Purpose: This study was conducted to suggest a method for financial projection of health insurance expenditures that reflects future changes in demographic structure. Methods: Using data associated with the number of patients and health insurance cost per patient, generalized linear models (GLM) were fitted with demographic explanatory variables. Models were constructed separately for individual medical departments, types of medical service, and types of public health insurance. Goodness-of-fit of most of the applied GLM models was quite satisfactory. By combining estimates of frequency and severity from the constructed models and results of the population projection, total annual health insurance expenditures were projected through year 2060. Results: Expenditures for medical departments associated with diseases that are more frequent in elderly peoples are expected to increase steeply, leading to considerable increases in overall health insurance expenditures. The suggested method can contribute to improvement of the accuracy of financial projection. Conclusion: The overall demands for medical service, medical personnel, and relevant facilities in the future are expected to increase as the proportion of elderly people increases. Application of a more reasonable estimation method reflecting changes in demographic structure will help develop health policies relevant to above mentioned resources.

Purpose: This study was conducted to explore the meaning and contents of high-quality aged care facilities and provide basic data for evaluation of service quality in such facilities. Methods: The focus group interviews and participants consisted of two user groups, for a total of 16 family caregivers of the elderly living in facilities and four service provider groups, for a total of 26 chief managers and caregivers working in aged care facilities. All interviews were recorded and transcribed as they occurred. Content analysis was used and debriefing notes were referred to in order to analyze the data. Results: Four themes of a high-quality aged care facility emerged from the analysis; 1) a place to rest for comfortable later years; 2) systematic value-based management; 3) providing professional care; 4) comprehensive service provision in response to diverse needs. Conclusion: The findings of the study showed the importance of client centered care and ethical mindset of providers, which had not been included in the existing quality evaluation programs. Based on these results, medical treatments, end-of-life care and more comprehensive and extended services including family care need to be provided in facilities to ensure good quality aged care.

Purpose: This study was conducted to identify the sociodemographic characteristics and health belief related to rotavirus vaccination behavior among mothers of infants. Methods: Data collection was performed through an on-line survey between 13 and 16 October, 2016, and the subjects targeted were 240 mothers with infants between the ages of 8 months and 12 months. The collected data were analyzed using $X^2$ test, Fisher's Exact test, ANOVA, and Logistic Regression with SPSS 23.0 program. Results: The complete rotavirus vaccination rate was 76.7%, the incomplete vaccination rate was 9.2%, and the non-vaccination rate was 14.2%. Factors associated with complete rotavirus vaccination were the mother's age (OR=3.306, 95% CI=1.087 to 10.054), the perceived benefits (OR=6.500, 95% CI=2.163 to 19.528) and the self-efficacy (OR=11.568, 95% CI=2.921 to 45.818), and approximately 40.8% of explanation power was observed. Conclusion: To increase the rotavirus vaccination rate, counseling and education by nurses should be performed to increase the self-efficacy and public awareness of the benefits of rotavirus vaccination for mothers with infants.

Purpose: This study was conducted to identify factors that influence the suicidal ideation of the unemployed. Methods: Participants in this study consisted of 207 unemployed individuals from G city those who were participating in activities in a job center. A survey was conducted from June 13 to September 21, 2014. Research tools were suicidal ideation, self-esteem, somatization, job-seeking anxiety status, problem-focused coping, and family support. Data were analyzed using SPSS 12.0, and included the mean, standard deviation, t-test, one-way ANOVA and Scheffe test. Pearson's correlation coefficient and multiple regression by stepwise selection were also conducted to identify factors influencing suicidal ideation. Results: Suicidal ideation differed significantly according to marital status and spouse income. Suicidal ideation was positively correlated with somatization and job-seeking anxiety status, and negatively correlated with self-esteem and family support. Effective variables were family support (${\beta}=-.03$, p<.001), somatization (${\beta}=.22$, p=.001), spouse income (Yes)(${\beta}=-.18$, p=.003) and self-esteem (${\beta}=-.14$, p=.041). These variables explained 28.2% of the variance in suicidal ideation. Conclusion: Based on the results of this study, it is necessary to develop family support improvement programs to decrease suicidal ideation of the unemployed.

