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Research Papers
The Effects of a Self-Efficacy Theory-Based Exercise Program for Patients Undergoing with Total Knee Arthroplasty
Kyung-Hye Park, Hee-Young Kang
J Korean Acad Nurs 2024;54(4):547-562.   Published online October 22, 2024
DOI: https://doi.org/10.4040/jkan.24027
AbstractAbstract PDFSupplementary MaterialePub
Purpose

This study was performed to develop a self-efficacy theory-based exercise program for total knee arthroplasty (TKA) and to test the program’s efficacy in ameliorating knee pain and restoring function as measured by lower extremity muscle strength, 3 meter walking time, Korean Western Ontario McMaster Index (WOMAC), exercise self-efficacy, and length of hospital stay for TKA patients.

Methods

This quasi-experimental study incorporating a non-equivalent control group and pretest-posttest non-synchronized design non-synchronous design was applied to assess self-efficacy reinforcement strategies based on self-efficacy theory. The exercise program consisted of the following steps: TKA, education to prevent postoperative complications, and muscle strength exercises. Respective exercise and control groups included 29 and 27 participants. The experimental group received eight sessions of the program from three weeks before TKA to four weeks after TKA. Collected data were analyzed using the chi-square test, Mann–Whitney U test, and ranked ANCOVA and t-tests using IBM SPSS Statistics 23.

Results

Experimental group showed significant improvement in lower extremity muscle strength (F = 8.63, p = .005), 3 meter walking time (z = - 5.02, p < .001), WOMAC index (z = - 2.22, p = .027), self-efficacy for exercise (z = - 3.29, p = .001), and length of hospital stay (t = - 2.11, p = .040) compared to the control group. No significant differences in knee pain and range of motion were observed.

Conclusion

These findings indicate that a self-efficacy theory-based exercise program can be an effective exercise strategy that patients undergoing TKA can easily follow at home without assistance. It is thus recommended as an exercise intervention for TKA patients.

