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Effects of Overseas Volunteering Programs on Meaning of Life, Subjective Happiness and Professional Self Concept of College Students

Objectives: This study investigated effects of 2 weeks of overseas volunteering programs, taken by college students in public health on meaning of life, subjective happiness, and professional self-concept. Methods/Statistical Analysis: Subjects were those students who participated or did not participate in a college-administered 2 weeks of overseas volunteering program. A part of descriptive survey was used and values in repeats and variance analysis were measured to collect data. Values of professional images, meaning of life, subjective happiness were collected and verified according to each developer’s standards. Collected data was analyzed using SPSS Program 18.0. Descriptive statistics was applied for general characteristics of subjects, and variable changes between groups were analyzed with repetitive measurements and variance analysis. Findings: Our study was a descriptive survey showing changes in meaning of life, subjective happiness and professional self-concept after students in public heath took part in overseas volunteering programs. Such programs generated long-term effects of self-esteem as a global leader and citizen, mental happiness, inner calmness and subjective happiness onto participants. Those programs also brought positive changes in entire life of female students. With promotion of such programs students should be given opportunities to keep passion, confidence, and positive life attitude. Under the meaning of life entry, significant differences in population (F=1.507, p=>.001, η2=.223), survey period (F=31.94, p=>.001, η2=.441), and combined population and survey period (F=5.417, p=.006, η2=.118) were found. Under the subjective happiness entry, Significant differences in population (F=5.442, p=.022, η2=.062), survey period (F=98.21, p=>.001, η2=.708), and combined population and survey period (F=4.259, p=.017, η2=.095) were also found. These results, therefore, demonstrated that college students in public health gave positive assertions to meaning of life, their satisfaction level with their own life was higher in general, and their inner changes stayed longer. Improvements/Applications: Our results strongly indicated that, overseas volunteering programs gave participating students opportunities for changes of their own inner selves.


Introduction
As globalization has been accelerated, governments support various programs politically and financially to raise talented people from enterprises, governments and universities as global leaders 1 . Since1990s, our government has been running various programs, such as working holidays, long-term and short-term study-abroad courses, volunteering, overseas employments and ventures 2 .
College students in public health could get a sense of globalized international health market trend and professional roles in international public health field. Particularly, it turned out that students wanted to seek overseas volunteering as a way to increase practical experiences and understanding levels. Overseas volunteering experiences could step up not only international standings of each country but adaptive skills of participants.
Motives for joining overseas volunteering vary from selflessness, such as talents donation or sharing, to selfachievements, studies, escape from stress, and anxiety for other cultures or career developments 3 . But, whatever motives there might be, students who had overseas experience showed higher satisfaction than those who joined domestic volunteering programs. This was reasoned from the fact that even though unexpected harsh realities in foreign countries initially affect students who were not prepared, they started to perceive responsibility and made improvements on facing conditions and finding solutions as a global leader 2 .
The poorer countries in which students volunteer stimulated them to grow natural interests in poverty, human rights and quality of life 3 . They also developed stress and anxiety from being successful, competition and materialism-oriented social structure even though they were in wealthier environments. They started to have various inner changes, mulling over quality of life, self-reflection, life values, desire for spiritual fulfillments, etc. They came across fundamental issues of their own through relationship with local residents who have different life style and culture 4 . Furthermore, through volunteering experiences, they went through the process of figuring out meaning and ways of life, and had chances to develop self-maturity and mind, different from the previous 5 .
As their curricula deepened, students in public health tended to possess professional mind and selflessness, and tried to formulate good images and to take pride in their profession 6 . Those who participate in overseas volunteering become aware that infections, deformities and lack of medical infrastructure resulted from low quality in living environments and medical malpractice. This awareness drove them to take care of children in need and to help residents improve their life quality, and to secure their occupational mind as public health professionals 5 . They even started to bring out pure joy of devotion to others and fulfilling their subjective satisfaction 7 .
They realized that happiness came not from accumulation of materials but from attitude toward life. They put emphasis on changing attitude toward life itself, which function as a buffer to alleviate pain despite negatives of unhappiness, death, etc 8,9 . They could have turning points by experiencing particular activities and think about present and future lives of their own4. They pursued mental stability and would like to find positive meaning of life and happiness 9 . Such subjective happiness and stability are considered to be an important factor to live a life and help to overcome stress from clinical demanding duties, interpersonal relationships and death 10 .
Previous studies showed that sharing and devotion awaken participating students to live as a global citizen and to have positive changes 2 . Most studies focused on qualitative aspects of their experiences with participants in overseas volunteering or course programs as a mainstream 1-3 .
This study aims to find effects of overseas volunteering, relatively rare events in their lifetime, on meaning of life, subjective happiness and professional images. In addition, it is interesting to see to what extent it has changed attitude and mind of participating students going overseas for volunteering, and to see how long its effects last long instead of coming in short.

