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Original Articles
Applying Extended Theory of Planned Behavior for Lung Cancer Patients Undergone Pulmonary Resection: Effects on Self-Efficacy for Exercise, Physical Activities, Physical Function, and Quality of Life
Yeonjung Lim, Haejung Lee, Do Hyung Kim, Yeong Dae Kim
J Korean Acad Nurs 2020;50(1):66-80.   Published online January 31, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.1.66
AbstractAbstract PDF
Abstract Purpose:

This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection.

Methods:

This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ2 test, Fisher’s exact test, Mann-Whitney U test, t-test, and generalized estimation equations (GEE).

Results:

There were significant differences between the two groups regarding SEE (χ2=13.53, p=.009), PA (χ2=9.51, p=.049), functional status (χ2=10.55, p=.032), and 6MWD (χ2=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=-2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component.

Conclusion

The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.

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The Effects of Utilizing Smartphone Application Peer Support on Health Behavior and Body Mass Index among Breast Cancer Survivors
Gaeun Park, Haejung Lee, Hyun Yul Kim
J Korean Acad Nurs 2019;49(5):550-561.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.5.550
AbstractAbstract PDF
Abstract Purpose

This study aimed to identify the effects of utilizing Smartphone Application Peer Support (SAPS) on health behavior and body mass index (BMI) among overweight or obese breast cancer survivors (BCS).

Methods

A nonequivalent control group with a non-synchronized design was utilized and 36 participants (experimental group 14, control group 22) were recruited from August 2017 to September 2018. Participants were 40~65 years old, overweight or obese, had completed primary cancer treatment within the 12 months prior to the study, and had not done regular exercise during the last 6 months. The 3-month SAPS consisted of exercise and diet education (once p/2 weeks), peer support (once p/week), and self-monitoring using smartphone applications (5 times p/week). All participants underwent assessments at baseline, right after SAPS, and at 3 months after SAPS. Data were analyzed using repeated measures ANOVA.

Results

At the completion of SAPS significant differences were found between groups in motivation for exercise (t=-3.24, p=.005), physical activity (t=-4.15, p<.001), total calorie intake (t=3.42, p=.002), calories from fat (t=-3.01, p=.005), intake of vegetables (t=-2.83, p=.008), and BMI (t=5.21, p<.001). Significant differences in BMI (t=4.13, p<.001) remained up to 3 months after SAPS completion. No significant differences was shown between groups in self-efficacy for exercise, either immediately after or 3 months after SAPS.

Conclusion

The SAPS has the potential to improve motivation for exercise, health behavior, and BMI of BCS. However, special efforts are required to encourage participants to complete the intervention and maintain long-term effects for future trials.

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Comparison of Effects of Oral Health Program and Walking Exercise Program on Health Outcomes for Pregnant Women
Hae-jin Park, Haejung Lee
J Korean Acad Nurs 2018;48(5):506-520.   Published online October 31, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.5.506
AbstractAbstract PDF
Purpose

To compare the effects of the Interaction Model of Client Health Behavior (IMCHB)-based oral health program (OHP) and walking exercise program (WEP) on oral health behaviors, periodontal disease, physical activity, and psychological indicators (depression, stress, and quality of life) in pregnant women.

Methods

A nonequivalent control group pretest-posttest design was adopted to compare the effects of a 12-week OHP and WEP on pregnant women (n=65). Pregnant women were randomly assigned to the oral health group (OHG; n=23), walking exercise group (WEG; n=21), or control group (CG; n=21). Data were analyzed by the χ2-test, Fisher's exact test, Scheffe test, and repeated measures ANOVA, using the Statistical Package for the Social Sciences for Windows (version 21.0).

Results

The OHG and WEG showed significant improvements in oral health behaviors, periodontal disease, and psychological indicators as compared to the CG. The WEG showed significant improvement in physical activity as compared to the OHG and CG.

Conclusion

These findings indicate that the IMCHB-based OHP and WEP were effective in improving periodontal disease, physical activity, and psychological indicators. However, further studies are needed to identify the positive effects of the OHP and WEP on birth outcomes.