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A Prediction Model of Exercise Level in Patients with Ankylosing Spondylitis
Kim, Moon Ja , Lee, Eun Nam
J Korean Acad Nurs 2022;52(2):157-172.   Published online April 30, 2022
DOI: https://doi.org/10.4040/jkan.21238
AbstractAbstract PDF
Purpose
This study aimed to construct and test a hypothetical model to explain the predictive factors and causal pathways for exercise levels in patients with ankylosing spondylitis based on the self-determination theory. A conceptual framework was constructed assuming that autonomy support by health care providers would satisfy the three basic psychological needs of patients, which would increase their autonomous motivation for exercise, resulting in its initiation and continuation.
Methods
This cross-sectional study included 221 patients with ankylosing spondylitis who were visiting rheumatology clinics in two tertiary hospitals. Health Care Climate Questionnaire-exercise regularly, Basic Psychological Needs Satisfaction scale, Behavior Regulation in Exercise Questionnaire-2, and exercise level were used to collect data.
Results
The fitness of the hypothetical model met the recommended level (χ2/df ≤ 3, SRMR ≤ .08, RMSEA ≤ .08, GFI ≥ .90, AGFI ≥ .85, NFI ≥ .90, TLI ≥ .90, CFI ≥ .90). The model effect analysis revealed that autonomy support by health care providers had a positive effect on patients' autonomy, competence, relatedness, autonomous motivation, and exercise level. Competence and relatedness had positive effects on autonomous motivation and exercise level, respectively. Autonomous motivation had a positive effect on exercise level.
Conclusion
The predictive factors of exercise level in patients with ankylosing spondylitis were autonomous motivation, health care providers' autonomy support, competence, and relatedness. Considering these factors, we recommend the development of an effective program for improving exercise levels in these patients.
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Effects of Program to Promote Obesity Prevention Behaviors on Pre-Schoolers: Focused on Kindergartener in Korea
Hwang, Inju , Bang, Kyung-Sook
J Korean Acad Nurs 2021;51(2):188-202.   Published online April 30, 2021
DOI: https://doi.org/10.4040/jkan.20217
AbstractAbstract PDF
Purpose
This study aimed to develop a program to promote obesity prevention behaviors for pre-schoolers and to confirm the effectiveness of the program in Korea.
Methods
The program comprised 8 sessions for 4 weeks including combined classroom lectures and physical activities. A non-equivalent control group pre-post test study design was used, and seventy two children, aged 5 to 6 years (experimental group: 33, control group: 39) and their parents participated in the study. To examine the effectiveness of the program, children’s knowledge, intake of sugar-added beverages and fruits & vegetables, time of outdoor play and screen time, and parental self-efficacy were measured. Data were analyzed with SPSS/WIN ver. 22.0 and R 4.0.2, using descriptive analysis, chi-square test, Fisher’s exact test, the independent t-test, and Analysis of covariance (ANCOVA).
Results
The results showed that the experimental group reported significantly increased knowledge (p < .001) and longer time of outdoor play on weekends (p = .033). However, there were no significant differences in the intake of sugar-added beverages and fruits & vegetables, screen time, and parental self-efficacy in the two groups.
Conclusion
This study confirms the applicability of an obesity prevention intervention at kindergartens in Korea. The results can be used as basic data for the study of childhood obesity prevention in Korea.
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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
Hong, Chahwa , Lee, Haejung , Lee, Misoon
J Korean Acad Nurs 2021;51(2):173-187.   Published online April 30, 2021
DOI: https://doi.org/10.4040/jkan.20203
AbstractAbstract PDF
Purpose
To compare the effects of education only and exercise training combined with education on fall knowledge, fall efficacy, physical activity, and physical function in adults aged 70 years or older residing in elderly residential facilities.
Method
A three-group pre- and posttest design was utilized: education only (EO; n = 23), education and TheraBand (ET; n = 22), and education and walking (EW; n = 22). Fall education was provided for all three groups. In addition, TheraBand exercise training was provided for the ET and a walking exercise for the EW. Data were collected from November 1st, 2017 to February 15th, 2019 and analyzed with χ2 test, paired t-test, and one-way ANOVA using IBM SPSS/WIN ver. 22.0.
Results
Compared with the EO, the ET and the EW were more effective in terms of fall efficacy, physical activity, and lower extremity muscle strength. The EW showed higher improvement in walking abilities than the EO and the ET.
Conclusion
Exercise training combined with education is more effective in preventing falls among community-dwelling adults aged 70 years or older. When considering fall prevention programs for older adults, both TheraBand and walking exercise training combined with education can be chosen based on the participant’s physical status. Aggressive strategies to improve daily walking are required to maintain walking abilities among community-dwelling adults aged 70 years or older.
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Review Paper
Characteristics of Aerobic Exercise as Determinants of Blood Pressure Control in Hypertensive Patients: A Systematic Review and Meta-Analysis
Lee, Sun Hee , Chae, Young Ran
J Korean Acad Nurs 2020;50(6):740-756.   Published online December 31, 2020
DOI: https://doi.org/10.4040/jkan.20169
AbstractAbstract PDF
Purpose
The purpose of this study was to evaluate the effect on blood pressure (BP) and heart rate (HR) according to aerobic exercise characteristics in adults with hypertension using a systematic review and meta-analysis.
Methods
The related researches were selected from PubMed, EMBASE, Cochrane library, CINAHL, PsycINFO, SPORTDiscus and 5 domestic databases up to September 4, 2019. To estimate the effect size, random effect models were used to derive weighted mean differences (WMD) and their 95% confidence intervals (CI) of aerobic exercise on BP and HR.
Results
A total of 37 RCTs with 1,813 samples were included. Aerobic exercise was found to significantly reduce systolic BP (WMD, - 8.29 mmHg; 95% CI, - 10.12 to - 6.46), diastolic BP (WMD, - 5.19 mmHg; 95% CI, - 6.24 to - 4.14) and HR (WMD, - 4.22 beats/min; 95% CI, - 5.36 to –3.09). In detail, systolic BP and diastolic BP were significantly decreased in all groups of exercise types, frequency and duration. Systolic BP and diastolic BP were significantly decreased in the moderate and vigorous-intensity group. Exercise characteristics with the most dramatical change in systolic BP were water-based training, moderate-intensity, 3 times a week and 8 to 11 weeks of duration. In diastolic BP, the greatest effect size was over 24 weeks of exercise.
Conclusion
Moderate aerobic exercise, especially water-based exercise can be an important part of lifestyle modification for hypertensive patients. Also, it can be recommended in a variety of clinical settings for lowering BP and HR. However, there is insufficient evidence that low-intensity exercise is effective in lowering BP.
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Original Articles
Scale Development and Model Validation for the Process of Exercise Engagement for People with Prediabetes
Chang, Shu-Chuan , Yeh, Hsiu-Chen , Kuo, Yu-Lun
J Korean Acad Nurs 2020;50(2):298-312.   Published online April 30, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.2.298
AbstractAbstract PDF
Purpose
This study had two objectives: 1) to develop a scale for the process of exercise engagement (SPEE) for prediabetic individuals (PDIs); 2) to validate a structural model for the process of exercise engagement for PDIs.
Methods
A cross-sectional survey with simple random sampling was conducted from September 2013 to December 2015 (in Taiwan). A total of 310 PDIs were enrolled for scale development and model validation via item analysis, factor analyses, and structural equation modeling. The Kuo model was used as the basis for developing the Chinese version of the SPEE for PDIs.
Results
The SPEE contains five subscales with a total of twenty-one items that account for 54.9% to 65.9% of the total variance explained for assessing participants’ process of engagement during exercise. For Kuo model validation, the model measures indicated goodness of fit between the Kuo model and sample data. Analysis further revealed a direct effect between the creating health blueprints (CHB) stage and the spontaneous regular exercise (SRE) stage (b=.60).
Conclusion
The SPEE includes five subscales for assessing the psychological transition and behavioral expression at each stage of the process of exercise engagement for PDIs. The SPEE for people with prediabetes provides deeper insights into the factors of behavioral change stages that are required to initiate long-term health care outcomes and avoid developing diabetes. These insights are significant as they allow for patient- specific mapping and behavior modification to effect exercise.
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Effect of Resistance Exercise Program for Middle-Aged Women with Myofascial Pain Syndrome on Shoulder Pain, Angle of Shoulder Range of Motion, and Body Composition Randomized Controlled Trial, RCT
Kim, WonJong , Hur, Myung-Haeng
J Korean Acad Nurs 2020;50(2):286-297.   Published online April 30, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.2.286
AbstractAbstract PDF
Purpose
This study aimed to identify the effects of myofascial pain syndrome on shoulder pain, range of motion, and body composition around the shoulder in middle-aged women.
Methods
A total of 72 women participated in the randomized controlled trial. The subjects were grouped into an experimental group (n=39) and a control group (n=33). The experimental group received a resistance exercise program using an elastic band for 8 weeks, 3 days a week. The control group followed a normal daily for 8 weeks. Measurements were conducted three times; before the experimental treatment (pre-test), the 2nd and 8th weeks after treatment.
Results
Regarding the general characteristics and homogeneity of the dependent variables, there were no significant differences between the two groups, except for the thickness of the left and right muscles and the left fat. After treatment, shoulder pain was significantly different between the two groups (F=18.54, p <.001) and the range of shoulder motion was significantly different (left, F=86.70, p <.001; right, F=98.66, p <.001). Furthermore, there were a significant differences in the thickness of muscles between the two groups (left, F=40.20, p <.001; right, F=29.57, p <.001); however, the thickness of fat was not significantly different.
Conclusion
The resistance exercise program reduces shoulder pain and improves the range of motion of the shoulder joint and increases muscle mass on around the shoulder. It suggests to conduct a study to confirm the long-term exercise effect.
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Development and Effects of Smartphone App-Based Exercise Program for Hemodialysis Patients
Eun Jeong Ki, Hyang Sook So
J Korean Acad Nurs 2020;50(1):52-65.   Published online January 31, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.1.52
AbstractAbstract PDF
Abstract Purpose:

To examine the effects of a smartphone application-based exercise program on self-efficacy expectations (SEE) and outcome expectations regarding exercise (OEE), physical fitness, activity level, physiological indices, and health-related quality of life in a sample of hemodialysis patients.

Methods:

A quasi-experimental control group pre-test post-test design was used. Subjects were recruited from two university hospitals in G city. The subjects were assigned randomly by coin toss: 33 participants to the experimental group and 30 to the control group. A literature review and the self-efficacy theory were used to develop the smartphone program. Experts designed and verified the program to be userfriendly and in consideration of user interaction. Data were collected through a self-report pre-test post-test questionnaire and online medical records.

Results:

In the experimental group, the levels of physical fitness and physical activity were significantly improved post-test, but the scores on health-related quality of life and the physical indices did not improve. In the experimental group, the SEE and OEE post-test scores were also significantly higher than the pre-test scores, but the control group’s scores did not change.

