[Development of reproductive health program and identification of effect for married women immigrants]

The influence of eHealth literacy, reproductive health knowledge, and self-esteem on health-promoting behaviors in early adult women: a cross-sectional survey

PURPOSE

The purpose of this study was to investigate the influence of eHealth literacy, reproductivehealth knowledge, and self-esteem on early adult women's health-promoting behaviors (HPB). Thisstudy was based on Pender's health promotion model as a theoretical underpinning.

METHODS

Early adult women aged 18 to 35 years (n=165) were recruited by posting advertisements on social network sites for a student club and a faith-based community in Ansan, Korea. Willing individuals were invited to participate in the online survey from June 1 to June 30, 2022. Standardized instruments were used to measure HPB, eHealth literacy, reproductive health knowledge,and self-esteem. General characteristics included income level, perceived subjective health, and internet usage time. The collected data were analyzed using the independent t-test, one-way analysisof variance, Pearson correlation coefficients, and multiple regression.

RESULTS

The mean age of the respondents was 21.97±3.87 years. The total HPB score was 120.69,corresponding to a moderate level; and the total scores for eHealth literacy (30.24), knowledge ofreproductive health (23.04), and self-esteem (35.62) were higher than the midpoint. The model explained 53.3% of variance in HPB, and self-esteem (β=.48, p<.001) was the most influential factor.Other influential factors were, in descending order, higher economic level, higher subjective healthstatus, greater eHealth literacy, and less internet use time (<2 hours/day).

CONCLUSION

In order to promote the health of early adult women, counseling or programs that positively improve self-esteem appear promising, and eHealth literacy should be considered as a way topromote HPB using information technology.

Do family values and reproductive health knowledge influence reproductive health-promoting behaviors in married women? A cross-sectional survey

PURPOSE

Based on the World Health Organization framework on reproductive health, this descriptive correlational study investigated the factors affecting reproductive health-promoting behaviors ofmarried women, with a focus on family values and reproductive health knowledge.

METHODS

A cross-sectional survey was conducted on 170 married women between the ages of 25and 49 years living in Daegu, Korea. The general and reproductive health characteristics, family values, and reproductive health knowledge of married women were identified, as well as factors affecting reproductive health-promoting behaviors. A questionnaire survey was administered to investigate the impact of various factors on reproductive health-promoting behaviors.

RESULTS

Positive correlations were shown for family values (r=.78, p<.001) and reproductive healthknowledge (r=.55, p<.001). Family values (β=.35, p<.001) and reproductive health knowledge(β=.24, p<.001) were identified as factors influencing reproductive health-promoting behaviors. According to the regression model, the explanatory power of factors affecting reproductive health-promoting behaviors among married women was 51.2%.

CONCLUSION

A history of reproductive diseases, family values, and reproductive health knowledgewere identified as factors influencing reproductive health-promoting behaviors. These results willprovide basic data for the development of a reproductive health-promoting program, including apositive approach to reproductive health among married women, and will serve as a basis for furtherresearch on intervention strategies.

The effectiveness of a tailored programme to promote reproductive-health-promoting behaviour in young women based on the Precaution Adoption Process Model: A randomized controlled trial

AIM

The study aimed to evaluate a tailored reproductive health promotion programme based on the Precaution Adoption Process Model (PAPM) for young adults.

DESIGN

This was a two-group, non-blinded randomized controlled trial.

METHODS

This study was performed with women aged 18-25 who were not performing reproductive health-related behaviour from September 2018 to November 2018 in Seoul, South Korea. The participants were stratified by stage of PAPM (1, 2 or 3) and were randomly allocated to the intervention group (n = 30) and the control group (n = 30). Women in the intervention group were given the programme, which was customized according to the stage of PAPM over 8 weeks, such as lectures, giving information, discussions, practical training, Q&A, case experience and counselling. The control group received educational material. The primary outcomes were reproductive-health-promoting behaviour and rate of contraception use.

RESULTS

Reproductive-health-promoting behaviour was significantly higher in the intervention group than the control group post-intervention, as were reproductive health beliefs, motivation and self-efficacy.

