Journal of Korean Academy of Nursing

Development of a Well-Dying Awareness Scale for Middle-Aged adults in Korea: a mixed-methods study: Yu Jin Jung, Eun Joung Choi; Received October 15, 2024 Accepted February 2, 2025 Published online March 28, 2025; DOI: https://doi.org/10.4040/jkan.24121 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to develop a valid and reliable tool to measure awareness of well-dying among middle-aged adults.
Methods
A mixed-methods approach was adopted, consisting of a qualitative phase to identify the characteristics of well-dying and a quantitative phase to validate the instrument with middle-aged participants. Initially, 76 items were generated through a literature review and in-depth interviews, and these were reduced to 35 items through expert validation. A pilot survey was conducted with 112 individuals aged 40–65, selected via quota sampling from 17 administrative regions in South Korea. Based on the pilot survey results, the instrument was refined to 32 items for the main survey. The main survey included 314 participants recruited through quota sampling in Busan and Ulsan Metropolitan Cities and Gyeongsang Region. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability testing were performed to validate the instrument.
Results
The final scale comprised 23 items across six factors. EFA demonstrated an explanatory power of 69.1%, with factor loadings ranging from 0.53 to 0.88. CFA confirmed the instrument’s validity, and reliability was established with a Cronbach’s α of .93.
Conclusion
This instrument is a validated and reliable tool for measuring middle-aged individuals’ awareness of well-dying. It can serve as an effective resource for evaluating and assessing well-dying awareness in the middle-aged population.

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Nomogram for predicting changes in cognitive function in community dwelling older adults with mild cognitive impairment based on Korea Longitudinal Study of Ageing Panel Data: a retrospective study: Hyuk Joon Kim, Hye Young Kim; J Korean Acad Nurs 2025;55(1):50-63. Published online February 7, 2025; DOI: https://doi.org/10.4040/jkan.24059

Abstract PDF ePub: Purpose
This study aimed to identify factors associated with normal cognitive reversion and progression to dementia in older adults with mild cognitive impairment (MCI) residing in the community and to develop a nomogram.
Methods
This longitudinal study used secondary data from the Korea Longitudinal Study of Ageing Panel Data (2006–2018). The study included 1,262 participants aged 60 or older, with initial Mini-Mental State Examination scores ranging from 18 to 23. Data were analyzed using the Rao-Scott chi-square test, panel binary logistic regression, and receiver operating characteristic (ROC) curve in Stata ver. 17.0 (Stata Corp.).
Results
The rate of reversion from MCI to normal cognition was 37.0% after 2 years and 32.9% after 12 years. The rate of progression to dementia was 18.0% after 2 years and 30.2% after 12 years. In the nomogram for reversion to normal cognition, the most significant influences were grip strength, depression, number of meetings, age, and regular exercise, with an area under the ROC curve (AUC) of .66. In contrast, in the nomogram for progression to dementia, the most significant influences were age, grip strength, instrumental activities of daily living, number of social meetings attended, depression, and regular exercise, with an AUC of .69.
Conclusion
These nomograms can serve as an effective intervention tool for preventing dementia in the field of community health care since they can serve as a visual technique for presenting information on risk to individuals with MCI.

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An Investigation of the Cumulative Effects of Depressive Symptoms on the Cognitive Function in Community-Dwelling Older Adults: Analysis of the Korean Longitudinal Study of Aging: Kim, Eunmi , Oh, Jinkyung , Huh, Iksoo; J Korean Acad Nurs 2023;53(4):453-467. Published online August 31, 2023; DOI: https://doi.org/10.4040/jkan.23018

Abstract PDF

Purpose
This study investigated the cumulative effects of depressive symptoms on cognitive function over time in community-dwelling older adults. Methods: Data were investigated from 2,533 community-dwelling older adults who participated in the Korean Longitudinal Study of Aging (KLoSA) from the 5th (2014) to the 8th wave (2020). The association between cumulative depressive symptoms and cognitive function was identified through multiple regression analysis. Results: When the multiple regression analysis was conducted from each wave, the current depressive symptoms scores and cognitive function scores were negatively associated, regardless of the waves (B5th = - 0.26, B6th = - 0.26, B7th = - 0.26, and B8th = - 0.27; all p < .001). Further, when all the previous depressive symptoms scores were added as explanatory variables in the 8th wave, the current one (B8th = - 0.09, p < .001) and the previous ones (B5th = - 0.11, B6th = - 0.09, and B7th = - 0.13; all p < .001) were also negatively associated with the cognitive function score. The delta R² , which indicates the difference between the model’s R² with and without the depressive symptoms scores, was greater in the model with all the previous and current depressive symptoms scores (6.4%) than in the model with only the current depressive symptoms score (3.6%). Conclusion: Depressive symptoms in older adults have a long-term impact. This results in an accumulated adverse effect on the cognitive function. Therefore, to prevent cognitive decline in older adults, we suggest detecting their depressive symptoms early and providing continuous intervention to reduce exposure to long-term depressive symptoms.

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Systematic identification and quantification of factors and their interactions with age, sex, and panel wave influencing cognitive function in Korean older adults
Eunmi Kim, Jinkyung Oh, Jungsoo Gim, Iksoo Huh
Frontiers in Public Health.2025;[Epub] CrossRef

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Association between Visual Impairment and Nutritional Risk among Older Adults with Diabetes: A Population-Based Cross-Sectional Study: Yang, Eunjin , Lee, Kyung Hee; J Korean Acad Nurs 2023;53(2):167-176. Published online April 30, 2023; DOI: https://doi.org/10.4040/jkan.22141

Abstract PDF

Purpose
Despite the high prevalence of visual impairment caused by diabetic retinopathy and nutritional problems among older adults with diabetes, evidence regarding factors related to nutritional risk in this population is limited. Therefore, this study aimed to identify the correlates of nutritional risk among older adults with diabetes, focusing on visual impairment.
Methods
This study was a secondary data analysis of the 2020 National Survey of Older Koreans aged 65 years and above. The sample comprised 2,376 older adults with diabetes, and complex sample ANOVA and Rao–Scott chi-square tests were used to compare the groups according to visual impairment. Complex-sample logistic regression analyses were conducted to verify the association between visual impairment and nutritional risk.
Results
Older adults with diabetes, who also have severe visual impairment, are more likely to have nutritional risk status than those without impairment after controlling for covariates (odds ratio [OR] = 2.44, 95% confidence interval [CI] 1.16~5.13). Among the covariates, depression (OR = 3.58, 95% CI 2.60~4.94), dependent activities of daily living status (OR = 2.79, 95% CI 1.60~4.86), and experience of hospitalization during the past year (OR = 2.51, 95% CI 1.57~4.03) were strongly associated with nutritional risk.
Conclusion
Severe visual impairment increases the nutritional risk among older adults with diabetes. Therefore, it is essential to prevent visual impairment due to exacerbation of diabetes through appropriate management. Additionally, tailored nutritional interventions for visually impaired older adults with diabetes that consider visual characteristics are required.