Conclusion

The smartphone application-based exercise program based on self-efficacy theory significantly improved the level of physical fitness and activity, SEE, and OEE for hemodialysis patients. The use of this application-based exercise program for hemodialysis patients might be an effective nursing intervention tool for improving SEE, OEE, level of physical fitness, and physical activity.

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Nutritional Status of Liver Transplantation Recipients and Factors Influencing Nutritional Status
SinYoung Hwang, Smi Choi-Kwon
J Korean Acad Nurs 2019;49(3):340-348.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.3.340
AbstractAbstract PDF
Abstract Purpose

This study aimed to investigate the nutritional status of liver transplantation (LT) recipients and explore certain factors that influence nutritional status, including dietary patterns and physical activities.

Methods

This was a cross-sectional, descriptive study. The subjects included 211 LT recipients at a medical center outpatient clinic located in Seoul, Korea. The nutritional status, dietary patterns, and physical activities of each subject were measured using the body mass index (BMI), Mini Dietary Assessment (MDA), and Global Physical Activity Questionnaire. Independent t-test, one-way analysis of variance, and multiple linear regression analysis were used to analyze the data.

Results

The percentages of living and deceased donor LTs were 81.0% and 19.0%, respectively. The mean BMIs pre- and post-LT were 23.88 and 23.16 kg/m2, respectively, and the average MDA score was 36.55. More than 60.0% of the subjects had a moderate or high level of physical activity. In multivariate analysis, a higher BMI before LT (β=.72, p<.001), a lower Model for End-stage Liver Disease (MELD) score (β=-.18, p<.001), and being male (β=-.10, p=.024) contributed to better nutritional status post-LT. Patients within six months of LT were less engaged in muscle exercises than those post six months of LT (p=.020).

Conclusion

LT recipients in Korea have good nutritional status and a good level of physical activity. To improve recipients’ post-LT nutritional status, the pre-LT nutritional status should be considered, particularly in those with a higher MELD score. In addition, physical activity including muscle-strengthening exercises should be encouraged from an earlier stage.

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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
AbstractAbstract 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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Effects of Active Mandibular Exercise for Mouth Opening Limitation Patients after Maxillomandibular Fixation Release: A Non-Randomized Controlled Trial
Hyo Jin Jang, Myung Hee Kim
J Korean Acad Nurs 2018;48(1):26-37.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.1.26
AbstractAbstract PDF
Abstract Purpose

The aim of this study was to evaluate the effects of active mandibular exercise (AME) in patients with limited mouth opening after maxillomandibular fixation (MMF) release.

Methods

The study used a quasi-experimental, nonequivalent control group and a pre test-post test design. Sixty-two patients with Maxillomandibular Fixation Release were assigned to the experimental (n=31) or control group (n=31). The AME was performed in the experimental group for 4 weeks. The exercise AME consisted of maximal mouth opening, lateral excursion and protrusive movement. These movements were repeated ten times a day. After the final exercise of the day, the number of tongue blades used for mouth opening was noted. The effect of AME was evaluated after MMF release at different time intervals: a) immediately, b) after 1 week, c) after 2 weeks, d) after 4 weeks, and e) after 12 weeks. The exercise was assessed using the following criteria: a) mandibular movements, b) pain scores associated with maximal mouth opening, c) discomfort scores associated with range of movement, and d) daily life activities that involve opening the mouth.

Results

The experimental group showed significant improvement regarding the range of mandibular movements (maximal mouth opening (F=23.60, p<.001), lateral excursion to the right side (F=5.25, p=.002), lateral excursion to the left side (F=5.97, p=.001), protrusive movement (F=5.51, p=.001)), pain score (F=39.59, p<.001), discomfort score (F=9.38, p<.001). Daily life activities that involve opening the mouth were more favorable compared to those in the control group.

Conclusion

The AME in patients after MMF release is helpful for increasing mandibular movement range, decreasing pain and discomfort, and improving day life activities that involve opening the mouth. Therefore, AME is highly recommended as an effective nursing intervention.

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Effects of Low-intensity Exercise on Functional Ability in Hospitalized Elderly
Rhayun Song, Yeon Ok Suh, Young Rhan Um, Kyung Ja June, Beverly L Roberts
Journal of Nurses Academic Society 1997;27(4):807-819.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.4.807
AbstractAbstract PDF

The purpose of the study was to identify the effects of 12-week low-intensity exercise program on muscle strength, flexibility, balance, and cognitive characteristics related to the performance of activity of daily living(ADL). A total of 16 patients who were admitted to the medical unit of a general hospital in ChoongChung province were recruited eight for the exercise group and eight for the comparison group. Four levels of low-intensity exercise from 'ROM on bed' to 'exercise while walking' were then applied to the exercise group according to their physical condition. During hospitalization, patients in the exercise group performed each level of the prescribed exercise with the researchers until they felt. comfortable doing it independently. The researchers also visited the patients' homes after discharge to make sure they could perform the exercise with Theraband in their living environment. The exercise group was contacted by phone once a week to assess the frequency and intensity in which they performed the exercise as well as their physical condition. The subjects in the comparison group participated in measurements for the study without performing the exercise and were contacted by phone after discharge, in a matched time frame with the exercise group, to assess physical condition. Muscle strength, flexibility, balance, cognitive characteristics, and performance of ADL for the two groups were compared at the pretest and the posttest after the low-intensity exercise program by utilizing SPSSWIN and the results are as follows : 1) At the posttest, measurments of muscle strengths showed that the strength of the dorsal flexor in the exercise group was significantly higher than in the comparison group. 2) Objective balance for the exercise group was significantly better than for the comparison group as measured by 'standing on one foot' and Tinetti gait and balance control. 3) The exercise group showed significantly higher task self-efficacy than the comparison group. 4) Perceived exertion for ADL for the exercise group was significantly lower than for the comparison group. 5) Improvement of performance of ADL without assistance was significantly for the exercise group than the comparison group. The findings suggest that a low-intensity exercise program would be useful for the elderly who show decline in their physical functioning due to hospitalization by partly improving physical strength, task self-efficacy, and performance of ADL. Directions for further research on issues of motivating people to exercise as well as of standardizing various types of exercise were discussed.