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Development and Effects of Social Learning Theory Based Eye-Health Program for Preschoolers
Sunghwa Lee, Haejung Lee, Hyungsik Seo, Jaeho Jung
J Korean Acad Nurs 2018;48(4):407-418.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.4.407
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to develop an eye-health program based on social learning theory (EPST) of preschoolers and evaluate its effectiveness.

Methods

A nonequivalent control group pre-post test design was utilized and 141 six-year-old preschoolers and their parents participated (experimental group=69, control group=72) in the study. The EPST in this study included eye-health education and eye exercises. Attention, memory, replay, motivation, reinforcement, and self-efficacy were used as interventional strategies. To examine the effectiveness of EPST, proficiency in eye-health activities, refractive power, and visual acuity were measured before and after the intervention. Data were analyzed with SPSS WIN 21.0 using the Shapiro-Wilk test, χ 2-test, Mann-Whitney U test and Wilcoxon signed rank test.

Results

Following the intervention, eye-health activities, refractive power, and visual acuity significantly improved in the experimental group compared to the control group.

Conclusion

The results of this study suggest that EPST is effective in improving eye-health activities, refractive power, and visual acuity in preschoolers, and its wider implementation in educational institutions will promise improved eye-health among preschoolers.

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Predictors of Burnout among Informal Caregivers of Older Adults: Using Discriminant Analysis
Haejung Lee, Rhayun Lee
Journal of Korean Academy of Nursing 1999;29(3):585-595.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.3.585
AbstractAbstract PDF

The purse fo this study was to examine the predictors of burnout among informal caregivers of older adults. One hundred thirty seven caregivers of who had provided care to older adults over 60 years of age for more than one month were included in the study. Most of the caregivers where white (91%) and female (78%). mean ages of the caregivers were 64 years and 78% of them were married. Seventy percent of the older adults suffered from Alzheimer and related disease. In this study, caregivers and related disease. In this study, caregivers reported that they experience burnout once a month. The scores of emotional exhaustion and reduced personal accomplishment of the caregivers were in the moderate burnout rang. To examine the predictors of burnout, discriminant analysis was used. Caregivers were divided by two groups based on the sum of score (cutpoint=6) on three dimensions of burnout after each dimension was categorized into high(3), moderate(2), and low(1). Nine predictors were include in the analysis: Caregiver's age, employment status, Instrumental Activities of Daily Living (IADL) of the older adult, presence of dementia of the older adult, caregiver's empathy toward the older adult(emotional and cognitive), and 3 coping strategies (negative, problem-focused, cognitive reconstructioning). Catefgivers who reported high burnout showed higher cognitive empathy toward the adults than those who showed low burnout. Caregivers who experienced high burnout used negative coping more often, and cognitive reconstructioning coping and problem focused coping less often than their counterparts. Wilks' Lambda was .78 indicating that their differences between the two groups were signigicant. Cognitive empathy and cognitive reconstructioning coping showed high standardized canonical discriminant function coefficients over .40. Discriminant function with 9 predictors correctly classified 71% of the sample. In conclusion, informal caregivers also experienced certain level of burnout. Cognitive empathy and coping strategies predicted burnout experience of the caregivers. Based on this study, nursing intervention to the informal caregovers to improve their cognitive empathy toward the older adults and to modify their coping strategies in way to reduce burnout experience can be applied. Further research to develop effective nursing interventions for the purpose of reducing burnout experience by modifying predictors was suggested.

