Purpose: We present improvements to the Korean home visiting healthcare service based on analysis of Korean home visiting healthcare services considering recent sociodemographic changes and demands for healthcare services. Methods: This is a review study in which the results are derived through a literature review and data analysis. We collected data through a search of electronic databases, Google Scholar, and governmental websites. Results: Changes in Korean home visiting healthcare services are classified into four stages: 'introduction (1990-2000)', 'pilot project (2003-2006)', 'nationwide expansion (2007-2012)', 'various types (2013-2018)'. Korean home visiting healthcare service based on public health centers has achieved outcomes such as improved health behavior and health management, increased health management ability, and establishment of comprehensive healthcare infrastructure. Conclusion: In the future, the demand for home visiting healthcare service will increase steadily because of deepening social polarization, rapid aging of the population, and increases in chronic diseases. To improve health management and health equity, we suggest that Korean home visiting healthcare service will expand to all the people as a core public health service. It is necessary to establish a management team for various types of home visiting healthcare service in the public health center.

Purpose: This study conducted to identify factors affecting on the job stress among employees of community integrated health promotion programs. Methods: A total of 175 employees of community integrated health promotion programs in public health centers were asked to complete a pack of self-report questionnaires. The data were then analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: Employees' emotional labor was a bit higher than moderate. Employees' job stress was higher than that of general employees in public health centers but similar to police officers. Job stress had a positive relationship with emotional labor and a negative relationship with self-efficacy. Factors affecting on the job stress were emotional labor, self efficacy and working period for integrated health promotion. Conclusion: Based on the results of this study, employees of community integrated health promotion programs in public health centers need to develop effective interventions to help them effectively decrease job stress. This, in turn, will decrease emotional labor and increase self efficacy.

Purpose: This study was to conducted to investigate the prevalence and related factors of metabolic syndrome (MS) among Korean adults. Methods: We used secondary data of the sixth Korean National Health and Nutrition Examination Survey (KNHANES) from 2013 to 2015 and selected 4,939 adults 20 to 64 years old. General characteristics and health-related characteristics were included as related factors for analysis. Chi-square tests were used to compare the prevalence of MS between one-person and multiple-person households, while a multiple logistic regression model was used to identify factors to MS among one-person and multiple-person households. Results: MS of one-person households (26.4%) were significantly higher (${\chi}^2=7.81$, p=.017) than multiple-households (19.5%). Risk factors for MS were identified as walking, flexibility exercises, reading nutrition labels, and sleep hours in one-person households; and flexibility exercises and dietary control among multiple-person households using multiple logistic regression. Conclusion: Specialized health policies and programs should be provided to reduce MS prevalence in one-person households in consideration of risk factors revealed in this study.

Purpose: This study was conducted to identify factors influencing fundus examination to prevent diabetic retinopathy in diabetes patients to provide basic data to improve screening rates of fundus examinations. Methods: Raw data from the 6th Korea National Health and Nutrition Examination Survey, which is a cross-sectional and nationally representative survey, were used in this study. The subjects of the study were 1,029 adult diabetes patients over the age of 19 years who had been diagnosed with diabetes. The demographic characteristics, diabetes and disease-related characteristics and health behavior characteristics according to the fundus examinations were analyzed by the chi-squared test and logistic regression analyses were used to examine the factors influencing fundus examination. Results: A total of 333 patients underwent fundus examination at a screening rate of 32.2%. We identified factors influencing fundus examination in patients with diabetes as level of education, type of diabetes care, period of diabetes, and smoking. Conclusion: A multiple approach is required to raise the low screening rate of fundus examination, including specialized education for low-education groups. Moreover, nursing intervention should focus on subjects who do not engage in insulin and oral hypoglycemic agents and with diabetes for a long period.

Purpose: This study was conducted to examine the personal and social environmental factors affecting leisure time physical activity (LTPA) among adults living in rural communities. Methods: A cross-sectional study was conducted with a convenience sample of 282 adults living in three rural towns of Chungcheongbuk province. Leisure time physical activity was assessed through the Korean version of the Global Physical Activity Questionnaire (GPAQ), and social influence and social cohesion of social environment were assessed using reliable and validated measures. Multiple logistic regression analysis was conducted to explore personal and social environmental factors associated with LTPA. Results: The overall prevalence of leisure-time physical activity (LTPA) was 40.0%. Multiple logistic regression analysis showed that LTPA participation was associated with gender (OR=2.60, 95% CI=1.47-4.58), healthy eating (OR=1.15, 95% CI=1.01-1.31), unhealthy eating (OR=0.70, 95% CI=0.53-0.93) and social influence for physical activity (OR=1.11, 95% CI=1.03-1.20). However, social cohesion was not correlated with engaging in LTPA. Conclusion: Both personal and social environmental factors are associated with LPTA among rural adults living in Eup-Myen regions. Interventions to promote LTPA would likely benefit from considering healthy dietary intake and social influence for physical activity.

