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Authenticity and rizz – What do they have to do with journal editors and researchers? Authenticity and rizz - 它们与期刊编辑和研究人员有什么关系?
IF 0.6 Q3 NURSING Pub Date : 2023-12-31 DOI: 10.4069/kjwhn.2023.12.18
Sue Kim
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引用次数: 0
Factors influencing health-related quality of life in older adult women with sarcopenia: analysis of the Korean National Health and Nutrition Examination Survey 2019 影响患有肌肉疏松症的老年妇女健康相关生活质量的因素:2019 年韩国国民健康与营养调查分析
IF 0.6 Q3 NURSING Pub Date : 2023-12-31 DOI: 10.4069/kjwhn.2023.12.14
Sol Hyun Lee, Ju-Hee Nho, Hye Young Kim, Eun-Jee Lee
Purpose: This study aimed to identify factors influencing the health-related quality of life (HRQoL) of older adult women with sarcopenia.Methods: The study was secondary data analysis using data from the 2019 Korea National Health and Nutrition Examination Survey. The final sample consisted of 142 women aged 60 years and older with sarcopenia and were selected from 8,110 women. The participants was analyzed using complex descriptive statistics, independent t-test, and regression.Results: In terms of HRQoL, three general characteristics were found to be influential, with an explanatory power of 56.0%: difficulty climbing stairs, difficulty working, and perceived health status. Having no or mild difficulty when climbing stairs (B=.20, p=.001; B=.21, p<.001) and no or mild difficulty when working (B=.25, p=. 002; B=.208, p=.013) had a significant effect on HRQoL compared to severe difficulty. Having good or ordinary perceived health status had a significant effect on the HRQoL (B=.11, p<.001; B=.09, p<.001).Conclusion: Based on study findings that the HRQoL of older adult women with sarcopenia were influenced by difficulty climbing stairs and working, as well as good perceived health status, healthcare providers should assist elderly women to maintain physical activities in their daily lives.
目的:本研究旨在确定影响患有肌肉疏松症的老年女性健康相关生活质量(HRQoL)的因素:本研究利用 2019 年韩国国民健康与营养调查的数据进行二次数据分析。最终样本包括 142 名患有肌肉疏松症的 60 岁及以上女性,她们是从 8 110 名女性中挑选出来的。研究人员采用了复杂的描述性统计、独立t检验和回归分析:结果发现,有三个一般特征对患者的 HRQoL 有影响,解释力为 56.0%:爬楼梯困难、工作困难和感知健康状况。与严重爬楼梯困难相比,爬楼梯无困难或轻微困难(B=.20,p=.001;B=.21,p<.001)以及工作无困难或轻微困难(B=.25,p=.002;B=.208,p=.013)对 HRQoL 有显著影响。健康状况良好或一般对 HRQoL 有显著影响(B=.11,p<.001;B=.09,p<.001):根据研究结果,患有肌肉疏松症的老年妇女的 HRQoL 受爬楼梯和工作困难以及良好的健康状况的影响,医护人员应帮助老年妇女在日常生活中保持身体活动。
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引用次数: 0
Nursing care for women with gynecologic cancer receiving radiotherapy: current updates 对接受放射治疗的妇科癌症妇女的护理:最新进展
IF 0.6 Q3 NURSING Pub Date : 2023-12-31 DOI: 10.4069/kjwhn.2023.12.11
H. Moon
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引用次数: 0
An explanatory model of quality of life in high-risk pregnant women in Korea: a structural equation model 韩国高危孕妇生活质量的解释模型:结构方程模型
IF 0.6 Q3 NURSING Pub Date : 2023-12-31 DOI: 10.4069/kjwhn.2023.11.13.1
Mihyeon Park, Sukhee Ahn
Purpose: This study aimed to develop and validate a structural model for the quality of life (QoL) among high-risk pregnant women, based on Roy’s adaptation model.Methods: This cross-sectional study collected data from 333 first-time mothers diagnosed with a high-risk pregnancy in two obstetrics and gynecology clinics in Cheonan, Korea, or participating in an online community, between October 20, 2021 and February 20, 2022. Structured questionnaires measured QoL, contextual stimuli (uncertainty), coping (adaptive or maladaptive), and adaptation mode (fatigue, state anxiety, antenatal depression, maternal identity, and marital adjustment).Results: The mean age of the respondents was 35.29±3.72 years, ranging from 26 to 45 years. The most common high-risk pregnancy diagnosis was gestational diabetes (26.1%). followed by preterm labor (21.6%). QoL was higher than average (18.63±3.80). Above-moderate mean scores were obtained for all domains (psychological/baby, 19.03; socioeconomic, 19.00; relational/spouse-partner, 20.99; relational/family-friends, 19.18; and health and functioning, 16.18). The final model explained 51% of variance in QoL in high-risk pregnant women, with acceptable overall model fit. Adaptation mode (β=–.81, p=.034) and maladaptive coping (β=.46 p=.043) directly affected QoL, and uncertainty (β=–. 21, p=.004), adaptive coping (β=.36 p=.026), and maladaptive coping (β=–.56 p=.023) indirectly affected QoL.Conclusion: It is essential to develop nursing interventions aimed at enhancing appropriate coping strategies to improve QoL in high-risk pregnant women. By reinforcing adaptive coping strategies and mitigating maladaptive coping, these interventions can contribute to better maternal and fetal outcomes and improve the overall well-being of high-risk pregnant women.