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Effect of Regular Exercise During Dexamethasone Injection on the Body Weight, Weight of Hindlimb Muscle and Adrenal Gland in Young Rats
Myoung Ae Choe, Jung Ae Choi, Gi Soo Shin
Journal of Nurses Academic Society 1997;27(3):510-519.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.510
AbstractAbstract PDF

The purpose of this study was to determine the effect of regular exercise during dexamethasone injection on the body weight, weight of hindlimb muscles and adrenal gland in young rats. 80-100g Wistar rats were divided into control, exercise, dexamethasone injection(dexa), and exercise during dexamethasone injection(D+E) group. The dexa group received daily subcutaneous injection of dexamethasone at a dose of 5mg/kg body weight for 10 days. The exercise group ran on a treadmill for 60min/ day(20 minutes every 4 hour at 10m/ min and a 10degrees grade. The control group received daily subcutaneous injection of normal saline at a dose of 5mg/kg body weight for 10 days. The D+E group ran on a treadmill for 60min/day(20 minutes every 4hour) at 10m/min and a 10degrees grade. Body weight of both control and exercise group increased significantly until 10 days, the of both dexa and D+E group decreased significantly, resulting in 79.47 and 78.75% decrease respectively compared to the first day of experiment. Body weight and muscle weight of the soleus, plantaris and gastrocnemius decreased significantly with dexamethasone injection. Relative weight of the dexa group decreased significantly compared to that of the control group. Body weight and muscle weight of the soleus and plantaris of the D+E group showed a tendency to increase, and muscle weight of the gastrocnemius increased significantly compared to the dexa group. The Relative weight of the plantaris was comparable to the control group and that of the soleus and gastrocnemius tended to increase, in the exercise group. Body weight and muscle weight of the soleus and plantaris of the D+E group showed a tendency to increase, and muscle weight of the gastrocnemius increased significantly compared to the dexa group, The Relative weight of the soleus and gastrocnemius tended to increased and that of the plantaris of the D+E group increased significantly compared to the dexa group. Body weight, muscle weight and relative weight of the soleus, plantaris and gastrocnemius of the D+E group increased significantly compared to the dexa group Adrenal gland weight of the dexa and D+E group tended to increase, and that of the exercise group increased significantly. From these results. it can be suggested that regular exercise during dexamethasone injection might attenuate the decrease of body weight and hindllimb muscle weight induced by the dexamethasone injection.

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Effect of Endurance Exercise Prior to Occurrence of Muscle Atrophy on the Mass, Myofibrillar Protein Content and Fiber Crossectional Area of Atrophied Hindlimb Muscles of Rats
Myoung Ae Choe
Journal of Nurses Academic Society 1997;27(1):96-108.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.96
AbstractAbstract PDF

The purpose of this study was to determine the effect of endurance training prior to occurrence of muscle atrophy on the mass, myofibrillar protein content and fiber crossectional area of atrophied hindlimb muscles of rats. Adult female Wistar rats were trained prior to occurrence of muscle atrophy induced by hindlimb suspension. Training began on the lst day for 10min/day at 15m/min on a 0% grade, training exercise increased daily in time and intensity so that by the 4th week rats were running 60min/day, at 34m/min on a 13.5% grade. Wet weight and relative weight of soleus, plantaris and gastrocnemius muscle decreased significantly after seven days of hindlimb suspension. Wet weight and relative weight of soleus tended to increase and that of plantaris and gastrocnemius tended to decrease in the exercise group as compared to the control group. Myofibrillar protein content of soleus and gastrocnemius tended to in crease and that of plantaris tended to decrease in the endurance trained group as compared to the control group. Fiber crossectional area of Type I, II fiber in soleus and plantaris muscle tended to increase in the exercise group as compared to the control group. Wet weight and relative weight of soleus, plantaris and gastrocnemius decreased significantly, myofibrillar protein content of soleus, plantaris and gastrocnemius increased in hindlimb suspended rats following endurance training as compared to the control group. There was no change in fiber type percentage and crossectional area of type I and II fiber in soleus muscle and that of type I and II fiber in plantaris muscle decreased in the hindlimb suspended rats following endurance training as compared to the control group. Wet weight and relative weight of soleus and plantaris tended to increase, that of gastrocnemius increased significantly, myofibrillar protein content of soleus and plantaris muscle increased significantly and that of gastrocnemius tended to increase in the hindlimb suspended rats following endurance training as compared to sedentary rats following endurance training. Crossectional area of type I fiber of soleus muscle tended to increase, that of type I fiber of plantaris muscle increased significantly and that of type II fiber tended to increase in hindlimb suspended rats following endurance training as compared to sedentary rats following endurance training. The results suggest that endurance training prior to occurrence of muscle atrophy can attenuate the decrease of mass, myofibrillar protein content and fiber crossectional area induced by hindlimb suspension.

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An Effect of Muscle Strengthening Exercise Program on Muscle Strength, Pain, Depression, Self-efficacy, and Quality of Life of Patients with Knee Osteoarthritis
Mi Ra Lee
Journal of Nurses Academic Society 1996;26(3):556-575.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.3.556
AbstractAbstract PDF

In an attempt to investigate the effect of a muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy and quality of life of patients with knee osteoarthritis, a pre-experiment, one group pre-test and post-test design, was planned. Muscle strengthening exercise was carried out from May 22 through August 14, 1995 at isokinetic exercise room in rehabilitation department of University Hospital in Taejon. The subjects were seven female clients conveniently sampled from University Hospital located in Taejon, between 39 and 61 years of age, who had a osteoarthritis in knee. Muscle strengthening exercise program was composed of three sessions per week, one isokinetic exercise at angular velocity of 60degrees and 180degrees with Cybex isokinetic dynamometer and two resistance home exercise sessions with elastic band. Data were analyzed with frequency, percentage of change, Friedman test, Duncan test using SAS program. Results were obtained as follows: 1) Flexion and extension muscle strength at angular velocity of 60degrees and 180degrees were increased after 12weeks' exercise than those of before experiment. But exept flexion muscle strength at angular velocity of 180degrees (F=3.34, P=0.0261), there was no statistically significant difference among muscle strengths, which is measured every 3 weeks. 2) Pain was decreased after 6weeks' exercise than that of before experiment, and after 12weeks' exercise than that of 6weeks' exercise. There was statistically significant difference(F=4.28, P= 0.0396). 3) Depression was increased after 6weeks' exercise than that of before experiment, and after 12weeks' execise than that of 6weeks' exercise. There was no statistically significant difference between before experiment and after 6weeks' exercise. But, there was statistically significant difference between after 6weeks' exercise and 12weeks' exercise (F=9.38, P=0.0035). 4) Self-efficacy was decreased after 6weeks' exercise than that of before exercise. But, it was increased after 12weeks' exercise than that of before exercise and after 6weeks' exercise. But there was no statistically significant difference (F=1.46, P=0.2706). 5) Quality of life was increased after Gweeks' exercise than that of before exercise, and after 6weeks' exercise than that of 12weeks' exercise. But there was no statistically significant differ-ence(F=1.06, P=0.3816). Thus, the significant of muscle strengthening exercise for the improvement of muscle strength, pain, depression, is verified. But, this study was a preexperiment with small size subjects. So, controlled experimental study is necessary to determine the effect of this muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy, and quality of life of patients with knee osteoarthritis.

