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Research Papers
Examination of Predicting Factors for COVID-19 Vaccination Behaviors of University Students Utilizing the Theory of Planned Behavior
Heo, Yeon Jeong , Hyun, Hye-Jin
J Korean Acad Nurs 2024;54(2):178-192.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.24020
AbstractAbstract PDF
Purpose
This study aimed to examine the predictive factors of COVID-19 vaccination behavior by evaluating the moderating effect of perceived behavioral control on the theory of planned behavior.
Methods
Data were collected from August 6 to August 31, 2022 from 235 college students (aged 20~29 years) across 12 universities using a structured web-based survey. Statistical analyses were conducted using the SPSS and AMOS software.
Results
Attitudes toward COVID-19 vaccination, subjective norms, and intention to be vaccinated significantly influenced COVID-19 vaccination behavior. Attitudes and subjective norms indirectly affected COVID-19 vaccination behavior through intention to vaccinate, whereas intention to vaccinate had a direct effect. The moderating effect of perceived behavioral control on the relationship between subjective norms and intention to vaccinate was significant.
Conclusion
Interventions that foster a positive attitude toward COVID-19 vaccination and bolster subjective norms and perceived behavioral control can boost the intention to be vaccinated and facilitate the uptake of COVID-19 vaccination.
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Influence of Illness Uncertainty on Health Behavior in Individuals with Coronary Artery Disease: A Path Analysis
Jeong, Hyesun , Lee, Yesul , Park, Jin Sup , Lee, Yoonju
J Korean Acad Nurs 2024;54(2):162-177.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.23136
AbstractAbstract PDF
Purpose
This study aimed to investigate the influence of uncertainty-related factors on the health behavior of individuals with coronary artery disease (CAD) based on Mishel’s uncertainty in illness theory (UIT).
Methods
We conducted a cross-sectional study and path analysis to investigate uncertainty and factors related to health behavior. The study participants were 228 CAD patients who visited the outpatient cardiology department between September 2020 and June 2021. We used SPSS 25.0 and AMOS 25.0 software to analyze the data.
Results
The final model demonstrated a good fit with the data. Eleven of the twelve paths were significant. Uncertainty positively affected danger and negatively affected self-efficacy and opportunity. Danger had a positive effect on perceived risk. Opportunity positively affected social support, self-efficacy, perceived benefit and intention, whereas it negatively affected perceived risk. Social support, self-efficacy, perceived benefit and intention had a positive effect on health behavior. We found that perceived benefit and intention had the most significant direct effects, whereas self-efficacy indirectly affected the relationship between uncertainty and health behavior.
Conclusion
The path model is suitable for predicting the health behavior of CAD patients who experience uncertainty. When patients experience uncertainty, interventions to increase their self-efficacy are required first. Additionally, we need to develop programs that quickly shift to appraisal uncertainty as an opportunity, increase perceived benefits of health behavior, and improve intentions.
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Effects of a Health Partnership Program Using Mobile Health Application for Male Workers with Cardiovascular Risk Factors in Small and Medium Enterprises: A Randomized Controlled Trial
Kim, Eun Jin , Hwang, Seon Young
J Korean Acad Nurs 2024;54(1):44-58.   Published online February 29, 2024
DOI: https://doi.org/10.4040/jkan.23090
AbstractAbstract PDF
Purpose
This study aimed to apply a health partnership program using commercially available mobile health apps to improve cardiovascular risk factors in male employees and verify its effectiveness.
Methods
Using a randomized control group pretest-posttest design, male employees with cardiovascular risk factors from five small and medium-sized workplaces were randomly assigned to an experimental group (n = 32) and a control group (n = 31). The experimental group was encouraged to use three mobile health apps for 12 weeks to acquire the necessary cardiovascular disease-related information and practice strengthening training, walking, and diet management appropriate to their level. They also received feedback on their weekly activities and motivational text messages from health partners. Hypotheses were tested using the SPSS WIN 22.0.
Results
The experimental group showed a significant difference compared to the control group in terms of their perception of mobile health app (p < .05), self-efficacy for exercise and diet, self-management partnership, and cardiovascular disease prevention health behavior (p < .001). In particular, there were significant decreases in the body mass index, ratio, serum fasting blood sugar, total cholesterol, and triglyceride in the experimental group (p < .001); however, there was no significant difference in high-density lipoprotein-cholesterol.