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Insights into the associated risk factors of malnutrition among nursing home residents: A longitudinal study
Johanna de Almeida Mello, Emilie Schoebrechts, Patricia Ann Ivonne Vandenbulcke, Anja Declercq, Jan De Lepeleire, Christophe Matthys, Dominique Declerck, Joke Duyck
Clinical Nutrition.2024; 43(11): 166. CrossRef
Frailty and Visual Impairment in Elderly Individuals: Improving Outcomes and Modulating Cognitive Decline Through Collaborative Care Between Geriatricians and Ophthalmologists
Daniel Dinarvand, Johann Panthakey, Ahmed Hassan, Mohamed H. Ahmed
Diseases.2024; 12(11): 273. CrossRef
Malnutrition Risk in Community-Dwelling Older Adults with Dual Sensory Declines: Focusing on Social Determinants of Health
Ha Na Jeong
Research in Community and Public Health Nursing.2024; 35: 325. CrossRef

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Lived Experience of Middle-Aged Patients with Complex Regional Pain Syndrome: Seo, Young-suk , Lee, Sunhee; J Korean Acad Nurs 2022;52(6):598-607. Published online December 31, 2022; DOI: https://doi.org/10.4040/jkan.22086

Abstract PDF

Purpose
This qualitative study aimed to explore the lived and true meaning of experiences of middle-aged patients with complex regional pain syndrome.
Methods
The participants were 10 men and women aged 40 to 60 years who received outpatient treatment at a university hospital, could communicate, and agreed to participate in the study. Data were collected through individual interviews using open and semi-structured questions from September 2019 to July 2021 and were analyzed using the content analysis method suggested by Hsieh and Shannon (2005).
Results
As a result of this study, 42 summarized semantic units related to life experience, 15 subthemes, and seven themes were derived. The seven themes were “pressed by severe pain,” “frustrated because I cannot be part of the community,” “distressed because people do not recognize my disease,” “sad about conflicts with family,” “unmotivated because of desperate life,” “appreciating for support,” and “putting oneself together and living daily life.” Conclusion: The vivid experiences of the participants derived in this study are the basic data for developing treatment guidelines. In the future, we propose a study on life and family care experiences according to the developmental characteristics of the life cycle of patients with complex regional pain syndrome and develop and apply programs to support patients and their families.

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Experiences of diagnosis and treatment for upper limb Complex Regional Pain Syndrome: a qualitative analysis
Grace S Griffiths, Bronwyn L Thompson, Deborah L Snell, Jennifer A Dunn
Pain Medicine.2023; 24(12): 1355. CrossRef

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A Longitudinal Study of the Reciprocal Relationship between Depression and Income among Korean Older Men and Women: Lee, Jeong , Jeon, Gyeong-Suk; J Korean Acad Nurs 2022;52(4):451-463. Published online August 31, 2022; DOI: https://doi.org/10.4040/jkan.22052

Abstract PDF: Purpose
This study examined the reciprocal relationships between depression and income, and gender differences in these relationships among older adults in South Korea.
Methods
Using 2015 to 2019 of the Korea Welfare Panel Study (KoWePS), we studied 6,070 older adults (2,394 men and 3,676 women) aged 60 years over in 2015. The generalized estimating equation was employed to explore the effect of an individual income on depression and the reverse causal link-that of depression on income.
Results
The study found the reciprocal relationships between income and depression. Income has a significant impact on depression. Higher-income was linked to decreased risks of the Center for Epidemiologic Studies Depression (CES-D) scores among older adults (B = - 0.121, p < 0.001). Estimates of the reverse causal link show that higher CES-D scores were also linked to income reduction among Korean older adults (B = - 0.007, p < 0.001). In addition, we also observed gender differences in the impact of income on depression but not in the reverse causal link. Income has more detrimental to psychological consequence for older men (B = - 0.108, p < 0.001) than older women (B = - 0.057, p < 0.001).
Conclusion
The finding implies that both psychological and social protection policies for the elderly are needed in view of gender perspective.

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Influence of Social Capital on Depression of Older Adults Living in Rural Area: A Cross-Sectional Study Using the 2019 Korea Community Health Survey: Jung, Minho , Kim, Jinhyun; J Korean Acad Nurs 2022;52(2):144-156. Published online April 30, 2022; DOI: https://doi.org/10.4040/jkan.21239

Abstract PDF

Purpose
This study aimed to investigate the influence of social capital on the depression of older adults living in rural areas.
Methods
Data sets were obtained from the 2019 Korea Community Health Survey. The participants were 39,390 older adults over 65 years old living in rural areas. Indicators of social capital included trust, reciprocity, network, and social participation. Depression—the dependent variable—was measured using the Patient Health Questionnaire-9 (PHQ-9). Hierarchical ordinal logistic regression was conducted to identify factors associated with depression after adjusting the data numbers to 102,601 by applying the Synthetic Minority Oversampling Technique (SMOTE).
Results
The independent variables—indicators of social capital—exhibited significant association with the depression of older adults. The odds ratios of depression were higher in groups without social capital variables.
Conclusion
To reduce depression, we recommend increasing social capital. Factors identified in this study need to be considered in older adult depression intervention programs and policies.