目的:本研究旨在以罗伊适应模型为基础,开发并验证高危孕妇生活质量(QoL)结构模型:这项横断面研究收集了 333 名在韩国天安市两家妇产科诊所确诊为高危妊娠的初产妇的数据,或在 2021 年 10 月 20 日至 2022 年 2 月 20 日期间参与在线社区的数据。结构化问卷测量了QoL、情境刺激(不确定性)、应对(适应性或不适应性)和适应模式(疲劳、状态焦虑、产前抑郁、母亲身份和婚姻适应):受访者的平均年龄为(35.29±3.72)岁,从 26 岁到 45 岁不等。最常见的高危妊娠诊断是妊娠糖尿病(26.1%),其次是早产(21.6%)。孕妇的生活质量高于平均水平(18.63±3.80)。所有领域的平均得分均高于中等水平(心理/婴儿,19.03;社会经济,19.00;关系/配偶-伴侣,20.99;关系/家人-朋友,19.18;健康和功能,16.18)。最终模型解释了高危孕妇 QoL 变异的 51%,模型的整体拟合度可以接受。适应模式(β=-.81,p=.034)和不良应对(β=.46,p=.043)直接影响 QoL,不确定性(β=-. 21,p=.004)、适应性应对(β=.36,p=.026)和不良应对(β=-.56,p=.023)间接影响 QoL:制定旨在加强适当应对策略的护理干预措施以改善高危孕妇的 QoL 至关重要。通过加强适应性应对策略和减轻不良适应性应对策略,这些干预措施有助于改善孕产妇和胎儿的预后,并改善高危孕妇的整体福祉。
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引用次数: 0
Prevalence and associated factors of prenatal depression in pregnant Korean women during the COVID-19 pandemic: a cross-sectional study COVID-19 大流行期间韩国孕妇产前抑郁症的患病率和相关因素:一项横断面研究
IF 0.6 Q3 NURSING Pub Date : 2023-12-31 DOI: 10.4069/kjwhn.2023.11.22
Mi-Eun Kim, Ha-Neul Jung
Purpose: This study investigated the effects of prenatal education characteristics, pandemic-related pregnancy stress, and health behaviors during pregnancy on prenatal depression in pregnant women during the coronavirus disease 2019 (COVID-19) pandemic.Methods: The participants were 180 pregnant Korean women, recruited from internet communities for pregnancy preparation, childbirth, and childcare, from July 5 to 15, 2022. The collected data were analyzed using the t-test, analysis of variance, the Mann-Whitney U-test, the Kruskal-Wallis test, and multiple regression analysis.Results: The scores for pandemic-related pregnancy stress (24.50±6.37) and health behaviors during pregnancy (67.07±9.20) were high. Nearly half of the participants (n=89, 49.4%) presented with prenatal depression, with scores of 10 or greater. Prenatal depression had a positive correlation with gestational age (r=.18, p=.019) and pandemic-related pregnancy stress (r=.27, p<.001), and a negative correlation with health behaviors during pregnancy (r=–.42, p<.001). The factors associated with prenatal depression were pandemic-related pregnancy stress (t=4.70, p<.001), marital satisfaction (dissatisfied) (t=3.66, p<.001), pregnancy healthcare practice behaviors (t=–3.31, p=.001), family type (weekend couple) (t=2.84, p=.005), and gestational age (t=2.32, p=.022). The explanatory power of these variables was 38.2%.Conclusion: Since participants had a high level of prenatal depression during the pandemic, and infectious diseases such as COVID-19 may recur, strategies should be developed to improve pregnant women’s mental health with consideration of the unique variables that are relevant in a pandemic. It is also necessary to develop efficient online prenatal education programs that can be implemented even in special circumstances such as social distancing, and to evaluate their effectiveness.