Conclusion
Intervention using mobile apps based on partnership with health managers is effective in improving the objective cardiovascular risk index in male employees; therefore, such intervention should be continuously used as a useful lifestyle modification strategy in the workplace.
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Exploring Spatial Variations and Factors associated with Walking Practice in Korea: An Empirical Study based on Geographically Weighted Regression
Kim, Eunjoo , Lee, Yeongseo , Yoon, Ju Young
J Korean Acad Nurs 2023;53(4):426-438.   Published online August 31, 2023
DOI: https://doi.org/10.4040/jkan.23045
AbstractAbstract PDF
Purpose
Walking practice is a representative indicator of the level of physical activity of local residents. Although the world health organization addressed reduction in prevalence of insufficient physical activity as a global target, the rate of walking practice in Korea has not improved and there are large regional disparities. Therefore, this study aimed to explore the spatial variations of walking practice and its associated factors in Korea.
Methods
A secondary analysis was conducted using Community Health Outcome and Health Determinants Database 1.3 from Korea Centers for Disease Control and Prevention. A total of 229 districts was included in the analysis. We compared the ordinary least squares (OLS) and the geographically weighted regression (GWR) to explore the associated factors of walking practice. MGWR 2.2.1 software was used to explore the spatial distribution of walking practice and modeling the GWR.
Results
Walking practice had spatial variations across the country. The results showed that the GWR model had better accommodation of spatial autocorrelation than the OLS model. The GWR results indicated that different predictors of walking practice across regions of Korea.
Conclusion
The findings of this study may provide insight to nursing researchers, health professionals, and policy makers in planning health programs to promote walking practices in their respective communities.
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Moderating the Effects of Health Behaviors on Sexual Intercourse among Adolescents: A CrossSectional Study Using the 2020 Adolescent Health Behavior Survey
Lee, Eunmi , Yang, Youngran
J Korean Acad Nurs 2022;52(5):499-510.   Published online October 31, 2022
DOI: https://doi.org/10.4040/jkan.22080
AbstractAbstract PDF
Purpose
This study investigated the association between adolescent health behaviors (drinking, smoking, and drug use) and sexual intercourse, as well as the moderating effects of economic status, cohabitation with parents, and school type, among adolescents in Korea.
Methods
Secondary data from the 16th Adolescent Health Behavior Survey (2020) were used. A total of 395 schools and 54,948 middle and high school students participated in the study. Complex sample frequency analysis, the Rao–Scott test, and complex sample logistic regression analyses were performed.
Results
Sexual intercourse rates for men and women were 5.8% and 3.3%, respectively. Approximately 7.3% of high school students and 1.8% of middle school students reported having had sexual relations. Drinking (odds ratio [OR] = 3.15, 95% confidence interval [CI] = 2.82~3.52), smoking (OR = 6.75, 95% CI = 5.90~7.71), and drug use (OR = 3.03, 95% CI = 2.23~4.11) significantly increased the risk of sexual intercourse. Economic status and school type had moderating effects on the association between drinking and sexual intercourse.
Conclusion
Adolescent drinking, smoking, and drug use are associated with a higher risk of sexual experience. Thus, to reduce this risk, controlling alcohol consumption, smoking, and drug use is necessary. In addition, programs for healthy lifestyles and sexual intercourse should be differentiated according to the school type and the economic conditions of the adolescents’ households.
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Development and Evaluation of an Integrated Health Management Program for Psychiatric Patients with Metabolic Syndrome
Kwak, Yun Bock , Kim, Ji Young
J Korean Acad Nurs 2022;52(3):261-277.   Published online June 30, 2022
DOI: https://doi.org/10.4040/jkan.21222
AbstractAbstract PDF
Purpose
This study developed an integrated health management program for metabolic syndrome in psychiatric patients and examined its effects on self-efficacy, healthy lifestyle, physiological indicators, knowledge of metabolic syndrome, attitudes toward healthy behavior, and social support.
Methods
A non-equivalent control group pretest posttest design was used. The participants were 65 psychiatric patients with metabolic syndrome in psychiatric rehabilitation centers, with 33 in the experimental group and 32 in the control group. The experimental group participants engaged in daily mobile application and walking exercises three times a week for more than 40 minutes over 8 weeks, while those in the control group were provided education booklets. The outcomes were measured using self-report questionnaires, anthropometrics, and blood analyses. Intervention effects were analyzed using the independent t-test, Mann—Whitney U test, ANCOVA, and Ranked ANCOVA.