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The Effect of Walking Exercise Program on Cardiorespiratory Function and Flexibility in Elderly Women
Yun Hee Shin, Young Hee Choi
Journal of Nurses Academic Society 1996;26(2):372-386.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.2.372
AbstractAbstract PDF

Recently, the ratio of elderly in the population are fastly growing due to socio-economical development and the better medical service. Proportionally, the health problems in elderly are increasing, too. Medical professionals must try so that the elderly have the better life through health promotion and disease prevention as well as disease treatment. This study evaluated the effect of walking exercise program on the cardiorespiratory function and the flexibility in the elderly women. The design of research was one group pretest -posttest design. The subjects were eleven elderly women over sixty years old to live in K-city, Kyonggi-do. The type of exercise was walking, which was the most popular exercise in questionnaire. The exercise intensity was 40%~60% of the target heart-rate by Karvonen's method and maintained by the heart-rate monitor. The exercise period was five weeks and the exercise frequency was three times per week. The exercise duration was forty minites at first and gradually increased up to a hour. In order to evaluate the effect of walking exercise, we measured VO2 max, resting heart-rate, systolic/diastolic blood pressure, FVC, FEV1, the flexibility before and after the five week's exercise program. The data are analyzed by the paired t-test and Wilcoxon signed rank test using SAS package. The results are as follows: 1) The hypothesis that cardiorespiratory function will be improved was partly supported. In VO2 max(p=0.0001), resting heart-rate(p=0. 0030), systolic/diastolic blood-pressure (p=0.0387/p=0.0024), there was significant difference. FVC and FEV1 were increased after the exercise, but there were no significant difference. 2) The hypothesis that the flexibility will be improved was supported. There was significant difference in the flexibility (p=0.0140). As the further study, it is necessary to reevaluate the effect with more refined design. We also need to try meta-analysis about the results of previous studies obtained in the experimental setting and compare our result obtained in the field setting with them.

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The Effect of Circumvaginal Muscle Exercise on Sexual Function in Married Women
Young Sook Lee
Journal of Nurses Academic Society 1996;26(1):148-164.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.1.148
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The effect of circumvaginal muscle (CVM) exercises to improve sexual function in married women has not been investigated by currently acceptable research methods, nor have appropriate instruments and techniques to carry out such investigation been available. The purpose of this research was to study the effect of CVM exercise on sexual function, and of measuring CVM function after CVM exercises. The research tools used were a modified Derogatis Sexual Function Inventory questionnare and a pressure sensitive intravaginal balloon device. This research was conducted in Kwangju-city and Chonnam province, Korea from July, 1994 to July, 1995. The research used a non-equivalent control pre-post test quasi-experimental design. Forty-five healthy married female volunteers, aged 30?8, and were randomly assigned by age using the matching fixed-length blocks to two groups. The experimental group consisted of 21 women who were assigned a 25 -minute per day CVM home exercise program for six weeks. The control group of 24 women did not do the CVM home exercises. The CVM home exercise was developed by Dougherty (1989a) and adopted to Korea by Lee (1993). Data were analyzed by x2-test, Paired t-test, Spearman product-moment correlation using SAS/PC+. The results are summarized as follows: 1. There were no significant differences in the characteristics of the subjects between the exper imental and control groups before the CVM home exercises. 2. Hypothesis 1 that married women who participated in CVM home exercises would have higher mean scores on the sexual function (SF) than in those who did not participate in home exercise was supported. 3. Hypothesis 2 that married women who participated in CVM home exercises would have higher vaginal pressure on SF than in those who did not participate in home exercises was supported (mean maximum pressure, t= -7.338, P<.0001, peak maximum pressure, t=-11.164, P<.0001). 4. Hypothesis 3 that the more often (number of days) and the more frequent (numbers of times per day) that married women do CVM home exercise, the higher their mean scores on SF and vaginal pressures was supported (r =0.233, P<.01; r=0.352, P<.05). A six week CVM home exercise program using a tape recording showed that SF can be improved. Results of this study showed that married women who exercise on a regular basis for six weeks improve their sexual function and increase the mean vaginal pressure and peak maximum pressure (tested by electronic monitor). In conclusion, CVM exercise is effective in increasing SF.

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The Effects of Exercise Therapy and Exercise-Behavior Modification Therapy on Obesity, Blood Lipids, and Self-esteem of the Obese Middle-aged Women
In Hong Kim
Journal of Korean Academy of Nursing 2002;32(6):844-854.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.6.844
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PURPOSE: To examine the effect of the exercise therapy, and exercise-behavior modifi- cation therapy on obesity, blood lipids and self-esteem of the obese middle-aged women. METHOD: A total of 35 middle-aged women (BMI: over 30) were selected for this research. Walking at a 50% intensity was administered 4 days a week for 12 weeks, while the behavior modification therapy performed for 60~90 minutes per week for 12 weeks. RESULT: Body weight and BMI has significantly reduced in the case of EG and E.BG. The result of comparing body weight between groups showed significant difference between EG and CG, and E.BG and CG whereas BMI showed significant difference between EG and CG only. TC, TG, LDL-C, %TC/HDL-C have shown significant decrease in EG and E-BG, while HDL-C displayed significant increase in EG and E.BG. And HDL-C showed significant decrease in CG. As for comparison between groups, significant difference was noted in EG and CG, and E.BG and CG at TC, HDL-C, LDL-C, and in EG and CG at %TC/HDL-C. Self-esteem displayed significant increase in EG and E.BG; however, there was no significant different in CG. As for comparison between groups, there was significant difference noted in E.BG and CG only. CONCLUSION: The results showed that the exercise therapy and the exercise-behavior modification therapy were effective in changing obesity, blood lipids and self-esteem of the obese middle-aged women.