目的:本研究调查了2019年冠状病毒病(COVID-19)大流行期间,产前教育特征、大流行相关的孕期压力和孕期健康行为对孕妇产前抑郁的影响:研究对象为 2022 年 7 月 5 日至 15 日从备孕、分娩和育儿网络社区招募的 180 名韩国孕妇。收集的数据采用t检验、方差分析、曼-惠特尼U检验、Kruskal-Wallis检验和多元回归分析进行分析:与流行病相关的孕期压力(24.50±6.37)分和孕期健康行为(67.07±9.20)分都很高。近一半的参与者(89 人,49.4%)患有产前抑郁症,得分在 10 分或以上。产前抑郁与胎龄(r=.18,p=.019)和大流行相关的妊娠压力(r=.27,p<.001)呈正相关,与孕期健康行为(r=-.42,p<.001)呈负相关。与产前抑郁相关的因素有:与大流行相关的妊娠压力(t=4.70,p<.001)、婚姻满意度(不满意)(t=3.66,p<.001)、孕期保健行为(t=-3.31,p=.001)、家庭类型(周末夫妇)(t=2.84,p=.005)和孕龄(t=2.32,p=.022)。这些变量的解释力为 38.2%:由于参与者在大流行期间产前抑郁水平较高,而 COVID-19 等传染病可能会再次发生,因此应考虑到与大流行相关的独特变量,制定改善孕妇心理健康的策略。此外,还有必要开发即使在社会疏离等特殊情况下也能实施的高效在线产前教育项目,并对其有效性进行评估。
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引用次数: 0
Factors influencing the intention to engage in cervical cancer preventive behavior in human papillomavirus-infected women: a cross-sectional survey 人类乳头瘤病毒感染妇女宫颈癌预防行为意向的影响因素:横断面调查
IF 0.6 Q3 NURSING Pub Date : 2023-12-31 DOI: 10.4069/kjwhn.2023.11.13.2
Bogyeong Song, So Young Choi
Purpose: This study investigated the influence of cervical cancer knowledge, human papillomavirus (HPV) knowledge, self-efficacy, and uncertainty on the intention to engage in cervical cancer preventive behavior in HPV-infected women.Methods: This descriptive correlational study was conducted among 129 adult women aged 20 to 65 years who received positive HPV results at a general hospital in Changwon, Korea. The dataset was analyzed using descriptive statistics, the independent t-test, analysis of variance, the Pearson correlation coefficient, and multiple regression.Results: The mean score for the intention to engage in cervical cancer preventive behavior was high (4.43±0.65). This intention was significantly different according to age at first sexual intercourse (F=7.38, p=.001), HPV type (F=4.79, p=.010), vaccination (t=3.19, p=.002), and condom use (t=3.03, p=.003). The intention to engage in cervical cancer preventive behavior showed significant, weak-to-moderate positive correlations with HPV knowledge (r=.22, p=.012) and self-efficacy (r=.42, p<.001). Self-efficacy (β=.46, p<.001), first sexual intercourse at <20 years (β=.45, p<.001), first sexual intercourse at 20-24 years (β=.29, p=. 018), HPV high- and low-risk group infection (β=.26, p=.019), HPV high-risk group infection (β=.26, p=.026), and vaccination (β=.21, p=.007) significantly influenced the intention to engage in cervical cancer preventive behavior. These variables explained 34.6% of variance in intention.Conclusion: Study findings support the need to develop a program that effectively conveys accurate information about cervical cancer prevention to HPV-infected women and helps them enhance self-efficacy to boost the intention to engage in cervical cancer preventive behavior.