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The Effects of Perceived Stress on Depression among Middle-aged Adults with Diabetes Mellitus in Korea: Exploring the Mediating Role of Social Capital through a Descriptive Correlational Study
Kyung Ae Kim, Mi Ran Bang
Korean Journal of Adult Nursing.2025; 37(1): 50. CrossRef
An Observational Study on the Association Between Nutritional Intake and Mental Health Among Older Adults in Rural Areas
Kyeongmin Jang
Nursing & Health Sciences.2025;[Epub] CrossRef
Prediction model of weight control experience in men with obesity in their 30 s and 40 s using decision tree analysis
Myeunghee Han
Scientific Reports.2024;[Epub] CrossRef
The relationship between human capital and depression among middle-aged rural adults: The multiple-parallel mediating effects of social capital
Soo Mi Jang, Hyung Mi Ha
Korean Journal of Health Education and Promotion.2023; 40(1): 33. CrossRef

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Willingness to Use and Appropriate Payable Cost for Visiting Nurse Service for the Elderly in the Community: Seo, Soyoung , Jang, Soong-nang; J Korean Acad Nurs 2022;52(1):105-119. Published online February 28, 2022; DOI: https://doi.org/10.4040/jkan.21193

Abstract PDF

Purpose
This study aimed to measure willingness to use (WTU) and appropriate payable cost of visiting nurse service for the elderly and explore their impact factors.
Methods
The study included 752 participants selected from data that were completed in 2017 for the elderly aged over 60 nationwide. Logit and Tobit regression analysis were performed to confirm the influencing factors.
Results
The study found that 39.1% of the elderly in the community were WTU the visiting nurse service, and they reported that the cost per visit was 12,650 Korean Won. The factors influencing WTU were having less than moderate subjective health status (OR = 1.63, p = .011), being part of a social participating groups (OR = 1.50, p = .046), or participation in senior health promotion programs (SHPPs) (OR = 1.96, p = .003). The cost was also influenced by less than moderate subjective health status (β = 4.37, p = .021), being part of a social participating groups (β = 4.41, p = .028), or participation in SHPPs (β = 4.87, p = .023). Additionally, elderly people living alone who were used as covariates were highly WTU (OR = 2.20, p = .029).
Conclusion
This study provides evidence to predict demand for visiting nurse service and reflects consumer value in setting the service cost. This is the first study to derive cost from consumers' perspective regarding the service for the elderly. As it is the result of an open-ended survey, follow-up studies are needed to estimate more reliable and reasonable results.

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Health and Environmental Monitoring Services for Smart Healthy Cities : Current Practices and Challenges in Local Government Plans
Dong-ah Choi, Yun-jeong Song, Andy Hong
Journal of Korea Planning Association.2024; 59(5): 147. CrossRef

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Healthcare Considerations for Special Populations during the COVID-19 Pandemic: A Review: Kim, Jeung-Im , Im, YeoJin , Song, Ju-Eun , Jang, Sun Joo; J Korean Acad Nurs 2021;51(5):511-524. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21156

Abstract PDF

The coronavirus disease 2019 (COVID-19) has emerged as a threat to human health and public safety. People of all ages are susceptible to severe acute respiratory syndrome coronavirus 2 infection. However, the clinical manifestations of this infection differ by age. This study purposes to describe healthcare considerations for special populations, such as children, pregnant and lactating women, and older adults, who may have unique healthcare needs, in the pandemic situation. To realize the research purpose, we conducted a review of the practice guidelines of public documents and qualified studies that were published online/offline during a specific period. The review identified current knowledge on care for newborns, children in schools, pregnant women (from antenatal to postpartum care), and older adults suffering from high-risk conditions. Subsequently, we summarize vaccination guidance for special populations and, finally, discuss the issues currently affecting special populations. Therefore, this current knowledge on care for special populations helps nurses to provide accurate information on vaccinations aimed at preventing COVID-19 and protecting the masses from infection. Currently, the scarcity of information on COVID-19 variants necessitates further research on measures to reduce pandemic spread.

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The Use of Therapeutic Plasma Exchange in the Treatment of a Pregnant Woman with COVID-19 Induced Acute Respiratory Distress Syndrome
Sy Duong-Quy, Duc Huynh-Truong-Anh, Thanh Nguyen-Thi-Kim, Tien Nguyen-Quang, Thanh Nguyen-Chi, Nhi Nguyen-Thi-Y, Van Duong-Thi-Thanh, Carine Ngo, Timothy Craig
Pulmonary Therapy.2022; 8(2): 233. CrossRef

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Face Mask Usage, Knowledge and Behavior of Face Mask Usage in Older Adults Living Alone in the COVID-19 Era: Han, A-Reum , Park, Yeon-Hwan; J Korean Acad Nurs 2021;51(2):203-216. Published online April 30, 2021; DOI: https://doi.org/10.4040/jkan.20252

Abstract PDF

Purpose
This study analyzed the current status of face mask usage. It also identified factors related to the knowledge and behavior regarding the same among older adults living alone during the COVID-19 pandemic.
Methods
This descriptive study was conducted via a telephone survey involving 283 older adults living alone in S City from March to April 2020. Knowledge and behavior pertaining to face mask usage were measured using Hilda Ho’s Face Mask Use Scale; reliability of the measurement was Kuder-Richardson formula-20 = .62, Cronbach’s α = .92. Data were analyzed using descriptive analysis, independent t-test, Pearson’s correlation coefficient, and multiple linear regression.
Results
Older adults used one mask for 3.55 days on an average. The knowledge level was 9.97 (± 1.84) out of 12 and behavior level was 15.49 (± 1.55) out of 16. Level of education (β = - .31, p < .001), living region (β = .13, p = .017), personal income (β = .12, p = .041) significantly affected the face mask usage-related knowledge, and living region (β = .15, p = .010) significantly affected the face mask usage-related behavior.
Conclusion
Older adults living alone are aware of the effects of using face masks. However, their mask usage is inappropriate, for example, the prolonged use of the same mask. Considering the low level of face mask usage-related knowledge, it is necessary to develop customized education programs and infectious disease prevention strategies for older adults possessing low educational levels living alone in urban-rural complex areas.