Study Scheme
Repetitive descriptive surveys were performed with college students in nursing departments who experienced changes in meaning of life, subjective happiness and images as a nurse.

Subjects
Subjects were those students who participated or did not participate in a college-administered 2 weeks of overseas volunteering program in written agreement.

Method of Data Collection
Repetitive date collection was carried out on college students who took part in 12 or 23 months after an overseas volunteering program for 2 weeks starting from December 27th, 2012. Researchers got permission from the dean after purpose and methods of experiments were explained and agreed upon. Data was collected from both subjects of test (50 participants) and control (55 participants) groups. While data was being collected for 24 months, due to employment and missing data, final participants used for data collection were 40 of the test group and 44 of the control group.
Eun-Hee Park and Hae-Ryoung Park

Professional Self Concept
Professional images for this study could be regarded as a total of beliefs, thoughts and feelings about the profession. They were measured after some modifications and supplements of 11 developed tools by us and one professor in nursing department. The tools consisted of Liker-style 4-point evaluation over 26 questions in total, subareas in which included 12 questions of profession, 5 of communication, 6 of performance and 3 of organization. One point was given to 'no' and 4 points were given to 'yes' so higher points represent higher value of professional selfconcept. Reliability was Cronbach ' s α = .95 at the time of development but it was Cronbach ' s α = .877 for this study.

Meaning of Life
Meaning of life, used as an evaluating entry in this study was adopted from 'Meaning in Life Questionnaire' developed by 12 after translation and modifications by 13 .
The questionnaire consisted of Likert-style 7-point grade, subareas in which included 5 questions of meaning fulfillment and 5 of meaning discovery. One point was given to 'no' and 7 points were given to 'yes' so higher points meant higher professional self-concept. At the time of these tools development, the reliability was Cronbach ' s α= .902 but it was Cronbach ' s α= .761 at this study.

Subjective Happiness
Subjective happiness was measured with the questionnaire developed by 14 , which included 4 questions. By saying 'no' , 1 point was given and by saying 'yes' , 5 points were given, which indicates that higher points represent higher subjective happiness. The reliability was Cronbach ' s α = .860 at the development of those tools but it was Cronbach ' s α = .880.

Measuring Criteria
Collected data was analyzed using SPSS Program 18.0. Descriptive statistics was applied for general characteristics of subjects, and variable changes between groups were analyzed with repetitive measurements and variance analysis.

General Characteristics of Subject Groups
Subject groups included all the sophomore college students and the test and control group were 40 and 44 participants, respectively. Opinions of the test group about volunteering were divided into 27.5 % "positive", 67.5 % "negative" and 5.0 % "others" while the control was 15.9 % "positive", 75.0 % "negative" and 9.0 % "others", showing more positives in the test group as shown in Table 1.