Results
The experimental group showed a significant increase in self-efficacy (F = 8.85, p = .004, ηp2 = .13) and knowledge of metabolic syndrome (t = 2.60, p = .012, d = 0.60) compared to the control group. Additionally, the experimental group demonstrated a significant decrease in waist circumference (Z = - 2.34, p = .009, d = 0.58) and body mass index (Z = - 1.91, p = .028, d = 0.47) compared to the control group.
Conclusion
The integrated health management program for psychiatric patients with metabolic syndrome is effective in improving self-efficacy and knowledge of metabolic syndrome and decreasing physiological indicators such as waist circumference and body mass index.
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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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Factors Influencing Health Behavior Compliance in Adult Moyamoya Patients
Kim, Bo Eun , Song, Ju-Eun
J Korean Acad Nurs 2021;51(1):80-91.   Published online February 28, 2021
DOI: https://doi.org/10.4040/jkan.20222
AbstractAbstract PDF
Purpose
The purpose of this study was to identify factors influencing health behavior compliance in adult patients with moyamoya.
Methods
A descriptive correlation study was conducted to investigate the factors influencing health behavior compliance. Participants were 142 adult patients diagnosed with moyamoya disease who were hospitalized or visited an outpatient clinic in the Gyeonggi province. Data were collected from December 16, 2019 to April 14, 2020 using self-report questionnaires and analyzed using the IBM SPSS 26.0 Win software.
Results
The hierarchical multiple regression analysis demonstrated that self-efficacy (β = .60, p < .001), social support (β = .13, p = .032), and age (β = .21, p = .005) affected the health behavior of adults with moyamoya disease. These 3 variables explained 62.0% of the variance of health behavior compliance, and the most influential factor was self-efficacy.
Conclusion
Based on the results of this study, it concludes that nursing interventions should be focused on self-efficacy and social support to improve health behavior compliance with adult patients diagnosed with moyamoya disease. For that, various strategies to enhance self-efficacy and social support should be developed and actively applied in the clinical setting for adult moyamoya patients.
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An Exploratory Study on the Policy for Facilitating of Health Behaviors Related to Particulate Matter: Using Topic and Semantic Network Analysis of Media Text
Byun, Hye Min , Park, You Jin , Yun, Eun Kyoung
J Korean Acad Nurs 2021;51(1):68-79.   Published online February 28, 2021
DOI: https://doi.org/10.4040/jkan.20213
AbstractAbstract PDF
Purpose
This study aimed to analyze the mass and social media contents and structures related to particulate matter before and after the policy enforcement of the comprehensive countermeasures for particulate matter, derive nursing implications, and provide a basis for designing health policies.
Methods
After crawling online news articles and posts on social networking sites before and after policy enforcement with particulate matter as keywords, we conducted topic and semantic network analysis using TEXTOM, R, and UCINET 6.
Results
In topic analysis, behavior tips was the common main topic in both media before and after the policy enforcement. After the policy enforcement, influence on health disappeared from the main topics due to increased reports about reduction measures and government in mass media, whereas influence on health appeared as the main topic in social media. However semantic network analysis confirmed that social media had much number of nodes and links and lower centrality than mass media, leaving substantial information that was not organically connected and unstructured.
Conclusion
Understanding of particulate matter policy and implications influence health, as well as gaps in the needs and use of health information, should be integrated with leadership and supports in the nurses’ care of vulnerable patients and public health promotion.
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Original Articles
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
AbstractAbstract 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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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
AbstractAbstract 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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Effects of Spouse-Participated Health Coaching for Male Office Workers with Cardiocerebrovascular Risk Factors
So Hee Kang, Seon Young Hwang
J Korean Acad Nurs 2019;49(6):748-759.   Published online December 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.6.748
AbstractAbstract PDF
Purpose