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The Effects of Sasang Constitutional Diet for Essential Hypertension on Blood Pressure, Fat, and Serum Lipid: on the subjects with aerobic exercise and low salt diet at the same time
Eun Young Jeon
Journal of Korean Academy of Nursing 2002;32(5):673-683.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.5.673
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PURPOSE: This study was conducted to evaluate the effects of SaSang constitutional diet for essential hypertension on blood pressure, fat, and serum lipid on the subjects with aerobic exercise and low salt diet at the same time. METHOD: A non-equivalent control group time-series design was used. For the experimental group, aerobic exercise and SaSang constitutional diet were taught by researcher at health center. Test for hypothesis was done by repeated measured ANOVA. RESULT: There was significant decrease in systolic, diastolic, and MAP between the experimental group and control group over three different times. There was significant decrease in body weight, BMI, and body composition over three different times. But, there was no significant difference between groups and interaction by groups or over time. There was significant decrease in T/G and cholesterol over three different times. But, there was no significant difference in T/G, HDL, LDL, and total cholesterol between groups and interaction by groups or over time. CONCLUSION: Findings indicate that this study will contribute to develop nursing strategies for the regulation of the blood pressure as a means of alternative- complementary nursing intervention.

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Effect of Regular Exercise during Recovery Period Following Steroid Treatment on the Atrophied Type II Muscles Induced by Steroid in Young Rats
Myoung Ae Choe, Gi Soo Shin, Gyeong Ju An, Jung An Choi, Yoon Kyong Lee
Journal of Korean Academy of Nursing 2002;32(4):550-559.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.4.550
AbstractAbstract PDF

PURPOSE: This study was conducted to determine whether low intensity regular exercise following dexamethasone treatment could attenuate steroid-induced muscle atrophy. METHOD: 36 Wistar-rats(90-110g) were divided into six groups: control group(C), dexamethasone treatment group(D), sedentary group after normal sedentary period(C+S), sedentary group after dexamethasone treatment period(D+S), exercise group after normal sedentary period(C+E), and excercise group after dexamethasone treatment period(D+E). D, D+S, and D+E groups received dexamethasone injection(5mg/Kg) for seven days whereas C, C+S, and C+E groups received normal saline injection. Both C+E and D+E groups ran on a treadmill for 60 minutes/day(20minutes/4hours) at 15m/min and a 10degreegrade for seven recovery days. RESULT: Post-weight(body weight before muscle dissection) of D group significantly decreased by 16.03%, and that of D+E group significantly increased by 15.51% compared with pre-weight(body weight before steroid treatment). Type II muscle(plantaris and gastrocnemius) weights of D group were significantly lower than those of C group. Myofibrillar protein contents of type II muscles of D group tended to decrease comparing with C group. In D+E groups, body weights and relative weights of typeII muscles(muscle weight(mg)/post-weight(g)) tended to increase comparing with D+S group. CONCLUSION: It is suggested that steroid- induced muscle atrophy can be ameliorated through low intensity regular exercise after dexamethasone treatment.

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The Effect of the Dan-Jun Breathing Exercise Program on pulmonary function and psychological Health of Women in Midlife
Kyung Sun Hyun
Journal of Korean Academy of Nursing 2002;32(4):459-469.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.4.459
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PURPOSE: This study was to examine the effects of the Dan-Jun Breathing Exercise Program on pulmonary function and psychological health promotion of women in midlife. METHOD: Experimental group(20) was matched to control group(20) according to age, education, religion and marital status. The Dan-Jun Breathing Exercise Program was carried out for 80 minutes a day, 3 times a week for 12 weeks. FVC and FEV1.0/FVC(%) were measured by using the Health Management System developed by the Korean Physical Science Institution. The scores of depression, anxiety and hostility were measured by the Korean Manual of Symptoms-Checklist -90 revision. RESULT: 1) FVC of the experimental group was higher than that of the control group, FEV1.0/FVC(%) was not higher than that of the control group. 2) The scores for depression, anxiety and hostility in the experimental group were lower than those of the control group. 3) FVC of 6 weeks and 12 weeks experiment in the experimental group was higher than that of pre-experimental group. CONCLUSION: The Dan-Jun Breathing Exercise Program promotes the Pulmonary function and psychological health of women in midlife.

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Effects of Motivation-Enhancing Program on Health Behaviors, Cardiovascular Risk factors, and Functional status for Institutionalized Elderly Women
Rhayun Song, Kyung Ja June, You Ja Ro, Chun Gill Kim
Journal of Korean Academy of Nursing 2001;31(5):858-870.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.5.858
AbstractAbstract PDF

This study was to compare changes in health behaviors, motivational factors, cardiovascular risk factors, and functional status (SIP) after implementing the 6-month motivation-enhancing program to institutionalized elderly women.
METHODS
Sixty-four elderly women participated. Face to face interviews with blood sampling and anthropometric assessment were conducted at the pretest, 10 weeks and 6 months during the program.
RESULTS
1. The program participants showed significantly better health behaviors over 6 months. The mean motivational level was also significantly improved, especially for perceived benefits, perceived barriers, and emotional salience. 2. The mean of cardiovascular risk factors for the participants was 21.8 at the level of low to moderate risk. After completing the program, total risk score was significantly decreased to 18.7 at 10 weeks, and further to 17.7 at 6 months. A significant reduction was also found in HDL and LDL-cholesterol levels, blood pressure, obesity, inactivity, and stress. 3. The functional status (SIP) was 11% at the baseline and significantly changed in positive direction at 10 weeks (M=9.3) and at 6 month (M=6.3). The significant improvement was also found in physical and psychosocial dimensions and sleep/rest dimension.
CONCLUSION
The motivation enhancing program was effective to reduce cardiovascular risks and to improve the functional status of institutionalized elderly women by motivating them to perform better health behaviors.

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The Study on the Effect of Stage Based Exercise Motivational Intervention Program for the Elderly
Pyoung Sook Lee, Sung Ok Chang
Journal of Korean Academy of Nursing 2001;31(5):818-834.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.5.818
AbstractAbstract PDF

PURPOSE: This study aims at confirming exercise effects on obesity, mobility, self-efficacy, process of change, and decisional component by stage based exercise motivational intervention program for the elderly. The stage based exercise intervention program was constructed based on Transtheoretical Model.
METHODS
The design of this study is nonequivalent control group with repeated measuring by quasi-experimental study. The subjects of this study, composing of experimental group of 32 and control group of 28 were selected at one institution for the aged in Seoul.
RESULTS
1) The body fat (weight, BMI and circumference of waist), of the intervention group was significantly decreased than the control group. 2) The mobility of the intervention group was not significantly increased than control group. 3) The self-efficacy, Pros, Process of Change for exercise of the intervention group was not significantly increased than the control group. 4) The Cons for exercise of intervention group was not significantly decreased than the control group.
CONCLUSION
The above result have informed us that a stage-based exercise motivational intervention program for the elderly has the effect of decreasing old persons' body fat and has value as an effective means of nursing for the elderly.