Purpose: This study was conducted to determine if women's depression is influenced by their self esteem, stress, and social support. Methods: This study was a descriptive survey, and data were collected from the November 1 to December 20, 2015 using a self-reported questionnaire. The measurements were SES for self esteem, and CES-D for depression. A total of 165 middle-aged women participated through convenient sampling. Results: There were significant difference in self-esteem according to education level and monthly income. Additionally, there was an inverse correlation between stress and self esteem, as well as a significant strong correlation between self esteem, stress, social support and depression. Finally, multiple regression showed that self-esteem and stress had significant effects on depression, and their explanatory power was ${\Delta}R2(%)=47.9$ (${\Delta}F=66.526$, p<.001), p<.001). Conclusion: This study confirmed that depression was closely related to self-esteem and stress among middle-aged women. Based on these findings, we suggest that the health policies of reducing depression for middle-aged women should focus on reducing stress and reinforcing their self-esteem.

Purpose: It is thought to be crucial to guide diabetic children and adolescents through their adolescent period psychologically and emotionally. Therefore, we investigated what positive roles a type 1 diabetic camp program would play on subjects in terms of depression, anxiety, self-esteem and self-efficacy. Methods: This study evaluated 38 diabetic children and adolescents with type 1 diabetes who attended summer camp. Subjects were analyzed using a one-group pretest-posttest quasi-experimental research design. Results: There was a significant decrease in depression (t=3.55, p=.001) and anxiety (t=3.09, p=.004) after attending camp, as well as a significant improvement in self-efficacy (t=-3.64, p=.001). However, there was no significant change in self-esteem (t=0.14, p=.891). Conclusion: The results of this study indicate that type 1 diabetic camps are an effective intervention program to promote psychological and emotional stability among diabetic children; therefore, it is recommended that various diabetes programs related to camps be developed.

Purpose: Vitamin D is a fundamental element for bone metabolism. Recently vitamin D deficiency has been implicated in various diseases such as a cardiovascular disease, diabetes, and cancers. The aim of this study was to identify the risk factors associated with serum vitamin D deficiency among women office workers. Methods: We selected 369 women office workers using the secondary data of the 5th National Health & Nutrition Examination Survey 2010-2012. Data was analyzed by logistic regression of complex sampling design. Results: Women office workers with vitamin D deficiency, defined serum 25-hydroxyvitamin D concentration < 10ng/mL, were 12.5%. The risk factors for vitamin D deficiency were 20s aged group, married state and more than 40 working hours a week. The risk of vitamin D deficiency was decreased in those with alcohol drinking 1 to 4 times a month. The education level, income, region, smoking, physical activity and sun exposure time did not affect the risk of vitamin D deficiency significantly. Conclusion: Development of vitamin D deficiency prevention educational programs are required for women office workers who more than 40 hours a week in 20s. It should be considered health education including sun exposure duration and behavior.

Purpose: This study was conducted to examine the correlations among nursing professionalism, major satisfaction, self leadership and ego-resilience of nursing students. Methods: The subjects were 110 nursing students recruited from one university. Data were collected using structured questionnaire, and analyzed with the SPSS/SIN 23.0 program. Results: The results indicate that nursing students have levels of nursing professionalism, major satisfaction, self leadership and ego-resilience that are higher than the median. Nursing professionalism showed differences according to plans for after graduation and subjective health status. Nursing professionalism was significantly correlated with major satisfaction, self leadership and ego-resilience. Conclusion: Major satisfaction was the most influential factor predicting greater nursing professionalism. Thus, these factors should be considered when developing a program for enhancing nursing professionalism.