目的:本研究调查了宫颈癌知识、人乳头瘤病毒(HPV)知识、自我效能感和不确定性对感染 HPV 的女性宫颈癌预防行为意向的影响:这项描述性相关研究的对象是在韩国昌原市一家综合医院接受 HPV 阳性检测的 129 名 20 至 65 岁成年女性。采用描述性统计、独立 t 检验、方差分析、皮尔森相关系数和多元回归法对数据集进行了分析:宫颈癌预防行为意向的平均得分较高(4.43±0.65)。这一意愿在初次性交年龄(F=7.38,p=.001)、HPV 类型(F=4.79,p=.010)、疫苗接种(t=3.19,p=.002)和安全套使用(t=3.03,p=.003)方面存在明显差异。宫颈癌预防行为意向与 HPV 知识(r=.22,p=.012)和自我效能(r=.42,p<.001)呈显著的弱中度正相关。自我效能(β=.46,p<.001)、20 岁以下首次性交(β=.45,p<.001)、20-24 岁首次性交(β=.29,p=.018)、HPV 高危和低危人群感染(β=.26,p=.019)、HPV 高危人群感染(β=.26,p=.026)和疫苗接种(β=.21,p=.007)显著影响宫颈癌预防行为的意向。这些变量解释了 34.6% 的意向变异:研究结果表明,有必要制定一项计划,有效地向感染 HPV 的妇女传递有关宫颈癌预防的准确信息,并帮助她们增强自我效能感,从而提高参与宫颈癌预防行为的意愿。
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引用次数: 0
Analysis of suicide statistics and trends between 2011 and 2021 among Korean women 2011 年至 2021 年韩国女性自杀统计数据及趋势分析
IF 0.6 Q3 NURSING Pub Date : 2023-12-31 DOI: 10.4069/kjwhn.2023.12.14.1
Hyunjung Jang, Seokmin Lee, Sang-Hwa Park, Bobae Kang, Hyunkyung Choi
Purpose: This study aims to analyze the number of suicide deaths in women, trends in suicide mortality, characteristics of suicide by age, and outcomes of suicide means over the past decade (2011–2021) in South Korea.Methods: Using cause of death data from Statistics Korea, an in-depth analysis of Korean women’s suicide trends was conducted for the period of 2011–2021.Results: In 2021, women’s suicide death in Korea was 4,159, a rate of 16.2 per 100,000 population. The rate increased by 1.4% from the previous year. Since 2011, women’s suicide rate has been on a steady downward trend, but since 2018, it has been on the rise again. Suicide rates among women in their 20s and 30s have increased, especially since the coronavirus disease 2019 pandemic, and suicide rates among women over 70 years remain high. As compared to 2011, pesticide poisoning and hanging among the means of suicide have decreased significantly, while drug and carbon monoxide continue to increase.Conclusion: Suicide rates for Korean women in their 20s and 30s have increased significantly in recent years, and those for women over 70 years remain high. Therefore, it is necessary to investigate the causes and establish national policies for targeted management of these age groups, which contributes significantly to the rising suicide rate among Korean women.
目的:本研究旨在分析过去十年(2011-2021 年)韩国女性自杀死亡人数、自杀死亡率趋势、各年龄段自杀特征以及自杀手段的结果:方法:利用韩国统计局提供的死因数据,对 2011-2021 年韩国女性自杀趋势进行了深入分析:结果:2021 年,韩国女性自杀死亡人数为 4,159 人,自杀率为每 10 万人 16.2 人。与前一年相比,自杀率上升了 1.4%。自 2011 年以来,女性自杀率呈持续下降趋势,但自 2018 年以来,女性自杀率又呈上升趋势。尤其是2019年冠状病毒病大流行以来,二三十岁女性的自杀率有所上升,70岁以上女性的自杀率居高不下。与2011年相比,自杀手段中农药中毒和上吊的自杀率明显下降,而毒品和一氧化碳的自杀率持续上升:结论:近年来,韩国二三十岁女性的自杀率明显上升,70 岁以上女性的自杀率居高不下。因此,有必要调查原因,并制定国家政策,对这些年龄段的人群进行有针对性的管理。
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引用次数: 0
Influence of folic acid knowledge on effective folic acid intake in Chinese pregnant women: a cross-sectional study 叶酸知识对中国孕妇叶酸有效摄入量的影响:一项横断面研究
IF 0.6 Q3 NURSING Pub Date : 2023-12-31 DOI: 10.4069/kjwhn.2023.11.20
You Jing Jin, Hae Won Kim
Purpose: This study aimed to investigate the current status of effective folic acid intake and the level of folic acid knowledge of Chinese pregnant women and to analyze the relationship between effective folic acid intake and folic acid knowledge.Methods: From November 2021 to May 2022, 140 pregnant women at Yantai Yuhuangding Hospital in the Chinese province of Shandong, answered questions about their general characteristics, folic acid intake, and folic acid knowledge. The data were analyzed using the t-test, chi-square test, and logistic regression