diversity ; Humans

PURPOSE: The purpose of this study was to investigate factors affecting the experience of depression in school-aged children from multicultural families. METHODS: Data from 1,812 school-aged children of multicultural families were collected from the 2015 National Multicultural Family Survey. Logistic regression was conducted based on complex sample analysis using SAS 9.4. RESULTS: Significant predictors for experiencing depression were lower self-esteem, lower Korean proficiency, less time spent conversing with the father, lower degree of parental interest, poorer school adjustment, greater difficulties with schoolwork, and experiencing violence at school. CONCLUSION: This study showed that factors related to the individual, family, and school environment influenced the experience of depression. Based on a consideration of these factors, it is necessary to develop an effective program to prevent depression by establishing high-risk criteria for depression.
Child* ; Cultural Diversity ; Depression* ; Fathers ; Humans ; Logistic Models ; Parents ; Violence

PURPOSE: The aim of this study was to evaluate the influence of the mothers' native country on influenza vaccinations in adolescents in multicultural families. METHODS: Data were gathered from the 13th (2017) Youth Risk Behavior Web-Based Survey. Logistic regression analyses were conducted using a complex sample data analysis method. The participants in this study had a father who was born in Korea and a mother born outside of Korea. The sample included 481 adolescents. RESULTS: The analysis of non-adjusted confounding variables showed that influenza vaccination was higher in multicultural adolescents whose mother's native country had an annual minimum temperature less than 21℃ (odds ratio [OR]: 1.81, 95% confidence interval [CI]: 1.20~2.74). Furthermore, when the analysis was adjusted for confounding variables, an annual minimum temperature less than 21℃ in the mother's native country had a statistically significant association with influenza vaccination (OR: 2.12, 95% CI: 1.36~3.29). CONCLUSION: Multicultural adolescents belong to a socioeconomically vulnerable class, and their health promotion behaviors are influenced by their mothers' culture. Thus, healthcare providers and school nurses should provide adolescents with appropriate information related to influenza vaccination depending on their mothers' culture and their family's cultural background.
Adolescent* ; Confounding Factors (Epidemiology) ; Cultural Diversity ; Emigrants and Immigrants ; Fathers ; Health Personnel ; Health Promotion ; Humans ; Influenza Vaccines ; Influenza, Human* ; Korea* ; Logistic Models ; Methods ; Mothers ; Risk-Taking* ; Seasons* ; Statistics as Topic ; Vaccination*

Spirituality is an essential part of human beings. Spiritual care, designed to meet the spiritual needs of terminally ill patients and their families, is one of the most important aspects of hospice and palliative care (HPC). This study reviewed and analyzed literature utilizing the most commonly used Korean and international healthcare databases to identify care models that adequately address the spiritual needs of terminally ill patients and their families in practice. The results of this study show that spirituality is an intrinsic part of humans, meaning that people are holistic beings. The literature has provided ten evidence-based theories that can be used as models in HPC. Three of the models focus on how the spiritual care outcomes of viewing spiritual health, quality of life, and coping, are important outcomes. The remaining seven models focus on implementation of spiritual care. The “whole-person care model” addresses the multidisciplinary collaboration within HPC. The “existential functioning model” emphasizes the existential needs of human beings. The “open pluralism view” considers the cultural diversity and other types of diversity of care recipients. The “spiritual-relational view” and “framework of systemic organization” models focus on the relationship between hospital palliative care teams and terminally ill patients. The “principal components model” and “actioning spirituality and spiritual care in education and training model” explain the overall dynamics of the spiritual care process. Based on these models, continuous clinical research efforts are needed to establish an optimal spiritual care model for HPC.
Cooperative Behavior ; Cultural Diversity ; Delivery of Health Care ; Education ; Evidence-Based Practice ; Hospice Care ; Hospices* ; Humans ; Palliative Care* ; Quality of Life ; Spirituality ; Terminally Ill

PURPOSE: The aim was to present our experiences implementing a cultural diversity (CD) education program. METHODS: The authors held a 4-hour CD class for third-year medical students. The aim of the class was to facilitate students to realize and reflect on the importance of CD on healthcare delivery in Korea. The class was comprised of an orientation about CD in Korea, physicians and multicultural guests sharing their experiences with students, small group discussion, and Q&A panel with multicultural guests. Students provided written feedback for program evaluation. Authors classified their comments qualitatively. RESULTS: Students mostly responded positively to the class with a significant focus on interacting with the multicultural guests. Students realized the significance of CD in healthcare and reflected deeply on their discussion with the multicultural patients. Students needed more time to interact with multicultural guests from a greater range of cultures represented in Korea. Most did not need English interpretation. CONCLUSION: The aim of the class was achieved. Medical students' interaction with multicultural patients may promote the students' understanding and reflection about CD in health care.
Cultural Competency ; Cultural Diversity* ; Culturally Competent Care ; Delivery of Health Care ; Education ; Education, Medical, Undergraduate ; Healthcare Disparities ; Humans ; Korea ; Patient Safety ; Program Evaluation ; Students, Medical*

PURPOSE: This study evaluated the effect of a teaching model to improve cultural competency (TMCC) for Korean undergraduate nursing students. METHODS: A nonequivalent control group pretest/posttest quasi-experimental study was conducted with a convenience sample of 168 undergraduate nursing students in South Korea. The experimental group of 121 seniors was taught a 13-week teaching model in order to improve cultural competence. A control group with 47 junior students underwent nursing major courses, but did not take this teaching model. Before and after the program, students' level of cultural competency was measured using the Questionnaire for Cultural Competence (QCC) consisting of three sub-scales: “awareness and desire,” “encounter,” and “nursing skill and knowledge.” RESULTS: After the experiment, the experimental group showed significantly higher improvement in the Questionnaire for Cultural Competence in the three sub-scales of “awareness and desire,” “encounter,” and “nursing skill and knowledge” than the control group (p= < .050). CONCLUSION: A teaching model to improve cultural competence was effective in improving Korean undergraduate nursing students' cultural competency. Further studies need to be repeated in order to identify the effectiveness of the teaching model to improve cultural competency with graduate or clinical nurses.
Clinical Competence ; Cultural Competency ; Cultural Diversity ; Education, Nursing ; Humans ; Korea ; Non-Randomized Controlled Trials as Topic ; Nursing ; Students, Nursing

PURPOSE: The purpose of this study was to review intervention programs designed to promote mental health in multicultural children and adolescents living in Korea. METHODS: A systematic search with key words in Korean and English was conducted using 9 electronic databases. Twelve studies were included in the sample for systematic review and the Methodological Index for Non-Randomized Study (MINORS) was used to assess methodological rigor and quality of scientific evidence. RESULTS: Randomized controlled trials (RCTs) were used in 3 and quasi-experimental designs in nine studies. Interventions utilizing art therapy were found to be effective in improving school adjustment in these children, and in decreasing levels of depression and anxiety. Learning activities and self-image were not found to be effective. In all 12 studies discussion of the theory guiding the intervention was not included and all 12 studies were rated as having a high risk of bias based on MINORS criteria. CONCLUSION: Findings provide a basis for developing intervention programs to improve mental health in multicultural children and adolescents. Core strategies for promoting mental health in these children and adolescents include access to age and situational characteristics. For intervention effects, development of programs to improve self-esteem and resilience is important.
Adolescent ; Anxiety ; Art Therapy ; Bias (Epidemiology) ; Child ; Cultural Diversity ; Depression ; Humans ; Korea ; Learning ; Mental Health