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A comparative cross-cultural study of fear of COVID-19 in Persian and Turkmen elderly populations
Maliheh Makhtum, Naser Behnampour, Akram Sanagoo, Hossein Nasiri, Leila Jouybari
Journal of Research Development in Nursing and Midwifery.2023; 20(1): 11. CrossRef
Influencing factors on self-care of older adults living alone in a community during COVID-19: A cross-sectional study
Heeyoung Woo, Minkyung Gu
Journal of Korean Gerontological Nursing.2023; 25(1): 1. CrossRef
The association between depression and non‐compliance with COVID‐19 preventive behaviors in South Korean older adults stratified by sex
Jae Jun Lee, Namhee Kim, Min Kyung Park, Hyunju Ji, Gwang Suk Kim
International Journal of Geriatric Psychiatry.2023;[Epub] CrossRef
Factors Associated with Depression in Older Adults Living Alone during the COVID-19 Pandemic
Eun Hye Hong, Kyung Hee Lee
Journal of Korean Academy of Community Health Nursing.2022; 33(4): 418. CrossRef

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Family’s Perception of Proxy Decision Making to Authorize Do Not Resuscitate Order of Elderly Patients in Long Term Care Facility: A Q-Methodological Study: Cho, Hyeon Jin , Kang, Jiyeon; J Korean Acad Nurs 2021;51(1):15-26. Published online February 28, 2021; DOI: https://doi.org/10.4040/jkan.20188

Abstract PDF

Purpose
This study aimed to distinguish and describe the types of perceptions of do not resuscitate (DNR) proxy decisions among families of elderly patients in a long-term care facility.
Methods
This exploratory study applied Q-methodology, which focuses on individual subjectivity. Thirty-four Q-statements were selected from 130 Q-populations formed based on the results of in-depth interviews and literature reviews. The P-samples were 34 families of elderly patients in a long-term care hospital in Busan, Korea. They categorized the Q-statements using a 9-point scale. Using the PC-QUANL program, factor analysis was performed with the P-samples along an axis.
Results
The families’ perceptions of the DNR proxy decision were categorized into three types. Type I, rational acceptance, valued consensus among family members based on comprehensive support from medical staff. Type II, psychological burden, involved hesitance in making a DNR proxy decision because of negative emotions and psychological conflict. Type III, discreet decisions, valued the patients’ right to self-determination and desire for a legitimate proxy decision. Type I included 18 participants, which was the most common type, and types II and III each included eight participants.
Conclusion
Families’ perceptions of DNR proxy decisions vary, requiring tailored care and intervention. We suggest developing and providing interventions that may psychologically support families.

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Subjectivity study on health conservation of elderly hemodialysis patients
Eunji Yim, Mijin Yun, Sohyune Sok
BMC Geriatrics.2024;[Epub] CrossRef
Types of Empathy Among Certified Caregivers of Older Adults with Dementia
So-Hyeong Sim, Geun Myun Kim, Eun Joo Kim, Soo Jung Chang
Journal of Multidisciplinary Healthcare.2023; Volume 16: 2715. CrossRef

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Predictive Model for Quality of Life of the Older Men Living Alone: Kim, Su Jin , Jeon, Gyeong-Suk; J Korean Acad Nurs 2020;50(6):799-812. Published online December 31, 2020; DOI: https://doi.org/10.4040/jkan.20087

Abstract PDF

Purpose
This study aimed to construct and test a predictive model that explains and predicts the quality of life in older men living alone.
Methods
A self-report questionnaire was used to collect data from 334 older adult men living along aged 65 years or over living in Jeollanam-do provinces. The endogenous variables were depression, self-rated health, instrumental activity of daily life, health promotion behaviors, the number of social participation activities and quality of life. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs.
Results
The final model with 14 of the 8 analysed paths showed a good fit to the empiri cal data: χ²= 173.26(p < .001, df = 53),normed χ²= 3.27, GFI = .92, NFI = .90, CFI = .93, TLI = .89, RMSEA = .08 and SRMR = .06. Activities had direct effect on quality of life of older men living alone and social support had both direct and indirect effects. Meanwhile, function and socioeconomic status showed only indirect effects.The variables included in the eight significant paths explained 83.7% of variance in the prediction model.
Conclusion
Instrumental activities of daily living and social support effect directly on quality of life in the older men living alone. Findings suggest that health care providers including community nurses need to provide social support as well as empowerment programs of instrumental activities of daily living and health promotion for improving quality of life of the older men living alone.

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Changes in the health status and health-related quality of life of community-dwelling older adults living alone: one-year follow-up from a cohort study
Hana Ko, Belong Cho, Kyung-Choon Lim, Soong-Nang Jang, Sun Ju Chang, Yu Mi Yi, Hye Ryung Cho, So Im Ryu, Eun-Young Noh, Yeon-Hwan Park
Frontiers in Public Health.2023;[Epub] CrossRef
Influencing factors on self-care of older adults living alone in a community during COVID-19: A cross-sectional study
Heeyoung Woo, Minkyung Gu
Journal of Korean Gerontological Nursing.2023; 25(1): 1. CrossRef
A novel nomogram to stratify quality of life among advanced cancer patients with spinal metastatic disease after examining demographics, dietary habits, therapeutic interventions, and mental health status
Yue Li, Ze Long, Xiuju Wang, Mingxing Lei, Chunzi Liu, Xiaolin Shi, Yaosheng Liu
BMC Cancer.2022;[Epub] CrossRef
Associated Factors with Health-related Quality of Life among Older Adults with Diabetes in Korea
Eun-Kyung Lee, Sun-Young Jung
The Korean Journal of Rehabilitation Nursing.2022; 25(2): 61. CrossRef

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Effects of BeHaS Program on Health Behavior, Physiologic Index and Self-Esteem of the Elderly Living Alone with Metabolic Syndrome Based on Community Based Participatory Research: Kim, Jong Im , Kim, Sun Ae , Park, Keumok , Kim, Jiyoung , Lee, Lina , Choi, Si Wan , Ku, Bon Jeong; J Korean Acad Nurs 2020;50(4):571-582. Published online August 31, 2020; DOI: https://doi.org/10.4040/jkan.19261

Abstract PDF

Purpose
This study aimed to determine the effects of a 12-week metabolic syndrome BeHaS (Be Happy and Strong) program in elderly people with metabolic syndrome living alone, based on a community-based participatory research (CBPR).
Methods
A nonequivalent control group pre-posttest design was used, and the participants were 43 elderly people living alone (experimental group 24, control group 19). The experimental group received a one-hour program per week and two individual health consultations during 12 weeks. The control group received two sessions about the metabolic syndrome and two individual health consultations. The effects of health behavior, blood pressure, blood sugar levels, abdominal circumference, triglycerides, and self-esteem were evaluated. The data were analyzed using the independent t-test and Mann-Whitney U test.
Results
The health behavior with respect to the metabolic syndrome in the experimental group increased significantly (t = - 3.19, p = .002). Both diastolic blood pressure and abdominal circumference decreased in the experimental group (t = 2.00, p = .028 and t = 3.91, p < .001). No significant differences were observed between the groups in systolic blood pressure, fasting blood sugar levels, triglycerides, and self-esteem.
Conclusion
The 12-week metabolic syndrome BeHaS program using community resources improves the health of elderly people with metabolic syndrome living alone. Based on these findings, further studies on the effectiveness of the metabolic syndrome BeHaS program and the experiences of those who participated in the CBPR are warranted.

