Purpose: This study is to compare the difference in status between elderly individuals with and without a spouse. Methods: The study is based on the Fifth Korean National Health and Nutrition Examination Survey(KNHAENS), between 2010 and 2012. Subjects were over the age of 65 years who participated in the survey. Chi-square test and logistic regression of complex sampling design of the KNHAENS and used the survey analysis method by SPSS (version 18). Results: Sleep time of female elders living alone was the shortest which was 2.59 times that of male elders living with a spouse. Stress awareness of female elders living with a spouse was the highest, which was 3.21 times that of male elders living with a spouse. Depression was the highest in female elders living alone, which was 2.26 times that of male elders living with a spouse. Suicidal idea was the strongest in female elders living alone, which was 2.87 times that of male elders living alone. Conclusion: Female elders living alone were weakest in regards to socio-economical aspect with the highest rate of poverty, low educational status, and unemployment. The mental health status of females was worse than that of males. In particular, the mental health status of females living alone was the worst.

Propose: This study was to identify the factors affecting the oral health status in vulnerable elders receiving home visiting health care service. Methods: A total of 444 elderly people over the age of 65 at 33 public health centers in Daegu and Gyungbuk areas were included in this survey. The data were collected by personal interview with nurses using oral health knowledge, behavior, and status questionnaires from the $10^{th}$ to $22^{nd}$ of July, 2012. The data were analyzed with t-test, one-way ANOVA, $Scheff{\acute{e}}$ test, and stepwise multiple regression, using SPSS program. Results: Factors affecting the oral health status were chewing satisfaction with denture 14.5% (${\beta}=.391$, p<.001), denture care (wash with water) 3.2% (${\beta}=-.187$, p<.01), and types of health insurance (medical aid type1, 2) 1% (${\beta}=-.111$, p<.05). The factors explained 18.7% of variance in the oral health status of vulnerable elderly subjects. Conclusion: The results of this study indicate that in order to improve the oral health status of vulnerable elders, it is necessary to provide oral health education that includes the proper usage of denture to elders who receive home-visiting care.

Purpose: This study explored experiences of diabetes education among educators of diabetes. Methods: Data were collected from individual in-depth interviews with 10 nurses and 2 dieticians with had at least 3 years of experience in diabetes education. Data collection was conducted between May 2014 and February 2015. All interviews were recorded and stored as digital audio files, which were then transcribed verbatim. Data were analyzed through qualitative content analysis. Results: Analysis showed that four categories could be derived from the data: 1) barriers of diabetes education from an educator's perspective, 2) barriers of diabetes education form a patient's perspective, 3) facilitating factors of diabetes education from an educator's perspective, and 4) facilitating factors of diabetes education from a patient's perspective. Conclusion: This study suggests the necessity to strengthen the policy systems and financial support at a national level to provide diabetes education with higher quality to patients. In addition, it is required to develop various diabetes education programs with consideration to patient characteristics.

Purpose: The purpose of this study was to investigate the Nurses' perception of child abuse, effectiveness of reporting, and barriers to reporting. Method: We surveyed 155 nurses at a University Hospital by using convenience sampling. The perception of child abuse, effectiveness of reporting, and barriers to reporting were measured using structured questionnaires. Data analysis was performed using SPSS WIN 21.0 program. Results: In nurses' perception of child abuse, the perception of physical abuse was higher than that of others - such as neglect, sexual abuse, and emotional abuse. Among nurses, the perception of child abuse was different according to age, material status, children, nurse career, education level, religion, experience of education, and perception of mandated reporter. The results showed a significant correlation between the perception on child abuse and perception on the effectiveness of reporting, as well as between perception on the effectiveness of reporting and perception on barriers to reporting. Conclusion: Based on the findings of this study, it is suggested to develop education programs and guidelines to help nurses to make appropriate decisions for the proper professional intervention when a child abuse case is suspected.