This study aimed to examine the effect of spouses participating in health coaching on stage of the change, health behaviors, and physiological indicators among male office workers with cardiocerebrovascular disease (CVD) risk factors and compare the findings with trainers who provided health coaching only to workers.

Methods

A quasi-experimental pretest-posttest design was used. Convenience sampling was used to recruit participants from a manufacturing research and development company in the city of Gyeonggi province. The health coaching program for the experimental group (n=26) included individual counseling sessions according to workers' stage of change, and provision of customized health information materials on CVD prevention to workers and their spouses for 12 weeks through mobile phone and email.

Results

After 12 weeks of intervention, the total score for health behavior, and scores on the sub-areas of exercise and health checkups significantly improved in the experimental group, but there were no significant differences in the scores of stage of the change and physical indicators. The results of a paired t-test showed a significant decrease in the body mass index, abdominal circumference, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride values, and a significant increase in the high-density lipoprotein cholesterol value in the experimental group after the intervention.

Conclusion

To improve the health of male workers with CVD risk factors in the workplace, sharing health information with their spouses has proven to be more effective than health coaching for only workers. Therefore, it is important to develop strategies to encourage spousal participation when planning workplace health education for changing health-related behaviors.

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Effects of a Daily Life-Based Physical Activity Enhancement Program for Middle-Aged Women at Risk for Cardiovascular Disease
Kyung Ae Kim, Seon Young Hwang
J Korean Acad Nurs 2019;49(2):113-125.   Published online April 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.2.113
AbstractAbstract PDF
Purpose

The purpose of this study was to examine the effects of a daily life-based physical activity enhancement program performed by middle-aged women at risk for cardiovascular disease.

Methods

This study used a randomized control group pretest-posttest design. Middle-aged women aged 45 to 64 were recruited from two outpatient cardiology departments, and randomly assigned to an experimental group (n=28) and a control group (n=30). For the experimental group, after providing one-on-one counseling and education, we provided customized text messages to motivate them in daily life. To monitor the practice of physical activity, they also used an exercise diary and mobile pedometer for 12 weeks. Subjects' physical activities (MET-min/week) were measured using the International Physical Activity Questionnaire (IPAQ). Their physiological data were obtained by blood tests using a portable analyzer, and the data were analyzed using the SPSS 21.0/WIN program.

Results

There were significant differences in exercise self-efficacy, health behavior, IPAQ score, body fat, body muscle, and fasting blood sugar between the two groups. However, there were no significant differences in total cholesterol, hemoglobin A1c, high-density lipoprotein cholesterol, and waist-to-hip ratio.

Conclusion

Strengthening physical activity in daily life without being limited by cost burden and time and space constraints. Therefore, it is essential to motivate middle-aged women at risk for cardiovascular disease to practice activities that are easily performed in their daily lives.

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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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Effectiveness of Health Promotion Program Using Action Planning Strategy for Young Adults
Su Hyun Kim, Min Ji Kim, Sang Hee Kim, So Yeon Kim, Chae Yeon Park, Jee Yun Bang
J Korean Acad Nurs 2019;49(4):461-471.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.4.461
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to evaluate the effectiveness of a health promotion program utilizing action planning strategy for young adults.

Methods

A non-equivalent control group pre-post-test design was used. One hundred three university students participated in the study. Participants in the experimental group (n=51) were provided the health promotion program utilizing action planning strategy for five weeks. The program consisted of weekly sessions that included action planning and group feedback. The control group (n=52) was provided with health information every week for 5 weeks. Program outcomes, including self-efficacy, physical activity health behaviors, total exercise time per week, daily cigarette consumption, frequency of alcohol drinking per month, nutritional health behaviors, and subjective health status, were assessed at baseline and at follow-up after 5 weeks.

Results

The participants in the experimental group demonstrated significant increases in self-efficacy, physical activity health behaviors, weekly exercise time, and nutritional health behaviors and significant decreases in daily cigarette consumption than those in the control group.

Conclusion

The health promotion program utilizing action planning strategy is a brief and effective intervention to promote health behaviors among young adults. Further investigation is warranted to assess the program's effectiveness among other age groups and populations at high risk for chronic illness.