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Exploring the Impact of Smart Mobility and ICT Solutions on Older Adults’ Mobility: A Systematic Literature Review
Chengyuan An
IEEE Access.2024; 12: 159056. CrossRef
노인 대사증후군에 효과적인 중재: 체계적 문헌고찰과 메타분석
서현 이, 슬 구, 유미 서, 선화 반
Public Health Weekly Report.2023; 16(48): 1633. CrossRef
Comparison of the Effects of Education Only and Exercise Training Combined with Education on Fall Prevention in Adults Aged 70 Years or Older Residing in Elderly Residential Facilities
Chahwa Hong, Haejung Lee, Misoon Lee
Journal of Korean Academy of Nursing.2021; 51(2): 173. CrossRef

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Development and Validation of the Self-Care for Aspiration Pneumonia Prevention Scale in the Community Dwelling Elderly with Risk of Dysphasia: Yang, Eun Young , Lee, Shin-Young; J Korean Acad Nurs 2020;50(3):474-486. Published online June 30, 2020; DOI: https://doi.org/10.4040/jkan.20041

Abstract PDF

Purpose
The purpose of this study was to develop and validate a Korean version of the Self-Care for Aspiration Pneumonia Prevention(SCAPP-K) scale in older adults at risk of dysphasia.
Methods
The Hertz and Baas model of scale development and validation was used. Inthe development stage, items were generated via literature review and interviews with medical experts, older adults, and caregivers. Tenexperts assessed the items for content validity. Subsequently, 12 older adults participated in a pilot test to determine the comprehensibilityand appropriateness of the SCAPP-K scale. The validation stage involved a cross-sectional survey with 203 older adults for exploratoryfactor analysis (EFA) and 200 older adults for confirmatory factor analysis (CFA) and to determine convergent and discriminant validity. Totest the validity and reliability of the scale, EFA using principal component analysis with varimax rotation and CFA were conducted, andconvergent and discriminant validity as well as internal consistency reliability were determined.
Results
As a result of EFA, three self-carefactors (knowledge, resources, behaviors) with 21 items were validated. The CFA and convergent and discriminant validity indicated theapplicability of the three-factor self-care scale. The reliability of the SCAPP-K scale was acceptable, with Cronbach’s a=.87~.91.
Conclusion
The SCAPP-K scale has acceptable validity and reliability and can contribute to clinical practice, research, and education to improveself-care for the prevention of aspiration pneumonia in older adults at risk of dysphasia.

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Cause-specific mortality in Korea during the first year of the COVID-19 pandemic
Jinwook Bahk, Kyunghee Jung-Choi
Epidemiology and Health.2022; 44: e2022110. CrossRef
Translation of the Chinese version of the Self‐Care for Aspiration Pneumonia Prevention Scale and its validation among Chinese community dwelling elderly with risk of dysphasia
Zhen Yang, Fengmin Chen, Yibo Zhang, Sien Pan, Yingying Lu, Huijun Zhang
Nursing Open.2022; 9(3): 1902. CrossRef
Development and validation of a self-care scale for older adults undergoing hip fracture surgery: the HFS-SC
Eun-Jeong Jeon, Kyeong-Yae Sohng, Hye-Ah Yeom
BMC Nursing.2022;[Epub] CrossRef
Study on the characterization, biocompatibility and efficacy of sponge brush products for oral care
Song-Yi Yang, Ji-Won Choi, Sang-Hwan Oh
Korean Journal of Dental Materials.2021; 48(1): 27. CrossRef

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Factors Influencing Health Behavior Related to Particulate Matter in Older Adults: Park, Min Kyung , Kim, Gwang Suk; J Korean Acad Nurs 2020;50(3):431-443. Published online June 30, 2020; DOI: https://doi.org/10.4040/jkan.19201

Abstract PDF

Purpose
This study aimed to investigate health behavior related to particulate matter (PM) in older adults and examine the factors affectingit.
Methods
A cross-sectional survey design was used. Data were collected from 150 voluntary older adult participants from Songpa-gu inSeoul. The survey questions measured service perception and experience related to PM, risk perception related to PM, attitude toward riskof PM, and health behavior related to PM.
Results
The average score for health behavior related to PM was 79.37, ranging from 51 to 115.There was a significant positive correlation between health behavior related to PM and risk perception related to PM (r=.58, p <.001) as wellas between health behavior related to PM and attitude toward risk of PM (r=.70, p<.001). Multiple linear regression revealed that healthbehavior related to PM was predicted by levels of the existence of disease related to PM (β=.14, p=.019), service experience related to PM(b=.20, p=.021), risk perception related to PM (b=.20, p=.019), and attitude toward risk of PM (b=.44, p<.001). The model including thesevariables accounted for 47.0% of health behavior related to PM.
Conclusion
Korean older adults have the low level of health behaviorrelated to PM. The findings of this study emphasize that risk perception and attitude toward risk of PM should be evaluated, and theunderlying diseases related to PM and their service experience should be considered in developing intervention to improve health behaviorrelated to PM.

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Development and Effect of a Fall Prevention Program Based on the King's Goal Attainment Theory for Fall High-Risk Elderly Patients in Long-Term Care Hospital: Bom Mi Park, Ho Sihn Ryu, Kyeung Eun Kwon, Chun Young Lee; J Korean Acad Nurs 2019;49(2):203-214. Published online April 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.2.203

Abstract PDF

Purpose

The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects.

Methods

This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an χ²-test, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software.

Results

For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368).

Conclusion

These results indicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.

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Latent Class Analysis for Health-Related Quality of Life in the Middle-Aged Male in South Korea: Youngsuk Cho, Dong Moon Yeum; J Korean Acad Nurs 2019;49(1):104-112. Published online February 28, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.1.104

Abstract PDF

Purpose

This study aimed to identify types of quality of life (QoL) based on the 5 dimensions of EQ-5D and predict factors affecting types of QoL.

Methods

This study was a secondary analysis using data from the Korean Health Panel Survey- II(2012). Participants were 2,071 middle-aged men who had completed the additional survey in 2012 and the data were analyzed using SPSS 20.0 and Mplus 5.21 for latent analysis.