Cancer Screening Program Delivered by Community Health Workers for Chinese Married Immigrant Women in Korea

This quasi-experimental study used a cancer prevention program delivered by community health workers (CHWs) as an intervention to improve health literacy and increase screening uptake. The intervention group was educated by trained CHWs and received information about the nearby hospitals. After education, participants received telephone counseling once a month for 6 months. In the intervention group, CHWs met the participants individually and delivered the CD-ROM containing conversation scenarios with voice during the cancer screening test. The control group was provided educational materials related to breast and cervical cancers and a booklet containing information on mammography and Pap test. This study assessed the difference in mammography and Pap tests between the intervention and control groups. The results showed that the participants’ knowledge improved, and the rate of cancer screening tests did not decrease in the intervention group. Therefore, it is necessary to develop and apply various programs that train CHWs and apply them to immigrant women to promote health-related behaviors under the health system that they are not familiar with while living in another country.

Effects of a Lifestyle Intervention on Health-Promoting Behavior, Psychological Distress and Reproductive Health of Overweight and Obese Female College Students

This study aimed to examine the effect of a lifestyle intervention (LSI) on overweight or obese female university students. Participants: A total of 53 overweight or obese female college students participated. This study was conducted from May to December 2017 in Jeonbuk Province, South Korea. A quasi-experimental design using a non-equivalent control group pretest-posttest was used. The LSI consisted of providing health information, individual health counseling, lifestyle monitoring, and effective support based on the interaction model of client health behavior, which was implemented for 12 weeks. Significant group differences were found in health-promoting behavior, psychological distress, reproductive health, body weight, body fat, and triglyceride level among participants. LSIs are effective in improving health-promoting behavior, psychological distress, reproductive health, and body composition. Therefore, healthcare providers should develop and apply LSIs through interaction for overweight or obese female college students.

Theoretical evaluation of Cox’s interaction model of client health behavior for health promotion in adult women

This study aimed to evaluate Cox’s interaction model of client health behavior (IMCHB) as used in studies on women’s health. Using keyword combinations of “women” and “IMCHB” or “interaction model of client health behavior,” we searched the PubMed, MEDLINE, Embase, and RISS databases for studies on the promotion of women’s health published from January 2009 to April 2019. Finally, 11 studies were selected and evaluated according to seven criteria for theory evaluation, which combined Fawcett’s theory evaluation criteria and Chinn and Kramer’s criteria. We found that the IMCHB corresponds to a verifiable practical level of a middle-range theory, although it may be partially abstract. It contains all four concepts of the metaparadigm of nursing, in terms of a holistic philosophical approach. A theoretical evaluation demonstrated that the IMCHB has significance, generality, testability, empirical adequacy, and pragmatic adequacy for nursing practice and research. However, the lack of clear conceptual definitions and the presence of complex relationships among concepts resulted in a lack of internal consistency and parsimony. According to an in-depth verification through a review of the literature, the IMCHB has been used as a health promotion intervention strategy for various populations of women and has led to useful results in nursing practice. The IMCHB was confirmed to be a suitable theory for experimental and clinical research. Future research can build on this middle-range theory for women’s health research and practice.

Gender Differences and Relationships among Lifestyle and Reproductive Health in University Students

PURPOSE

University students happen to be in a transitional period at the beginning of one's adult life and thereby establish the basis for their health care. The negative lifestyles followed by students during this period can also affect their reproductive health. The purpose of this study was to identify lifestyle, reproductive health, gender differences and relationships between lifestyle and reproductive health in university students.

METHODS

We used a descriptive cross-sectional design. A total of 300 subjects were enrolled. Data were collected using structured questionnaires between October 11 and 25, 2017 and analyzed using SPSS 25.0. Subjects agreed to undergo a face-to-face interview, including administration of the Health Promotion Lifestyle Profile II (HPLP-II) and reproductive health (knowledge, attitude, and behaviors).

RESULTS

The mean age of the subjects was 21.4 years. HPLP-II and reproductive health behaviors were significantly different between the genders. The scores of physical activity and nutrition in females were significantly lower than males. The scores of safe sex and sexual responsibility in females were significantly higher than males, and the score of genital health management was significantly lower in females than males. High HPLP-II score was observed to be in correlation with high reproductive health attitudes and behaviors.