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Prediction Model of Exercise Behavior in Patients with Rheumatoid Arthritis
Eun Ok Lee, In Ja Kim, Jong Im Kim, Hyun Sook Kang, Sang Cheol Bae
Journal of Korean Academy of Nursing 2001;31(4):681-691.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.4.681
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PURPOSE: The exercise status in patients with rheumatoid arthritis, associations between exercise behavior and personal factors, and associations between exercise behavior and exercise-specific cognitions and their effects were assessed. METHOD: Four hundred thirty nine outpatients with rheumatoid arthritis were studied. The exercise status was measured by a single item. The intensity was multiplied by the frequency and duration of each exercise. The product of these intensity values for all exercises was defined as exercise behavior. Based on the Pender's revised health promotion model, exercise benefit, barrier, self-efficacy, enjoyment and social support were chosen as exercise specific cognitions and affect variables. Path analysis was used to identify the predictors of exercise behavior. Results: Compared to the duration before being diagnosed, the number of subjects who exercised regularly increased after being diagnosed. However over half of the subjects refrain from any sort of exercise and the type of exercise is very limited. Among the variables, exercise barrier, self-efficacy, and social support were found to be significant predictors of exercise behavior, and only previous exercise experience was found to be significant predictors of all behavior specific cognitions and affect variables. CONCLUSION: These findings suggest that studies should explore exercise behaviors and strategies to emphasize the cognitive-motivational messages to promote exercise behaviors.

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Effects of Exercise on Cardiopulmonary Functions and Shoulder Joint Functioning in Breast Cancer Patients undergoing Radiation Therapy after Breast Surgery
Young Ran Chae, Myoung Ae Choe
Journal of Korean Academy of Nursing 2001;31(3):454-466.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.3.454
AbstractAbstract PDF

PURPOSE: The purpose of this study was to determine the effects of exercise program on cardiopulmonary functions and shoulder joint functioning in breast cancer patients who under- went radiation therapy after surgery. METHOD: Subjects in the experimental group(N=12) participated in an exercise program for eight weeks. The Exercise program consisted of shoulder stretching, arm weight training, and walking on treadmill. Maximal oxygen uptake(o2max), maximal running time, shoulder joint range of motion, and shoulder functional assessment were determined before and after the exercise program. Baseline sociodemographic and medical data were compared between experimental group and control group using the Fisher's exact test and Mann- Whitney U test. For effects of the exercise program, repeated measures ANOVA were used. RESULT: 1) Following the exercise program for eight weeks, both o2 max and maximal running time tended to increase in experimental group comparing with the control group. 2) Shoulder abduction, extension and flexion of the operated upper extremity in the experimental group comparing with control significantly increased after the exercise program(p<0.05). 3) Shoulder flexion of the normal upper extremity in the experimental group comparing with control significantly increased after the exercise program(p<0.05). CONCLUSION: The
results
suggest that the exercise program for breast cancer patients undergoing radiation therapy after breast surgery can improve shoulder functions and increase cardiopulmonary functions, which are maximal oxygen uptake and maximal running time.

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Effects of Biofeedback Exercise Training in Hemiplegic Patients after Stroke
Keum Soon Kim, So Woo Lee, Myung Ae Choe, Myung Sun Yi, Eun Jung Kim
Journal of Korean Academy of Nursing 2001;31(3):432-442.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.3.432
AbstractAbstract PDF

PURPOSE: The purpose of this study was to investigate the effects of biofeedback exercise training on muscle activity and activities of daily livings (ADL) in hemiplegic patients. An experimental group consisting of 17 people, was given biofeedback exercise training for 30- 60 minutes per week for 5 weeks, while a control group consisting of 18 people, was given normal exercise with quasi-experimental design. RESULT: The results of the study show that biofeedback exercise is effective for improving muscle activity in hemiplegic patients, especially in the hemiplegic limbs. However, this study found no significant differences in ADL and IADL between the experimental and the control groups. It implies that ADL and IADL may not be improved for a short period of time, such as 5 weeks, for people with more than five years of hemiplegia. The study suggests that the effect of biofeedback exercise on ADL and IADL should be determined in hemiplegic patients in acute stage.

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The Effects of Planned Exercise Program on Metabolism, Cardiopulmonary Function and Exercise Compliance in Type 2 Diabetes Mellitus Patients
Ae Ran Hwang, Ji Soo Yoo, Chun Ja Kim
Journal of Korean Academy of Nursing 2001;31(1):20-30.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.1.20
AbstractAbstract PDF

This study was conducted to identify the effects of a planned exercise program based on Bandura's self efficacy model on metabolism, and the exercise compliance in type 2 diabetes mellitus patients. The study design was a nonequivalent pre-test post-test control design. Thirty four type 2 diabetes mellitus patients, who received follow-up care regularly through the diabetic out-patient clinic, were randomly sampled for this study. Twenty patients were assigned to the experimental group and fourteen patients were assigned to the control group. In the experimental group, a planned exercise program is composed of an individualized exercise prescription for 12 weeks, an individual education, and even a telephone coach program. In the case of the control group, they were instructed to continue with their usual schedules. The data collection period was from March 1999 to February 2000 Data were analyzed using SPSS/WINDOW 10.0program. The results were as follows. 1. In the experimental group, the level of fasting blood sugar has significantly decreased from 188.20 mg/dl to 155.55 mg/dl after planned exercise program (F= 16.86, p=.000). For lipid metabolism, body fat per cutaneous decreased from 27.16% to 26.57% after planned exercise program. The score of self efficacy has increased from 64.20 to 66.65 after planned exercise program and it was statistically significant (F=4.850, p=.040) The functional vital capacity has increased from 3.28 liter to 3.37 liter and it was statistically significant(F=7.300, p=.020). 2. In an after effect of a planned exercise program, 35 percent of the subjects who participated in a planned exercise program continued to exercise for another six months. In conclusion, the planned exercise program can improve cardiopulmonary function, glucose, and lipid metabolism. This program was show a positive effect on the self efficacy and exercise compliance.