Results

Three latent classes of QoL were identified: serious (2.4% of the sample), threatened (15.5%), and stable types (82.0%). The types and characteristics of QoL among the latent classes differed. On comparing latent type 1 with latent type 2, the socioeconomic status (p<.05), employment status (p<.05), and subjective health status (p<.001) were found to be significant. On comparing latent type 1 with latent type 3, the socioeconomic status (p<.05), current smoking status (p<.001), and subjective health status (p<.001) were found to be significant. On comparing latent type 2 with latent type 3, the socioeconomic status (p<.05), subjective health status (p<.001), stress (p<.001) were found to be significant.

Conclusion

The results showed significant heterogeneity in types of QoL and the predictors of QoL by types were different. These findings provide basic information for developing nursing interventions to improve QoL. Specific characteristics depending on the subtypes should be considered during the development of interventions.

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Development of the Korean Geriatric Loneliness Scale (KGLS): Si Eun Lee; J Korean Acad Nurs 2019;49(5):643-654. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.5.643

Abstract PDF

Abstract Purpose

The purpose of this study was to develop and psychometrically test the Korean Geriatric Loneliness Scale (KGLS).

Methods

The initial items were based on in-depth interviews with 10 older adults. Psychometric testing was then conducted with 322 community-dwelling older adults aged 65 or older. Content, construct, and criterion-related validity, classification in cutoff point, internal consistency reliability, and test-retest reliability were used for the analysis.

Results

Exploratory factor analysis showed three factors, including 15 items explaining 91.6% of the total variance. The three distinct factors were loneliness associated with family relationships (34.3%), social loneliness (32.4%), and a lack of belonging (24.9%). As a result of confirmatory factor analysis, 14 items in the three-factor structure were validated. Receiver operating characteristic analysis demonstrated that the KGLS’ cutoff point of 32 was associated with a sensitivity of 71.0%, specificity of 80.2%, and area under the curve of .83. Reliability, as verified by the test-retest intraclass correlation coefficient, was .89, and Cronbach's α was .90.

Conclusion

As its validity and reliability have been verified through various methods, the KGLS can contribute to assessing loneliness in South Korean older adults.

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Impact of Frailty, Depression, and Loneliness on Ego-Integrity in Community-Dwelling Elderly
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The Development and Evaluation of a Health Literacy-Adapted Self-Management Intervention for Elderly Cancer Patients Undergoing Chemotherapy: Yoon Sun Kim, Young Sook Tae, Kwuy-Im Jung; J Korean Acad Nurs 2019;49(4):472-485. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.4.472

Abstract PDF

Abstract Purpose

This study aimed to develop and evaluate the effectiveness of an adapted health literacy self-management intervention for elderly cancer patients undergoing chemotherapy.

Methods

The intervention in this study was systematically developed through the six stages of Intervention Mapping Protocol and was based on Fransen et al's causal pathway model. A quasi-experimental trial was conducted on a total of 52 elderly patients (26 in an experimental group and 26 in a control group) undergoing chemotherapy in Korea. The intervention consisted of seven sessions over 5 weeks. The experimental tool for this study was an adapted health literacy self-management intervention, which was designed to promote a reduction in the symptom experience and distress of elderly cancer patients through the promotion of self-management behavior. To develop efficient educational materials, the participants’ health literacy was measured. To educate participants, clear communication and the teach-back method were used. In addition, for the improvement of self-efficacy, four sources were utilized. For the promotion of self-management behavior, five self-management skills were strengthened. Data were collected before and after the intervention from June 4 to September 14, 2018. The data were analyzed with SPSS/WIN 21.0.

Results

Following the intervention, self-management knowledge and behavior and, self-efficacy significantly improved in experimental group. Symptom experience and distress decreased in the experimental group compared to the control group.

Conclusion

The self-management intervention presented in this study was found to be effective in increasing self-management knowledge and behavior and, self-efficacy, and ultimately in reducing symptom experience and distress for elderly patients undergoing chemotherapy.

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Experiences of Ego Integrity Recovery in Elderly Cancer Patients: Grounded Theory Approach: Han-Gyo Choi, Hye-Ah Yeom; J Korean Acad Nurs 2019;49(3):349-360. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.349

Abstract PDF

Abstract Purpose

This study was conducted to derive a substantive theory on lived experiences of elderly cancer patients.

Methods

The data were collected from February to March 2018 through in-depth personal interviews with 14 elderly cancer patients. The collected data were analyzed based on Corbin and Strauss's grounded theory.

Results

The core category was “the journey to find balance in daily lives as a cancer patient by recovering disturbed ego integrity.” The core phenomenon was “shattered by suffering from cancer,” and the causal conditions were “physical change” and “limitations in daily life.” The contextual conditions were “decreased self-esteem,” “feelings of guilt toward the family,” and the sense of “economic burden.” The participants’ action and interaction strategies were “maintaining or avoiding social relations,” “seeking meaning of the illness,” “falling into despair,” and “strengthening the willingness to battle the cancer.” The intervening conditions were “support from health care providers and family,” “dissatisfaction with health care providers,” “spiritual help from religion,” and “the improvement or worsening of health conditions.” The consequences were “having a new insight for life,” “living positively along with cancer illness,” and “the loss of willingness to live.” A summary of the series of processes includes the “crisis stage,” “reorganizing stage,” and the “ego integration stage.”

Conclusion

This study explored the holistic process of ego integrity impairment and the recovery experience of elderly cancer patients. This study is expected to be used as a basis for the development of nursing interventions that can support patients when coping with all stages of their cancer illness trajectory.

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Reversals in Decisions about Life-Sustaining Treatment and Associated Factors among Older Patients with Terminal Stage of Cardiopulmonary Disease: Jung-Ja Choi, Su Hyun Kim, Shin-Woo Kim; J Korean Acad Nurs 2019;49(3):329-339. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.329

Abstract PDF

Abstract Purpose

The purpose of this study was to investigate the frequency, patterns, and factors of reversals in decisions about life-sustaining treatment (LST) among older patients with terminal-stage chronic cardiopulmonary disease.

Methods

This was a retrospective correlational descriptive study based on medical chart review. De-identified patient electronic medical record data were collected from 124 deceased older patients with terminal-stage cardiopulmonary disease who had made reversals of LST decisions in an academic tertiary hospital in 2015. Data were extracted about the reversed LST decisions, LST treatments applied before death, and patients’ demographic and clinical factors. Multivariate logistic regression analysis was used to identify the factors associated with the reversal to higher intensity of LST treatment.