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Structural Equation Modeling of Self-Care Behaviors in Kidney Transplant Patients Based on Self-Determination Theory
Hye Won Jeong, Hyang Sook So
J Korean Acad Nurs 2018;48(6):731-742.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.6.731
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to test a hypothesis explaining direct and indirect relationships among the factors affecting self-care behaviors of kidney transplant patients, based on self-determination theory.

Methods

Data were collected from 222 outpatients with kidney transplantation. The endogenous and exogenous variables of the hypothetical model consisted of healthcare provider's autonomy support, duration after kidney transplantation, basic psychological need satisfaction, autonomous and controlled motivation, depression, and self-care behaviors. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0.

Results

The hypothetical model demonstrated a good fit: RMSEA=.06, SRMR=.04, TLI=.94, CFI=.97. Statistically significant explanatory variables for the self-care behaviors of kidney transplant patients were duration after transplantation and basic psychological need satisfaction. Healthcare provider's autonomy support was indirectly significant, while autonomous motivation, controlled motivation and depression were not statistically significant for self-care behaviors. The variables accounted for 59.5% of the self-care behaviors of kidney transplant patients.

Conclusion

It is necessary to develop an autonomy support program for healthcare providers to enhance the self-care behaviors of kidney transplant patients. Preventing the deterioration of self-care behaviors will be possible by conducting this program at one year and six years post-transplantation. In addition, the results suggest the need to developing personalized autonomy support programs for healthcare providers that can meet the basic psychological need satisfaction of kidney transplant patients.

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Development of Health Behavior Assessment Tool of the Korean Elders
Young Hee Choi, Soon Yi Kim
Journal of Nurses Academic Society 1997;27(3):601-613.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.601
AbstractAbstract PDF

This project was conducted using a survey method and through interviewing with four persons aged 60 years and over. An interview with an open-ended questionnaire was also used for elderly persons, families, oriental medicine doctor and nurses. topic-related literature review was also done. In total, 382 statements were derived. For content validity, nursing professionals were involved in this study. From that 48 items are developed. The subjects were 340 elderly persons over 60 years old. Data were collected during February and March 1997 and analyzed using the SPSS package The result are as follows. 1. Items with low Cronbach Coefficient alpha which means low correlation with total items were removed. 2. Factor analysis was done in order to confirm construct validity and eight factors were obtained from the results. The first factor, 'positive cognition of the aging process', the second factor, 'relationship network' the third factor, 'maintenance of physical functioning, the fourth factor', 'maintenance of peaceful mind' the fifth factor, 'keeping up with daily tasks' the sixth factor, 'continuous adequate body movement' the seventh factor, 'involvement of religion in the elderly person's life and the eight factor', 'appropriate resting'. Cronbach Coefficient alpha for the 33 items was .9127 Based on the result, the following is suggested 1. It is anticipated that the fundamental health of elderly person could be promoted by assessing healthy behaviors of elderly person with this assessment tool. 2. Further studies could be derived from this research. 3. Validity of this assessment tool should be further tested with and a larger sample of elderly person including in-patient elderly persons as well as nursing home residents.

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College Women's Health Concept and Health Behavior
Shin Jeong Kim, Eun Sook An
Journal of Nurses Academic Society 1997;27(2):264-274.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.2.264
AbstractAbstract PDF

The purpose of this study was to explore the health concept of college women and their pattern of health behavior. The research was a descriptive method using a self-report questionnaire which include open-ended questions. The subjects were 195 college women ages from 19 to 25 years. The results of this study were as follows : 1. Perceived health Concepts by College women were physical well - being, powerfulness, ability of role performance, ability of social adaptation, emotional stability, satisfactory life, harmony. 2. Health behaviors cleanliness by college women were : taking food selectively, maintaining cleanliness, making an effort to be healthy, avoiding stimulants, living positively, relaxing physically, endeavoring to maintain physical function.