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Discriminating Power of Socio-demographic and Psychological Variables on Addictive Use of Cellular Phones Among Middle School Students
Haejung Lee, Myoung Soo Kim, Hyun Kyung Son, Sukhee Ahn, Jung Soon Kim, Young Hae Kim
Journal of Korean Academy of Nursing 2007;37(6):957-965.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.6.957
AbstractAbstract PDF

PURPOSE: The purpose of this study was to examine the degrees of cellular phone usage among middle school students and to identify discriminating factors of addictive use of cellular phones among sociodemographic and psychological variables. METHODS: From 123 middle schools in Busan, potential participants were identified through stratified random sampling and 747 middle school students participated in the study. The data was collected from December 1, 2004 to December 30, 2004. Descriptive and discriminant analyses were used. RESULTS: Fifty seven percent of the participants were male and 89.7% used cellular phones at school. The participants were grouped into three groups depending on the levels of the cellular phone usage: addicted (n=117), dependent (n=418), non-addicted (n=212). Within the three groups, two functions were produced and only one function was significant, discriminating the addiction group from non-addiction group. Additional discriminant analysis with only two groups produced one function that classified 81.2% of the participants correctly into the two groups. Impulsiveness, anxiety, and stress were significant discriminating factors. CONCLUSION: Based on the findings of this study, developing intervention programs focusing on impulsiveness, anxiety and stress to reduce the possible addictive use of cellular phones is suggested.

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The Effects of Smart Program for Patients Who Underwent Percutaneous Coronary Intervention (SP-PCI) on Disease-Related Knowledge, Health Behavior, and Quality of Life: A Non-Randomized Controlled Trial
Jueun Lee, Haejung Lee
J Korean Acad Nurs 2017;47(6):756-769.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.6.756
AbstractAbstract PDF
Abstract Purpose

To identify the effects of a smart program for the patients who underwent percutaneous coronary intervention (SP-PCI) on coronary disease-related knowledge, health behaviors, and quality of life.

Methods

A nonequivalent control group with a non-synchronized design was utilized and 48 participants (experimental=22, control=26) were recruited from a university hospital in Gyeongsang area from May to December, 2016. The 12-week SP-PCI consisted of self-study of health information using smart phone applications (1/week), walking exercise (>5/week) using smart band, feedback using Kakao talk (2/week), and telephone counseling (1/week). Patients in the control group received usual care from their primary health care providers and a brief health education with basic self-management brochure after the PCI. Data were analyzed using the SPSS 21.0 program through descriptive statistics, c2 test, and t-test.

Results

After the 12-week SP-PCI, the experimental group showed higher levels of coronary disease-related knowledge (t=2.43, p=.019), heart-related health behaviors (t=5.96, p<.001), regular exercise (Z=-4.47, p<.001), and quality of life-MCS (t=3.04, p=.004) and showed lower levels of stress (Z=-3.53, p<.001) and sodium intake (t=-4.43, p<.001) than those in the control group. There were no significant group differences in medication adherence and food intake in total energy, lipids, and cholesterol.

Conclusion

The suggested SP-PCI provided easy access and cost-effective intervention for patients after PCI and improved their knowledge of the disease, performance of health behaviors, and quality of life. Further study with a wider population is needed to evaluate the effects of SP-PCI on disease recurrence and quality of life for patients after PCI.

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Effects of a Progressive Walking Program on Physical Activity, Exercise Tolerance, Recovery, and Post-Operative Complications in Patients with a Lung Resection
Inah Kim, Haejung Lee
J Korean Acad Nurs 2014;44(4):381-390.   Published online August 15, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.4.381
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to identify the effects of a Progressive Walking program (PW) on physical activity, exercise tolerance, recovery, and post-operative complications for patients with a lung resection.

Methods

A nonequivalent control group non-synchronized design was utilized and 37 participants with a lung resection (22 for control group, 15 for experimental group) were recruited at A university hospital from December 2012 to August 2013. The PW consisted of preoperative education, goal setting, and feedback, provided to the experimental group, and usual care to the control group. Data were analyzed using the SPSS WIN 18.0.

Results

A higher proportion of patients in the experimental group showed adequate levels of physical activity (p= .001), shorter period of chest tube retention (≤ 7 days; p= .011), and shorter stay in the hospital (≤ 10 days; p= .036) than patients in the control group. Patients in the experimental group reported longer 6-minute walking distance (p= .032) and lower levels of dyspnea (p= .049) than patients in the control group. The PW did not influence the occurrence of pulmonary complications.

Conclusion

The findings of this study suggest that the PW could be a useful strategy for improving patients’ post-operative health and reducing cost after lung resection.