Purpose: The purpose of this study was to evaluate the effects of a comprehensive exercise program for the prevention of urinary incontinence (UI), frailty, and depression, as well as the promotion of physical function in community-dwelling elderly female living alone. Methods: A nonequivalent control group pretest-posttest design was employed. The participants were 76 vulnerable elderly female with a mild-to-moderate urinary incontinence. The exercise group completed 12 weeks of a moderate intensity, comprehensive exercise program. Descriptive statistics, independent t-tests and ANCOVA were used for data analysis with SPSS. Results: Upon the completion of the 12-week exercise program, significant improvements for UI symptoms (p=.001), timed up and go (p<.001), frailty (p=.006), and depression (p<.001) were observed, but not for hand grip strength (p=.053). Conclusion: The findings of this study indicate that the 12-week comprehensive exercise program for the prevention of urinary incontinence had positive effects on improving UI symptoms, physical function, levels of frailty and depression in elderly women living alone. More prolonged exercise programs with other types of exercise should be developed for these vulnerable elderly women, and future studies are encouraged to confirm the effect of the comprehensive exercise program in other settings.

Purpose: The purpose of this study was to explore the barriers and solution of providing long-term care (LTC) services at home for the beneficiaries with mild dementia. Methods: The data were collected by interviewing three focus groups consisting of 10 home-visit nurses and analyzed through the analytic process by Morgan and Krueger. Results: The barriers of providing LTC services for clients were identified as follows: inadequateness of the current LTC model for elderly individuals with mild dementia and inappropriateness of the personal environment for home care. The solutions for these barriers were suggested as follows: building up a safe environment for home care and maintaining an appropriate standard utilization plan of LTC service. Conclusion: The current service model for the beneficiaries with mild dementia should be modified in order to provide comprehensive long-term care services based on their complex needs.

Purpose: The purpose of this study was to examine the effects of Motivational Interviewing(MI) training program on communication skill and self-efficacy of home visiting nurses(HVNs). Methods: This study has a mixed-methods design that includes a one-group pre-post test study and focus group interviews(N=23). From April 16th to June 11th in 2014, total six two-hour sessions of MI training program were provided to the participants. The quantitative outcomes were collected using Global Interpersonal Communication Competence Scale(GICC-15) and Self-efficacy Scale, and the qualitative data were obtained by 5 focus group interviews. Group pre-post changes were evaluated by paired t-tests and the qualitative data were analyzed by content analysis method. Results: MI training program led to significant enhancement in communication skills(Z=-3.62, p<.001) and self-efficacy(Z=-3.67, p<.001). The qualitative study revealed that the participants had positive experiences to express empathy, support self-efficacy, and respect autonomy for their clients applying reflective-listening and affirmation skill. Conclusion: The HVNs who participated in the MI training program showed improved communication skills and self-efficacy in the quantitative and qualitative studies. A randomized clinical trial is needed to confirm the value of MI training program for HVNs.

Purpose: This study was to identify the current issues and challenges of the nursing education program in Cambodia and to suggest recommendations to improve it. Methods: The World Health Organization Global Standards for the Initial Education of Nurses and Midwives were used as the analytic framework. Data were collected through a critical, constructive analysis of the literature, as well as observation with stakeholders in the area. Results: Cambodia experienced a shortage of nurses based on the demands of nurses. Moreover, the lack of institutional capacity, out dated and rudimentary nursing curriculum, under qualified nursing faculty, overcrowded classrooms, and lack of fundamental education materials and equipment for nursing education hampered the maintenance and improvement of the quality of pre-service nursing education in Cambodia. Conclusion: Strengthening the nursing educational resources and infrastructures, along with proper retention and enhancement of the faculty's capacity, clinical mentorship, and sustainable management of the nursing curriculum were recommended. Integrating the nursing theory and process into clinical practice and using strategic partnerships, would improve the quality and quantity of nursing education in Cambodia. There needs to be a synergistic relationship between nursing education and training relevant to the nursing care to meet the needs of the Cambodian population.