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Continence Self-Efficacy to Increase PFM Exercise Adherence in SUI
Jeung Im Kim
Journal of Korean Academy of Nursing 2000;30(7):1743-1751.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.7.1743
AbstractAbstract PDF

Stress urinary incontinence is most common type in urinary incontinence. Most women had been suffering with stress urinary incontinence for more than a year in the community without seeking medical help. Under the assumption that stress urinary incontinence will be treated or improved by keeping PFM exercise with his/her continence confidence, this study was conducted. This study examined Continence self-efficacy effect on PFM exercise adherence. Subject were in 48 women aged 20 to 75 years with stress urinary incontinence and were recommended by their doctor to attempt PFM exercise as one treatment method.. Data were collected by self-administered report using Continence Self-Efficacy Scale, PFM exercise adherence check sheet. Telephone support was used as a method of CEIP to increase Continence self-efficacy. Continence self-efficacy score was higher in the intervention group than in control group (T=-3.23, P<.01), PFM exercise adherence was better in the intervention group than in control group (T=-4.03, P<.001). Through this research, it was also found that there were three types in attitude toward treatment; those who want to be treated completely, those who want to be relieved, and those who think urine loss is no problem. It can be concluded that to increase Continence self-efficacy was useful to the PFM exercise adherence of women with stress urinary incontinence.

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A study of the Stage of Change and Decisional balance: Exercise Acquisition, Smoking Cessation, Mammography Screening and Kegel's Exercise Acquisition in Korea
Sung Ok Chang, Young Joo Park, Chang Seung Park, Yeo Jin Lim
Journal of Korean Academy of Nursing 2000;30(5):1265-1278.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.5.1265
AbstractAbstract PDF

This study was carried out to assess the perception of decisional balance of Korean subjects about 4 health behaviors and to identify the influencing factor of decisional balance for exercise acquisition, smoking cessation, mammography screening and Kegel's exercise acquisition. All are representative health behaviors nurses can intervene in Korea based on the Transtheoretical model. Convenient samples of 2,484 subjects (191; exercise, 169; smoking cessation, 1903; mammography screening and 221; Kegel's exercise) were selected from cities and counties over 9 provinces throughout Korea, and the data was collected from January 1, 1999 to February 29, 2000. The research instrument were the Decisional Balance Measure for Exercise (Marcus & Owen., 1992), Smoking Cessation (Velicer et al., 1985), Mammography Screening (Rakowski et al.,1992) and Kegel Exercise (Lim, 1999) and Stage of Change Measure for Exercise (Marcus et al, 1992), Smoking Cessation (DiClemente et al., 1991), Mammography Screening (Rakowski et al.,1992) and Kegel's Exercise (Lim, 1999). The data was analyzed by the SAS Program. The results are as follows; 1. According to the stage of change measure, 2,484 subjects were distributed in each stage of change for four health behaviors: 1,233 subjects (49.8%), 745 subjects (30.2%), 113 subjects (4.7%), 156 subjects (6.5%), and 216 (8.7%) belonged to the pre- contemplation stage, contemplation stage, preparation stage, action stage and maintenance stage. They were all series of stages of change in their efforts to do health behavior. 2. Factor analysis identified 3 factors (1 of Pros, 2 of Cons) for the exercise, 4 factors for smoking cessation (2 of Pros, 2 of Cons), 2 factors (1 of Pros, 1 of Cons) for the mammogram screening and 2 factors (1 of Pros, 1 of Cons) for Kegel's exercise of decisional balance. 3. The analysis of variance and multiple comparison analysis showed that for all 4 samples, the Cons of changing the problem behaviors outweighed the Pros for subjects who were in the pre- contemplation stage, The opposite was true for subjects in action and maintenance stage. 4. Through the discriminant analysis, it was found that one factor of Pros for exercise, one factor of Cons for smoking cessation, 1 factor of Cons for mammogram screening and one factor of Cons for Kegel's exercise were the more influencing factors, than others in discriminating the stages of change.
Results
are consistent with the applications of the Transtheoretical model, which have been used to understand how people change health behaviors. This results provide some evidence that subject's report of his/her health behavior corresponds to beliefs about usefulness of related health behaviors. The results of this study have implications for patients' health education and health intervention strategies. The findings of this study give useful information for nursing educators for 4 health behaviors, especially the factors relating to decision making in the different stages of change.

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The Effect of the Self Efficacy Promotion and Exercise Training Program of Kidney Transplant Recipients
Jae Hyun Ahn
Journal of Korean Academy of Nursing 2000;30(5):1181-1194.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.5.1181
AbstractAbstract PDF

This study was attempted to evaluate how the self efficacy promotion and exercise training program effect on the postoperative general conditions of transplant recipients after kidney transplantations. The subjects were selected randomly among the patients who underwent renal trans- plantations at three major transplantation hospitals in Seoul, Korea. This study was carried out between November 1999 and March 2000. The observed subjects in this study consisted of 56 patients. The exercise training group(n=16) received the self efficacy promotion and exercise training program for 12 weeks which contained general knowledge for compliance instruction, exercise training and self efficacy promotion education. The self efficacy group(n=18) received general knowledge for compliance instruction and self efficacy promotion education but no exercise training was given. The control group(n=22) were not offered any education. The knowledge for compliance, self efficacy, physical conditions(weight, muscle strength, muscle endurance, flexibility), lab studies (hemoglobin, creatinine, cholesterol), activities of daily living and quality of life were evaluated 3 times, before the experiment, at 8 weeks and at 12 weeks. The data were analyzed with mean, standard deviation, Chi-square test, ANOVA and Scheff test. The results were as follows: 1. The knowledge and self efficacy score of the exercise training group and self efficacy group were significantly increased than those of the control group(p=.0001). 2. The weight of the exercise training group was significantly decreased compared to those of the self efficacy group and the control group(p=.0001). Muscle strength (grip strength, back lift strength), and flexibility of all 3 groups were significantly changed(p=.0001). However, muscle endurance in all 3 groups showed no significant differences. 3. The hemoglobin level of the exercise training group and the self efficacy group were significantly increased compared to that of the control group(p=.0001) and the cholesterol levels of the exercise training group and the self efficacy group were significantly decreased compared to that of the control group(p=,0001). However, the creatinine levels in all 3 groups showed no significant differences. 4. The activities of daily living scores of the exercise training group was significantly increased than that of the control group (p=.0003), and the quality of life scores of the exercise training group and the self efficacy group were significantly better than that of the control group(p=.0001). It would be expected that this self efficacy promotion and exercise training program could be applied widely as an effective nursing intervention for kidney transplant recipients.

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