analysis, and were presented with frequency with percentage or mean±standard deviation.Results: Only 16.4% of the pregnant women (n=23) took folic acid effectively, using the following four criteria. Of all pregnant women who took folic acid, 72.2% took folic acid starting 1 month before pregnancy, 70.8% took folic acid up to 3 months after pregnancy, 36.8% took 400 μg every time, and 78.6% took folic acid more than 24 days every month. The score for folic acid knowledge was relatively high (5.61±2.18 on a scale of 0–9). A higher folic acid knowledge score correlated with more effective folic acid intake (t=4.10, p<.001).Conclusions: Our study shows that the current recommendations to prevent neural tube defects through effective folic acid intake supplementation are not being fully implemented in China. Furthermore, folic acid knowledge was positively correlated with the effectiveness of its intake. Future education related to effective folic acid intake should emphasize the four methods of effective folic acid intake, especially regarding the recommended dose of 400 μg every time.
目的:本研究旨在调查中国孕妇叶酸有效摄入量和叶酸知识水平的现状,并分析叶酸有效摄入量和叶酸知识之间的关系:2021年11月至2022年5月,中国山东省烟台市玉皇顶医院的140名孕妇回答了有关其一般特征、叶酸摄入量和叶酸知识的问题。数据采用t检验、卡方检验和Logistic回归分析,以频数加百分比或均数±标准差表示:根据以下四个标准,只有 16.4%的孕妇(23 人)有效服用叶酸。在所有服用叶酸的孕妇中,72.2%的孕妇从怀孕前 1 个月开始服用叶酸,70.8%的孕妇在怀孕后 3 个月内服用叶酸,36.8%的孕妇每次服用 400 μg,78.6%的孕妇每月服用叶酸超过 24 天。叶酸知识得分相对较高(5.61±2.18,0-9 分)。叶酸知识得分越高,叶酸摄入越有效(t=4.10,p<.001):我们的研究表明,目前通过有效补充叶酸来预防神经管畸形的建议在中国并未得到充分实施。此外,叶酸知识与叶酸摄入的有效性呈正相关。未来与叶酸有效摄入相关的教育应强调叶酸有效摄入的四种方法,尤其是每次400微克的推荐剂量。
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引用次数: 0
How do mothers with young children perceive endocrine-disrupting chemicals?: an exploratory qualitative study 有幼儿的母亲如何看待干扰内分泌的化学物质?
IF 0.6 Q3 NURSING Pub Date : 2023-12-31 DOI: 10.4069/kjwhn.2023.11.28
SoMi Park, ChaeWeon Chung
Purpose: Despite the health impacts of endocrine-disrupting chemicals (EDCs) beginning in the early stages of life, there is little research on the perception of EDCs among Korean mothers, who are primarily responsible for protecting children. This study aimed to explore how mothers with young children perceived EDCs for their concerns, the issues they faced, and the way they dealt with them.Methods: An exploratory qualitative design was utilized. Twelve mothers who were recruited from snowball sampling participated in voluntary interviews. Individual in-depth interviews lasting approximately 47 to 60 minutes were recorded and transcribed verbatim. The data were analyzed using qualitative content analysis as suggested by Graneheim and Lundman.Results: Four categories, 10 subcategories, and 25 condensed meaning units were identified by interpreting mothers’ underlying meanings. The four categories were ‘Knowledgeable yet contrasting ideas regarding EDCs,’ ‘Negative health impact, but more so for children,’ ‘Inaction or trying to minimize exposure,’ and ‘Need for early, reliable resources and social change.’ Mothers were knowledgeable about EDCs and actively needed further education and support. While they tended to focus more on the health impact of EDCs on their children and were optimistic about their health risks, paying less attention to their preventive behaviors.Conclusion: Healthcare professionals must consider mothers’ perceptions of EDCs in future education and interventions regarding EDCs impact on women’s life stages such as puberty, pregnancy, and childrearing. Also preventive strategies that can be applied to their daily lives are needed.