Purpose: The purpose of this study was to understand the role of community health nurse through a nurse practitioner of primary health care post. Methods: An assay, 'Even if we were allowed to look at', written by a nurse practitioner of primary health care post was analyzed with the contents analysis method. Results: In the assay, we checked the following roles: client-oriented, delivery-oriented, and population-oriented roles described and classified by Clark. In particular, direct care such as in-patient care, home visiting nursing care, and drug prescription was frequently performed. Moreover, community health nurse has been listening, counselling, expressing sympathy, and advocating vulnerable elderly people economically and psychologically. Conclusion: The assay gave us a better understanding of the role of community health nurse, and we need more assays delineating the role of community health nurse in others setting as well primary health care post.

Purpose: This study was conducted to examine the individual and community level factors associated with physical activity and to identify its relative effects using a multilevel analysis among Korean adults in certain counties. Methods: A cross-sectional data of 39,547 adults (age range of 19~64 years) living in 82 counties from the 2013 Korean Community Health Survey (KCHS) was analyzed. Individual and social correlates from KCHS and physical environmental data from the Korean Statistical Information Service were collected. A multilevel logistic regression was performed using Stata 10.0 IC. Results: Multilevel analyses showed that the effect of social and physical environmental on engaging in moderate or vigorous physical activity (MVPA) was significant in comparison to the influence of individual correlates. The individual factors that were associated with participating in MVPA included gender, marital status, education, job, and household income. In the community level, social environmental factors associated with engagement in MVPA were higher satisfaction with healthcare service (OR=3.410, 95% CI=1.109~11.269), a high level of social support (OR=5.920, 95% CI=1.459~22.657) and social network (OR=1.025, 95% CI= 1.017~1.032). Conclusion: To promote moderate or vigorous physical activity in Korean adults in some counties, social environmental factors should be considered along with individual correlates.

Purpose: This study was conducted to help with the development of an intervention program in efforts to prevent suicidal ideation and suicide. The study also sought to generate strategies for improving health conditions by ascertaining and analyzing potential factors that may influence suicidal ideation according to age group in adults. Methods: Data on general characteristics and suicidal ideation from 447 adults aged between 20 and 59 years, living in Y city, Gyeonggi Province, South Korea, were collected based on a structured questionnaire, The data were analyzed using SPSS20.0 statistics program. Results: The results showed that 48.6% of young and older adults have experienced suicidal ideation while 44.5% of middle-aged adults have had suicidal thoughts. With regard to suicidal ideation, young and older adults revealed relevant differences in terms of gender, residential type, degree of stress and subjective physical and mental health, while middle-aged adults revealed relevant differences in terms of marital status and degree of stress. With regard to factors that influence suicidal ideation, it was found that the relevant variables of young and older adults included gender, residential type, depression, degree of stress, and subjective physical and mental health, while for middle-aged adults, relevant variables included marital status and degree of stress. Conclusion: These findings indicate that as stress and depression decreases, subjective physical and mental health improves. Therefore, this study proposes that developing and operating an intervention program can help prevent suicidal ideation in local residents.

Purpose: This study was to examine the factors (depression, level of health status, physical function, depression) influence health related quality of life (EQ5D) in community dwelling elderly according to sex. Methods: A total of 226 elderly subjects over the age of 65 years in community were included. Data were collected by measuring the physical function (muscle endurance, flexibility, balance, and cardiovascular endurance) and by using a questionnaire about EQ5D, depression, health status. Data were analyzed by SPSS 18.0 and AMOS 18.0. Results: The major findings of this study are as follows. Explained variance of EQ5D by regular exercise, physical function, and level of health status was 19% for male elderly subjects and 26.0% for female elderly subjects. The effect was different according to sex. Depression has the effect on EQ5D (${\beta}=-.356$, p<.001) in females, while the level of health status has the effect (${\beta}=.314$, p=.027) in males. Conclusion: The results of this study indicate that the effect of regular exercise, physical function, and level of health status were different on EQ5D according to sex. Thus, different health programs according to sex are necessary to increase the quality of life in elderly individuals.