Discussion
This study investigated pre-and post-changes in meaning of life, subjective happiness and professional images of college students majoring in public health which experienced overseas volunteering, and whether these experiences could affect overall life of those college students. Meaning of life in the test group had 40.85 (12 months after) and 40.47 (23 months after) while the control group had 37.65 (12 months after) and 39.95 (23 months after). While test group maintained increased values without fluctuations, those in control group were gradually increased depending on measurement periods. What made different between two groups was that the test group recognized meaning of life and maintained con-  9 . Consistent with studies conducted on middle and elderly classes, those who were actively involved in volunteering had higher values in meaning of life, self-control and self efficiency 15 .
The analysis of previous studies demonstrated that participants liked to live their fulfilled life through returning their devotions to society 16 . Especially, the significant increase of meaning of life in both groups resulted from dealing with patients who had serious illness or faced death. During this kind of maturing process, they thought deeply about the meaning of their life and assigned special meanings to their committed duties. Noticeably, there have been few studies conducted on finding meaning of life using college students in public health as a subject. Those studies have been conducted, focusing on middle-aged or elderly people. It is necessary to initiate more studies on meaning of life of college public health students because they have important missions of taking care of ill patients, giving reasons for living a life and helping patients have their life back.
Our studies showed that meaning of life had a statistically significant difference in population, measurement period and combined population and measurement period. There should be a continuous incentive to keep overseas volunteering going rather than one-time experience because students who participated in volunteering work had better meaning of life and remained in happy life.
Subjective happiness in the test group had higher values and maintained without much fluctuation, 21.96 (12 months after) and 21.85 (23 months after) but subjective happiness in the control group were increased gradually, depending on measurement periods, 19.13 (12 months after) and 21.25 (23 months after). It was reported that salary people who had higher index of physical, mental and cognitive wellness felt more subjective happiness and improved quality of life. In particular, those who make well use of off-work activities, such as sports and dancing had higher subjective happiness 17 . One study argued that female students in nurse had low grades in subjective happiness but this contrasting result would be eliminated because female students who were satisfied with their major study improved their subjective happiness 18 . Meanwhile, nurse students who experienced short-term courses found another self in them and showed positive attitudes and positive changes 19 .
It was considered that subjective happiness did not result from objective and external factors but from self-imposed reactions when positive evaluation could be made possible, based on internal integration and experience 20 . Our study showed that reason why subjective happiness was kept increasing and maintained in high was internal changes of students who participated in overseas volunteering 10 . It was also considered that seeking what could be done for people in need against harsh environments for themselves, and experiences on taking care of and curing those people could help promote patient's health and care of quality.
Our study showed that subjective happiness had a statistically significant difference in population, measurement period, combined population and measurement period, which indicates participating students felt more subjective happiness and kept it longer. Since such a volunteering program affected participants' attitude toward their life and brought positive mind to real life, such programs could have positive impacts on all the participating students.
In professional self-concept, the test group had 109.17 (12 months after), 118.45 (23 months after) while the control group scored 110.34 (12 months after) and 117.87 (23 months after), showing a similar pattern in both groups.
Professional self-image was not fixed but incessantly or dynamically changed as it was continuously formulated by influence of changes or developments in social culture, contemporary values and circumstances 21 . Therefore, as shown in our study, one-time experience of volunteering program could hardly make participants change images on professions. As recent social recognition changes on public health professionals improved, it was widely accepted that all the health practitioners, including specialists, nurses and other health workers are necessary and images on them has been changed toward positive 22 . However, as professional self-concept could change depending on social interaction and experience, students in public health are needed to strengthen educational background in order to have positive views on their jobs, to have desirable job ethics 23 .
Overseas volunteering programs improved meaning of life, subjective happiness and resulted in long-term positive effects. Participants experienced changes in quality of life, weighed significance on subjective elements and felt both feelings more when their own subjective elements were harmonized. Therefore, students are needed to be taken care of to move out of their boundary and to mingle with other people in different culture so that they could experience inner changes.
Effects of Overseas Volunteering Programs on Meaning of Life, Subjective Happiness and Professional Self Concept of College Students Although the program ended in one-time event, it could have influential effects on their recognition of life so overseas volunteering and short-term courses had to be available frequently. More support is need not for such programs to be terminated shortly.

Conclusion
Our study was a descriptive survey showing changes in meaning of life, subjective happiness and professional self-concept after students in public heath took part in overseas volunteering programs.
Such programs generated long-term effects of selfesteem as a global leader and citizen, mental happiness, inner calmness and subjective happiness onto participants. Those programs also brought positive changes in entire life of female students. With promotion of such programs students should be given opportunities to keep passion, confidence, and positive life attitude.