Results

The use of inotropic agents was the most frequently reversed LST treatment, followed by cardiopulmonary resuscitation, intubation, ventilator therapy, and hemodialysis. Inconsistency between the last LST decisions and actual treatments occurred most often in hemodialysis. One-third of the reversals in LST decisions were made toward higher intensity of LST treatment. Patients who had lung diseases (vs. heart diseases); were single, divorced, or bereaved (vs. married); and had an acquaintance as a primary decision maker (vs. the patients themselves) were significantly more likely to reverse the LST decisions to higher intensity of LST treatment.

Conclusion

This study demonstrated the complex and turmoil situation of the LST decision-making process among older patients with terminal-stage cardiopulmonary disease and suggests the importance of support for patients and families in their LST decision-making process.

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Prediction Modeling on Family Life Satisfaction of Old Adults Living at Home: Young Mi Huh, Sohyune Sok; J Korean Acad Nurs 2018;48(5):534-544. Published online October 31, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.5.534

Abstract PDF

Purpose

This study was conducted to construct and test a structural model on family life satisfaction of aged individuals living at home. The conceptual model was based on Bandura's self-efficacy and social cognitive theories (1977; 1986) and Bowen's (1976) family systems theory.

Methods

From January 25 to March 5, 2016, 227 older adults living at home completed a structured questionnaire. Data were analyzed to calculate the direct and indirect effects of factors affecting family life satisfaction. SPSS WIN 20.0 and AMOS 20.0 were used.

Results

The hypothetical model was a good fit for the data. The model fit indices were χ²=78.05, χ²/df=1.35, RMSR=.02, GFI=.98, AGFI=.96, NFI=.94, CFI=.98, and RMSEA=. 05. Family life satisfaction was positively affected by perceived collective family efficacy, status of physical health, family communication, and family support. Depression resulted in a significant negative effect. Family differentiation had a significant indirect effect on family life satisfaction. The model explained 76% of variance in family life satisfaction.

Conclusion

Perceived collective family efficacy, status of physical health, depression, family differentiation, family communication, and family support were significant factors explaining family life satisfaction among older adults staying at home. Further research should be conducted to seek intervention strategies to improve family life satisfaction among older adults living at home by focusing on the respective contributing factors.

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The Effect of Pain Catastrophizing on Depression among Older Korean Adults with Chronic Pain: The Mediating Role of Chronic Pain Interference and Sleep Quality
Kyoung-eun Lee, Hyunju Ryu, Sun Ju Chang
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Development and Effects of Combined Exercise Program for Older Adults with Sarcopenia Based on Transtheoretical Model: Seoyoun Park, Mee Ock Gu; J Korean Acad Nurs 2018;48(6):656-668. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.6.656

Abstract PDF

Abstract Purpose

The purpose of this study was to develop and examine the effects of combined exercise program for older adults with sarcopenia based on transtheoretical model (TTM).

Methods

A non-equivalent control group with a pretest-posttest design was used. The subjects consisted of 43 older adults with sarcopenia in precontemplation stage, contemplation stage and preparation stage of TTM (experimental group: 22, control group: 21). The developed program consisted of 36 sessions for 12 weeks including combined exercise (60 minutes) and TTM based strategies for enhancing exercise behavior (10 minutes) per session. Data were collected before, immediately after the program between July 31 to October 27, 2017. The data were analyzed using independent t-test, Mann-Whitney U test with SPSS/WIN 18.0.

Results

Compared with their counterparts in the control groups, older adults with sarcopenia in the experimental group showed a significantly greater improvement in process of exercise behavior change, pros and cons of decisional balance for exercise behavior, exercise self-efficacy, parameters of muscle, and the level of physical performance.

Conclusion

The study findings indicate that this combined exercise program for older adults with sarcopenia based on TTM model was effective and can be recommended as a nursing intervention for older adults with sarcopenia.

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An Ethnography on the Healthy Life of the Aged Women Participating the Senior Centers: Eunha Kim, Jinhyang Yang; J Korean Acad Nurs 2018;48(3):349-361. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.3.349

Abstract PDF: Abstract Purpose
This ethnography was performed to explore patterns and meanings of healthy life among aged women using senior centers.
Methods
The informants were 21 individuals aged 65 years and older at 2 community-based senior centers. Data were collected from iterative fieldwork through in-depth interviews and participant observations and analyzed using text analysis and taxonomic methods developed by Spradley. Field notes were used with follow-up interviews and dialogue between authors to enhance interpretation.
Results
Patterns of healthy life among aged women using senior centers were categorized by age groups within the context of the four cultural elements of taking care of the body, relationality, temporality, and spatiality: active and passive control, maintenance of interdependence and individuality, expansion and maintenance of the daily routine, unity of peer relations and sustenance of family relations, spending time productively and tediously, and complementary and alternative space of the family relations.
Conclusion
The informants in this study demonstrated healthy life by maintaining and strengthening continuous relationships developed in the senior centers without being isolated from the family and society. Patterns of their healthy life differed across age groups within the socio-cultural context. Therefore, interventions should be tailored to address age groups and community needs.

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The Effects of a Health Mentoring Program in Community-dwelling Vulnerable Elderly Individuals with Diabetes: Ki wol Sung, Hye Seung Kang, Ji Ran Nam, Mi Kyung Park, Ji Hyeon Park; J Korean Acad Nurs 2018;48(2):182-194. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.2.182

Abstract PDF

Abstract Purpose

This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes.

Methods

A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0.

Results

Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups.

Conclusion

These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population.

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Bo-Kyoung Cha
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Actor and Partner Effects of Health Status, Marital Satisfaction and Self Efficacy on Retirement Preparation of Middle Aged Couples: Actor-Partner Interdependence Model Analysis: Eun Hee Jung, Sung Hee Shin; J Korean Acad Nurs 2018;48(2):154-166. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.2.154

Abstract PDF

Abstract Purpose

This study aimed to identify the actor and partner effects of health status, marital satisfaction, and self efficacy on retirement preparation in middle aged couples using the Actor-Partner Interdependence Model.

Methods

Participants were 121 middle aged couples living in Seoul, Gyeonggi-do and Daegu City, Korea. All measures were self-administered. The collected data were analyzed using SPSS 20.0 and AMOS 20.0.