CONCLUSION

The result revealed differences in lifestyle and reproductive health between both the genders. For improvement of reproductive health of university students, provision of lifestyle intervention including healthy nutritional habits and physical activity is imperative.

Relationships among Lifestyle, Depression, Anxiety, and Reproductive Health in Female University Students

PURPOSE

To identify relationships among lifestyle, psychological distress, and reproductive health in female university students.

METHODS

We used a descriptive cross-sectional design. A total of 275 subjects were enrolled. Subjects agreed to undergo a face-to-face interview, including administration of structured questionnaires to determine health promotion lifestyle profile II (HPLP-II), depression anxiety stress scale for depression and anxiety (DASS-D, DASS-A), and reproductive health (knowledge, attitude, behavior, menstruation irregularity, dysmenorrhea, and gynecologic symptoms).

RESULTS

The mean age of subjects was 21.2 years. Those with low HPLP-II score showed significantly high menstruation irregularity. Those with high depression and anxiety had significantly high reproductive symptoms. In addition, high HPLP-II score was correlated with low depression, anxiety, and high reproductive health.

CONCLUSION

The life style of female university students is associated with depression, anxiety, and reproductive health. To improve female university students' reproductive health, life style interventions including healthy nutritional habit, physical activity, and stress management are important.

Factors influencing use of family planning in women living in crisis affected areas of Sub-Saharan Africa: A review of the literature

BACKGROUND

far too many women continue to die from pregnancy and childbirth related causes. While rates have decreased in the past two decades, some areas of the world such as sub-Saharan Africa continue to have very high maternal mortality rates. One intervention that has been demonstrated to decrease maternal mortality is use of family planning and modern contraception, yet rates of use in sub-Saharan countries with the highest rates of maternal death remain very low.

AIM

to review available research and summarize the factors that inhibit or promote family planning and contraceptive use among refugee women and women from surrounding areas living in Sub-Saharan Africa.

DESIGN

a review of the literature.

DATA SOURCES

Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), OVID, power search, and PubMed databases.

REVIEW METHODS

studies included were: (1) published in English from 2007 to present; (2) primary research; and (3) focused on family planning and contraceptive use among refugee women and women in surrounding areas. Findings were discussed within the framework of the Interaction Model of Client Health Behavior.

FINDINGS

twelve studies met the inclusion criteria. Utilization of modern contraceptive methods was low. Women were socially influenced to avoid the use of contraceptives by husbands and others in the community. Reasons were a lack of trust in western medicine and the desire to have large families. Low socioeconomic status and proximity of family planning clinics were barriers to access. Women believed that health care providers were unqualified, many described being treated with disrespect in the health clinics. Knowledge and understanding of contraceptives was low; while most women knew different methods were available, there were many misconceptions. Believing that certain contraceptives cause death, infertility and side effects, contributed to fear of use. This lack of knowledge and fear, even with the desire to space and limit births, affected motivation to use contraception.

CONCLUSIONS

developing new approaches to educating women, men (husbands), community leaders as well as healthcare providers is needed to address the multi-factorial issues that contribute to underuse of family planning services, thus contraceptive use.

IMPLICATIONS FOR PRACTICE

while lack of access to family planning is a barrier to use, interventions that improve access must be affordable and include education regarding contraceptive methods, preferably from those within the community. However, education and access is not sufficient unless the issue of disrespect by healthcare providers is addressed. Respectful and culturally sensitive care for all women, regardless of socio-economic status or country of origin, must be provided by midwives and other women health providers.

[Effects of Web-based Preconception Health Promotion Program for Couples about to be Married]

PURPOSE

This study was done to develop a Web-based preconception health promotion program to improve preconception health promotion awareness, perceived benefits, perceived self-efficacy and health behavior, and to reduce perceived barriers in couples about to be married.

METHODS

Participants were assigned to the experimental group (n=26 couples) or control group (n=25 couples). This program was comprised of a six hour Web-based lecture series which was given to the experimental group over a four week period.