目的:尽管干扰内分泌的化学品(EDCs)对健康的影响始于生命的早期阶段,但对于主要负责保护儿童的韩国母亲而言,有关她们对 EDCs 感知的研究却很少。本研究旨在探讨有年幼子女的母亲如何看待 EDC,她们所关注的问题,以及她们处理这些问题的方法:采用探索性定性设计。从滚雪球抽样中招募的 12 位母亲参加了自愿访谈。深入访谈持续了约 47 至 60 分钟,并进行了录音和逐字记录。根据 Graneheim 和 Lundman 的建议,采用定性内容分析法对数据进行了分析:通过解释母亲的基本含义,确定了四个类别、10 个子类别和 25 个浓缩意义单元。这四个类别分别是:"对 EDCs 有一定了解,但想法截然不同"、"对健康有负面影响,但对儿童影响更大"、"不作为或试图尽量减少接触 "以及 "需要早期、可靠的资源和社会变革"。母亲们对 EDCs 有一定的了解,并积极需要进一步的教育和支持。虽然她们往往更关注 EDCs 对子女健康的影响,并对子女的健康风险持乐观态度,但对自己的预防行为关注较少:结论:医疗保健专业人员在今后就 EDCs 对女性青春期、怀孕和育儿等人生阶段的影响开展教育和干预时,必须考虑母亲对 EDCs 的看法。此外,还需要制定可应用于日常生活的预防策略。
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引用次数: 0
A comparison of the perceived importance and performance of midwives’ roles between midwives and nurses in Korea: a cross-sectional study 韩国助产士和护士对助产士角色的重要性和表现的认知比较:横断面研究
IF 0.6 Q3 NURSING Pub Date : 2023-12-31 DOI: 10.4069/kjwhn.2023.11.13
K. Kim, Yunmi Kim, Jummi Park
Purpose: This study aimed to identify the perceptions, importance, and performance of midwives’ roles among midwives and nurses in Korea.Methods: A descriptive correlational design was employed. Data were collected from 164 nurses and 79 midwives from April 1 to June 25, 2021. Midwives enrolled in the Korean Midwifery Association and nurses and midwives from two hospitals each Daegu and Gyeonggi Province in Korea were invited to participate. The independent t-test, chi-square test, the Welch-Aspin test, and Pearson correlation coefficient were used for analysis.Results: The midwives’ role perception score (3.47±1.46) was lower than that of nurses (3.95±0.85), and the midwives’ role performance score (2.98±0.83) was also lower than that of nurses (3.34±0.89). Significant differences were observed between midwives and nurses in their perception and performance of roles related to prenatal management, childbirth management, management of psychological changes, postpartum management, and newborn care. Higher role perception and performance among midwives were linked to the management of psychological changes and women’s health, indicating potential areas for future development.Conclusion: The study results suggest directions for developing new roles for midwives. It is necessary to find a way to expand the field of midwives in public health by benchmarking the roles of midwives in various countries.
目的:本研究旨在确定韩国助产士和护士对助产士角色的看法、重要性和表现:方法:采用描述性相关设计。从 2021 年 4 月 1 日至 6 月 25 日收集了 164 名护士和 79 名助产士的数据。韩国助产士协会注册的助产士以及韩国大邱和京畿道各两家医院的护士和助产士受邀参加。采用独立 t 检验、卡方检验、韦尔奇-阿斯平检验和皮尔逊相关系数进行分析:助产士的角色认知得分(3.47±1.46)低于护士(3.95±0.85),助产士的角色表现得分(2.98±0.83)也低于护士(3.34±0.89)。助产士和护士在产前管理、分娩管理、心理变化管理、产后管理和新生儿护理方面的角色认知和表现存在显著差异。助产士在心理变化管理和妇女健康方面的角色认知和表现较高,这表明未来发展的潜在领域:研究结果为助产士新角色的发展指明了方向。结论:研究结果为助产士新角色的发展指明了方向,有必要通过对各国助产士的角色进行比照,找到扩大助产士在公共卫生领域的作用的方法。
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引用次数: 0
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Korean Journal of Women Health Nursing
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