Purpose: This study examined the relationships among type D personality, self-efficacy, health promoting behaviors and mediating effects, as well as type D personality and health promoting behaviors of college students. Methods: From 10 May to 24 May 2013, a convenience sample of 223 subjects was recruited from a college in G city. Data analysis consisted of Pearson's correlation coefficient, followed by regression analysis. Results: The prevalence of type D personality was 21.4%. Type D individuals showed lower self-efficacy and interpersonal relationships than non-type D individuals. Type D personality (NA*SI) had signigicant negative correlations with self-efficacy and HPLP-II. Self-efficacy fully mediated the relationship between type D personality(NA*SI) and HPLP-II. Conclusion: One reason why type D individuals have maladaptive health behaviors is low self-efficacy.

Purpose: The goal of this study was to define and clarify the concept of "self management" of children with chronic diseases. Methods: For analyzing the concept of self management, this study used the hybrid model. This study involved in-depth interviewing nine children with chronic disease. Results: The concept of self management of children with chronic disease can be categorized with three dimensions: internal, environmental, and behavioral aspects. Besides, five attributes and thirteen indicators were analyzed. The concept of self management of children with chronic disease can be expressed as a kind of process; a) re-established yourself (internal dimension), b) assistance by the surrounded (environmental dimension), and c) positive health management behavior with self control of daily life (behavioral dimension). Conclusion: The self management is important for children with chronic disease to control their disease for long time. The attributes and indicators drawn by this study could be used for tool development and useful resources of self management competence in children with chronic disease.

Purpose: This study was conducted to predict the effects of behavioral intention on pap screening tests in unmarried college women using a path model. Methods: The study subjects were 216 university students and data were collected through self-report questionnaires including knowledge, attitude, subjective norms, perceived behavioral control, behavioral intentions to take the Pap test, and health responsibility. Results: Knowledge regarding the Pap test was moderate. The factors of knowledge, attitude, and perceived behavioral control negatively influenced the behavioral intention of the Pap test. However, the factors of subjective norms and health responsibility positively influenced behavioral intention. Conclusion: Subjective norms are the most importance factor to increase the intentions of the Pap test among unmarried college women. It is also necessary to eliminate barriers to undergoing pap testing, as well as to provide nursing intervention to obtain correct knowledge and a positive attitude regarding the Pap screening test.

Purpose: This phenomenological study was conducted to describe and understand the experience of vulnerable elderly individuals with diabetes by identifying the meanings and structures of the experience. Methods: The data were collected through in-depth interviews of six vulnerable elderly individuals with diabetes aged over 65 years. The interview data were audio-recorded, transcribed verbatim and checked for accuracy. The Colaizzi's method of phenomenology was used to analyze the data. Results: Four theme clusters were extracted as follows: 'Life adversity', 'Adaptability to the life', 'Replacement of absence of family with social support', 'Difficulty of self-care'. Conclusion: The results provide an in-depth understanding of life experiences of vulnerable elderly individuals with diabetes. The findings will be useful to nurses caring for this population.

Purpose: The purpose of this study was to investigate the degree of obesity and dietary self-efficacy scale and to identify factors that affect obesity in upper-grade elementary school students. Methods: A total of 458 fifth to sixth grade elementary school students in Seoul and Chuncheon city, and rural areas of Gangwon Province, were included in this study. The data was analyzed by descriptive statistics, ${\chi}^2$-test, t-test, ANOVA, and logistic regression. Results: The results revealed significant differences in the obesity region, perceived body image, experience of weight loss, family member of mother's age, mother's job and father's job between 'not obesity group' and 'obesity group'. The logistic regression analysis revealed that obesity was related with gender, region, and perceived body image. Conclusion: Gender, region, and perceived body image showed a relationship with obesity in upper-grade elementary school students. Thus, to develop obesity management program for upper grade elementary school students, we should be considered the gender, region, and perceived body image should be considered.