RESULTS

Results for the two groups showed: 1) a significant difference in preconception health promotion awareness in men (self-perception: z=-3.62, p<.001 content: F=18.49, p<.001) and in women (self-perception: z=-2.89, p=.004 content F=36.93, p<.001), 2) a significant difference in perceived benefits in men (z=-3.09, p=.002), and in women (F=6.38, p=.004), 3) a significant difference in perceived barriers in men (F=3.64, p=.030), and in women (F=11.36, p<.001), 4) a significant difference in perceived self-efficacy in men (F=12.16, p<.001), but no significant difference in women (F=1.93, p=.166), 5) a significant difference in health promoting behavior in men (F=16.31, p<.001), and in women (F=10.99, p=.001).

CONCLUSION

The results of this study show that the program is an effective nursing intervention in couples about to be married. Therefore, this program can be useful in encouraging health-promoting behavior for couples about to be married.

[Effects of a Customized Birth Control Program for Married Immigrant Postpartum Mothers]

PURPOSE

This study was conducted to develop a customized birth control program and identify its effects on attitude, subjective norm, behavioral control, intention, and behavior of contraception among immigrant postpartum mothers.

METHODS

In this experimental study, Vietnamese, Filipino or Cambodian married immigrant postpartum mothers were recruited. They were assigned to the experiment group (n=21) or control group (n=21). The customized birth control program was provided to the experimental group for 4 weeks.

RESULTS

The experimental group showed a significant increase in the score of attitude, subjective norm, behavioral control, intention, and behavior of contraception.

CONCLUSION

Findings in this study indicate that the customized postpartum birth control program, a systematic and integrative intervention program composed of customized health education, counseling and telephone monitoring, is able to provide effective planning for postpartum health promotion and birth control behavior practice in married immigrant women.

Influencing Factors of Intention to Receive Pap Tests in Vietnamese Women who Immigrated to Taiwan for Marriage

PURPOSE

This study aimed to explore the factors associated with the intention to receive a Pap test among married immigrant women of Vietnamese origin living in Taiwan.

METHODS

This was a cross-sectional community-based study. We enrolled 281 women aged 30 years and over in the study, from July 2013 to January 2014. The participants' characteristics, cervical cancer knowledge, Pap test knowledge, attitudes toward cervical cancer, barriers to receiving a Pap test, fatalism, and intention to receive a Pap test, were measured using self-report questionnaires. Hierarchical multiple regression analyses were performed to examine the variables associated with participants' intentions to receive a Pap test.

RESULTS

Vietnamese women with low scores on the measures of cervical cancer knowledge and perceived barriers to receiving a Pap test were more willing to receive the test, as were those with high scores on the measures of Pap test knowledge and fatalism. Women who received a Pap test in the previous year were more willing to receive a Pap test within the next 3 years.

CONCLUSIONS

Preventive healthcare for immigrant women should be a focus of nurses. The development of culturally appropriate health education and strategies should enhance their knowledge of Pap tests and reduce perceived barriers to Pap test participation. This study's results can be a reference for nurses who work with immigrant women.

[Effects of Lifestyle Intervention on Fatigue, Nutritional Status and Quality of Life in Patients with Gynecologic Cancer]

PURPOSE

The purpose of this study was to examine the effect of lifestyle intervention on the development of fatigue, nutritional status and quality of life of patients with gynecologic cancer.

METHODS

A nonequivalent control group quasi-experimental design was used. Participants were 49 patients with gynecologic cancer. They were assigned to the experiment group (n=24) or the control group (n=25). The lifestyle intervention for this study consisted of physical activity, nutritional education, telephone call counseling, health counseling, monitoring for lifestyle, and affective support based on Cox's Interaction Model of Client Health Behavior and was implemented for six weeks.

RESULTS

Significant group differences were found for fatigue (p =.037), nutritional status (p =.034) and social/family well-being (p =.035) in these patients with gynecologic cancer.

CONCLUSION

Results indicate that this lifestyle intervention is effective in lessening fatigue, and improving nutritional status and social/family well-being. Therefore, nurses in hospitals should develop strategies to expand and provide lifestyle interventions for patients with cancer.