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Factors Influencing Depression among Middle-School Girls
Haejung Lee, Hee Young Jung, Eunyoung Yun, Hwa-Yun Um, Young-Ju Jee
J Korean Acad Nurs 2011;41(4):550-557.   Published online August 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.4.550
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the prevalence of depression among school girls in Korea and identify factors influencing the tendency to depression.

Methods

A self-report survey was conducted with South Korean middle schoolgirls who were in the 8th and 9th grades. Four hundred and one schoolgirls were included in the study. The instruments utilized in this study were the Center for Epidemiologic Studies - Depression Scale and Social Problem Solving Inventory-Revised. Data were analyzed using descriptive statistics, Pearson correlation and multiple logistic regression with SPSS WIN 14.0 program.

Results

The average depression score of the participants was 20.68, which indicates moderate levels of depression. About 35% of the schoolgirls in this study reported a tendency to depression. Significant predictors for depression were 'decreased problem-solving abilities', 'no family members with whom they can discuss their concern', 'decreased satisfaction in relationship with friends', and 'increased negative self-perception of body-image'.

Conclusion

The study findings suggest that schoolgirls require special concern regarding the risk of developing depression. Regular depression screening could be beneficial for early detection of depression in schoolgirls and enhancing problem-solving ability could be considered as an effective strategy to reduce the risk of depression among schoolgirls.

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Effects of a Cognitive-Behavioral Nursing Intervention on Anxiety and Depression in Women with Breast Cancer undergoing Radiotherapy
Myung-Sook Yoo, Haejung Lee, Jung-A Yoon
J Korean Acad Nurs 2009;39(2):157-165.   Published online April 28, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.2.157
AbstractAbstract PDF
Purpose

The purpose of this study was to analyze the effects of a cognitive-behavioral nursing intervention on anxiety and depression of patients with breast cancer undergoing radiotherapy.

Methods

A nonequivalent control group design was used for the study. The research participants were patients with breast cancer (N=71; experimental group=35, comparison group=36) who received radiotherapy at P university hospital. The experimental group received a 6-week cognitive-behavioral nursing intervention (2 hr/week), which included nursing counseling, education about treatment choices for breast cancer and possible side effects and management strategies during radiotherapy, and rehabilitation exercise.

Results

Following the intervention, the experimental group showed significantly lower levels of anxiety (Experimental group=34.60±6.35, Comparison group=44.63±9.93, t=3.552, p<.001) and depression (Experimental group=10.20±6.61, Comparison group=17.81±10.85, t=3.542, p<.001) than the comparison group.

Conclusion

The findings from this study showed that cognitive-behavioral counseling applied by nurses is very effective to reduce anxiety and depression among patients with breast cancer. Therefore, providing nursing counseling to broader spectrum of patients with cancer should be considered. Further research would warrant future clinical application of nursing counseling.

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The Effect of Assertiveness Training on Communication Related Factors and Personnel Turnover Rate among Hospital Nurses
Myung Ja Kang, Haejung Lee
Journal of Korean Academy of Nursing 2006;36(5):681-690.   Published online August 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.5.681
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the effects of assertiveness training on nurses' assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate.

Method

A non-equivalent control group pretest-posttest design was used in this study. Nurses were assigned into the experimental or control groups, each consisting of 39 nurses. Data was collected between January to March 2004. An ‘Assertiveness Training Program’ for Nurses developed by Park was used for the study. To emphasize assertiveness practice, 5 practice sessions utilizing ABCDE principles were added to Park's program. To examine the effects of the program, differences between the two groups in assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate were analyzed using ANCOVA.

Results

The assertiveness training was effective in improving the nurses' assertiveness behaviors, but was not effective in improving interpersonal relations, reducing the subjects' communication conflicts, changing the conflict management style or reducing their personnel turnover rate.

Conclusion

There have been many studies about factors affecting nurses' personnel turnover rates, but few have been done about methods of intervention to reduce the personnel turnover rate. Thus, this study provides a significant contribution in attempting such an intervention from nursing management perspectives.

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