Results

1) Wife's self efficacy and marital satisfaction showed direct actor and partner effects on retirement preparation in middle aged couples. Wife's health status showed an indirect actor effect through wife's self efficacy and marital satisfaction on wife's retirement preparation, and showed an indirect partner effect through husband's self efficacy on husband's retirement preparation. 2) Husband's self efficacy and marital satisfaction showed only direct actor effect on retirement preparation. Health status among the husbands showed an indirect actor effect on husband's retirement preparation through their self efficacy and marital satisfaction, and an indirect partner effect through wife's marital satisfaction on wife's retirement preparation. 3) The actor effect size of health status on self efficacy and marital satisfaction was larger among husband's than wife's. Additionally, the partner effect size of health status on self efficacy and marital satisfaction was different between the two groups; however, the actor and partner effect size of self efficacy and marital satisfaction on retirement preparation was the same for husband and wife.

Conclusion

The results of this study indicate that nursing intervention strategies for improving self efficacy and marital satisfaction are strongly needed to enhance retirement preparation of middle aged couples in Korean community.

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Effects of a Memory and Visual-Motor Integration Program for Older Adults Based on Self-Efficacy Theory: Eun-Hwi Kim, Soon-Rim Suh; J Korean Acad Nurs 2017;47(3):431-444. Published online June 30, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.3.431

Abstract PDF

Purpose

This study was conducted to verify the effects of a memory and visual-motor integration program for older adults based on self-efficacy theory.

Methods

A non-equivalent control group pretest–posttest design was implemented in this quasi-experimental study. The participants were 62 older adults from senior centers and older adult welfare facilities in D and G city (Experimental group=30, Control group=32). The experimental group took part in a 12-session memory and visual-motor integration program over 6 weeks. Data regarding memory self-efficacy, memory, visual-motor integration, and depression were collected from July to October of 2014 and analyzed with independent t-test and Mann-Whitney U test using PASW Statistics (SPSS) 18.0 to determine the effects of the interventions.

Results

Memory self-efficacy (t=2.20, p=.031), memory (Z=-2.92, p=.004), and visual-motor integration (Z=-2.49, p=.013) increased significantly in the experimental group as compared to the control group. However, depression (Z=-0.90, p=.367) did not decrease significantly.

Conclusion

This program is effective for increasing memory, visual-motor integration, and memory self-efficacy in older adults. Therefore, it can be used to improve cognition and prevent dementia in older adults.

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Determinants of Health Promoting Behavior of Middle Aged Women in Korea: Sook Ja Lee, Eun Sook Park, Young Joo Park; Journal of Nurses Academic Society 1996;26(2):320-336. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.2.320

Abstract PDF: Health promoting behaviors of an individual are affected by various variables. Recently, there has been a growing concern over important health problems of the middle aged women. Physiological changes in the middle aged women and their responsibility for family care can result in physical and psychological burden experienced by middle aged women. This study was designed to test Pender's model and thus purpose a model that explains health promoting behaviors among middle-aged women in Korea. The hypothetical model was developed based on the Pender's health promoting model and the findings from past studies on women's health. Data were collected by self-reported questionnaires from 863 women living in Seoul, between 20th, April and 15th, July 1995. Data were analyzed using descriptive statistics and correlation analysis. The Linear Structural Relationship (LISREL) modeling process was used to find the best fit model which assumes causal relationships among variables. The results are as follows; 1. The overall fit of the hypothetical model to the data was good expect chi -square value (GFI=.96, AGFI=.91, RMR=.04). 2. Paths of the model were modified by considering both its theoretical implication and statistical significance of the parameter estimates. Compared to the hypothetical model, the revised model has become parsimonious and had a better fit to the data expect chi-square value (GFI=. 95, AFGI=.92, RMR=.04). 3. Some of modifying factors, especially age, occupation, educational levels and body mass index (BMI) are revealed significant effects on health promoting behaviors. 4. Some of cognitive -perceptual factors, especially internal health locus of control, self-efficacy and perceptive health status are revealed significant effects on health promoting behaviors. 5. All predictive variables of health promoting behaviors, especially age, occupation, educational levels, body mass index(BMI), internal health locus of control, self-efficacy and perceptive health status are explained 20.0% of the total variance in the model.

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A phenomenological perspective and discovery of meaning in mid-aged women's experience of mastectomy: Kyung Rim Shin; Journal of Nurses Academic Society 1995;25(2):295-315. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1995.25.2.295

Abstract PDF

This qualitative nursing research used a hermeneutic phenomenological approach to discover meaning in mid-aged women's experience of mastectomy. The ultimate aim of the inquiry was to discover the essence of mid-aged women's experience and promote understanding. The study was guided by Van Manen's method for doing research. The method of inquiry included: turning to phenomenon of interest; inquiring and investigating experience as it was lived rather than as conceptualized; reflecting and analyzing essential themes which characterize phenomenon; and describing phenomenon through art of writing and rewriting. Multiple strategies for data collecting were needed: in depth face-to-face interview; analysis of women's writings; artistic works; and analysis of examples of phenomenon in art, literature, and drama. Although the experience was different for all of the women interviewd, essential themes of experience emerged; Self-discovering of vicious disease, Divining punishment-unfortunate women, loss of self though the scar, a nightmare, change of life values and attitudes, rediscovering living alone, living through with fearing of death. Findings from artistic and creative inquiry further validated findings and meaning descovered. The study illuminated meaning and simultaneously validated the phenomenological research process. Essential themes for understanding women's experience, implications for education, research, and practice, direction and need for continuing inquiry were identified.

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The Age at Menopause and Related Factors in Korean Women: Young Joo Park, Hesook Suzie Kim, Hyun Choel Kang; Journal of Korean Academy of Nursing 2002;32(7):1024-1031. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.7.1024

Abstract PDF

This cross-sectional design was to identify the age at menopause of Korean women using a national sample, and to examine relationships between age at menopause and the anthropometric, sociodemographic, biological and life style behavioral factors. Two thousand eight hundred seven naturally postmenopausal women aged between 41-65 years were recruited by self-selection from 7 metropolitans and 6 provinces in Korea from Dec. 20, 1998 to April 30, 1999. The age at menopause of Korean women was 49.2 years (mean) and 50.0 years (median). The range of age at menopause was 33.0 to 61.0 years. The significant influencing factors on age at menopause were body mass index, mother's and sister's age at menopause, alcohol use, physical activity, coffee preference, and residential area. The menopausal age of Korean women has slightly increased compared to a previous study.

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