Purpose: This study was conducted to identify the factors influencing of HPV vaccination and vaccination intention among Korean adult women through a systematic review. Methods: A systematic review was conducted across international and domestic electronic databases and nine of 193 studies were identified for this review. Results: Meaningful variables influencing HPV vaccination and its intention included socioeconomic status (age, economic level, and education level), knowledge level, health beliefs, attitudes toward HPV vaccination, and previous experiences. Economic level and knowledge influenced HPV vaccination and vaccination intention, which was consistent with the results of previous studies. Eight studies measured knowledge level regarding cervical cancer or HPV vaccination; however some instruments lacked reliability and validity report. Conclusion: There is a need for governmental support to reduce the burden of HPV vaccination cost, to publicize the benefits and to provide general information regarding HPV vaccination. Finally, it is necessary to develop an instrument with confirmed reliability and validity to measure HPV knowledge.

Purpose: This study was conducted to identify the effects of a group cognitive improvement program on cognitive function, depression and self-esteem in elderly individuals with mild cognitive impairment. Methods: This was an experimental study that employed a pre-post design of a non-equivalence control group. The subjects were 52 elderly people with mild cognitive impairment, 25 of whom were assigned to the experimental group and 27 to the control group. The program was conducted for a total of 12 sessions for 60 minutes each. Data were analyzed using the ${\chi}2-test$, Fisher's exact test, and Independent t-test with the SPSS 20.0 program. Results: After the intervention, the group who participated showed improvement in all areas of cognitive function based on MMSE-KC (F=26.37, p.<0.001), the Rey Complex Figure Test: copy (F=20.66, p.<0.001), Immediate memory of Seoul Verbal Learning Test-Elderly's version (F=29.68, p.<0.001), delayed memory (F=45.79 p.<0.001), memory recall (F=28.97, p.<0.001), Forward of Digit Span Test (F=9.25, p=.004), backward (F=8.33, p.=0.006), language comprehension (F=13.42, p.<0.001), and digit symbol coding (F=17.74, p.<0.001) relative to the control group. Moreover depression (F=24.09, p.<0.001) was decreased in program participants, whereas self-esteem (F=40.24, p.<0.001) was increased. Conclusion: The program could be a useful intervention because the results show that the group cognitive improvement program has a significant effect on cognitive function, depression and self-esteem in elderly with mild cognitive impairment.

Purpose: This study the mediating effects of marital intimacy the relationship between depression and marital satisfaction of infertile women. Methods: 165 infertile women visiting a hospital in Gyeonggi-do and Busan, Korea from January 2016 to April 2016. The data was analyzed the SPSS WIN 22.0 program. Results: Depression, marital satisfaction, and marital intimacy averaged $1.51{\pm}.32$ (range of scale 0~3), $3.50{\pm}.56$ (range of scale 1~5), and $3.74{\pm}.65$ (range of scale 1~5), respectively. Depression had a negative correlation with marital satisfaction (r=-.361, p<.001) and marital intimacy(r=-.183, p<.001). Marital intimacy also had a positive correlation with marital satisfaction (r=.637, p<.001). Marital intimacy partial mediating effects between depression and marital satisfaction (${\beta}=.591$, p<.001). Conclusion: the intimacy of couple can alleviate the causal consequences that lead to a decrease in the marital satisfaction due to depression. Therefore, healthcare providers for infertile women should screen depressed women and help support infertile women from negative values for marriage depression. In addition, it is necessary to include interventions for maintaining and enhancing the intimacy of couples during infertility treatment.

Purpose: This study was conducted to identify the barriers and improvements to promoting physical activity among children using community child care centers. Methods: A qualitative research using focus group interviews was employed. Three focus group interviews were conducted with a total of 18 service providers, and open-ended questions were used. All interviews were recorded as they were spoken and transcribed and data were analyzed using qualitative content analysis. Results: Two main themes in the barriers to promoting physical activity were 'lack of resources' and 'limitations of program composition'. In addition, five sub-themes emerged as a result of analysis: 1) lack of human resources, 2) lack of finance, 3) lack of space, 4) one-off and short-term physical activity programs, 5) learning-oriented programs. Conclusion: The results indicate that it is necessary to have adequate human resources and a realistic government subsidy that allow community child care centers to provide sufficient services to children. In addition, promoting physical activity can be achieved through physical activity programs focused on peer group advisors, habituation, and development of programs suited to the needs of children and their environment.

Purpose: This study was conducted to identify the effects of Satir's model based communication education on communication competence, emotional intelligence and depression-happiness in regional public hospital nurses. Methods: A non-equivalent control group pretest-posttest quasi-experimental design was used. The subjects were 36 nurses of the experimental group and 36 nurses of the control group. Satir's model based communication education was conducted for two days and the dependent variables were measured using the global interpersonal communication competence scale (GICC), emotional intelligence scale and short depression-happiness scale (SDHS). Data were analyzed by the Chi-squared test, Fisher's exact test and ANCOVA using SPSS 21.0. Results: Communication competence (F=12.7, p<.001) was significantly increased in the experimental group, as was emotional intelligence (F=6.67, p=.01). Conclusion: The results of the study suggest that Satir's model based communication education is an effective method to increase public hospital nurses' communication competence and emotional intelligence.