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Perceived Weight and Health Behavior Characteristics Normal and Over-weight Middle-aged Women
Hyun Sook Jo
Journal of Nurses Academic Society 1996;26(2):387-398.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.2.387
AbstractAbstract PDF

The objective of this study was to clarify whether there are any differences between normal and over-weight middle-aged(40~59yrs)women in their perceived weight, health status, health conception and health behavior choices. The sample consisted of 39 normal weight and 55 over-weight (11% above on the Body Index Scale) women who live in Juan, Inchon. The Participants were randomly selected in each weight group considering socio-demographic factors. The findings from this study are summarized below. 1) Among the 55 overweight middle-aged women, 16 were above 20% on the Body Index Scale and 14 were above 30%. Twenty-fivc(45.5%) of the overweight group and 12(30.8%) of the normal weight group had one disease, and there were 12(21.8%) in the overweight group and 8(20.5%) in the normal weight group where one of the family members had a disease, but these differences were not statistically significant. The average monthly family income for the overweight group was won 1,880,000 compared to won 2,140,000 for the normal weight group, but this difference was also not significant. The age range for the whole group was between 40 and 59(mean=46.8 for total, 48.6 for overweight and 45.7 for normal weight group). Again no significant difference found. Occupations were housemaker 53(56.4%), private business(13.8%), salarywoman(9.6%), and teacher(2.1%). Thirty housemaker(54.5%) from the overweight group and 23(59%) from the normal group did not constitute a statistically siganificant different. For the educational status, 34(61.8%) of the overweight women and 33(84.6%)of the normal weight group finifished high school or more educational courses, but there was no significant statistical difference. Elven(20.0%) of the overweight women and 5(12. 8%) of the normal weight group were single, but again no significant statistical difference was found. 2) A test for difference in health characterisics between two weight groups indicated that two groups do not show statistical differences in their perceived health status, health conception or health behavior choice. That is, the overweight group, also perceive their health status as good as the normal group, and regard 'Health' as a state that enables them to carry out social roles and functions rather than as the traditional concept of health as no disease or no symtoms. Moreover, the overweight group selected their health behaviors not for the prevention of diseases or maintenance of health but for promotion of health. To determine if no statistical difference might be related to the overweight group's failure of perceive themselves as overweight, the perceived and objective overweight status were compared by the chi-square analysis, and no difference was found(X2=49.37, df=l, p=.000). However, 7(17.9%) of the normal group perceived themselves as being overweighted and 7(12.7%) of the overweight group thought they were of normal weight. Even though the overweight group employed in this study perceived themselves as being overweight, they regarded themselves as healthy as those in the normal weight group. It was shown that there was no statistical difference between two groups in health conception, and that they chose health behaviors to promote health status. 3) Perceived health conception was shown to be significantly related to health behavior choice (r= .28, p=.006 for whole group: r=.33, p=.014 for overweight group: and r=.12, p=.463 for normal group). There was an indication that the more complicated the perceived health conception was, the more the trend of health behavior choice to promote health. This was especially true for the overweight group. But, the perceived health status did not related to health behavior choice statistically(r=.13, p=.202), and it was thought that reasons for selecting health behaviors were not related to their health status. That is, the overweight group perceive themselves as healthy as the normal weight group or thought that overweight itself does not incur any risk on their health. Data from two groups were combined and analyzed with multiple regression methodology, because the relationship pattern of the two groups was similar. The analysis showed that health behavior has a significant relationship with age and the perceived health conception(r2=. 1517, p=.05, F=8.133). It means they come to health behavior along with their health conception and their age rather than their weights, perceived weight, health status or other social characteristics. This study was intended to understand how overweight middle-aged women perceive 'weight' and 'health', and how they meet their health related needs in comparison with normal weight middle-aged women. Other factors related to the health behavior in overweight middle-aged woman need to be determined through further descriptive studies outlined in the following recommendations, a) Reseach with the study area expanded. b) Reseach with grouping more detailed: much more overweight and underweight group c) Reseach on restricted relationship between overweight and age or profession. d) Reseach on what overweight middle-aged women do to reduce their weight and what factors motivate them to do it.

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Social Support, Stressful Life Events, and Health Behaviors of Korean Undergraduate Students
Young Joo Park, Sook Ja Lee, Ka Sil Oh, Kyoung Ok Oh, Jeong Ah Kim, Hee Soon Kim, Sang Soon Choi, Sung Eun Yi, Choo Ja Chung, Hoa Yun Jun
Journal of Korean Academy of Nursing 2002;32(6):792-802.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.6.792
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PURPOSE: This cross-sectional study was designed to explore the relationship among social support, experienced stressful life events and health behaviors of Korean undergraduate students, and validate the mediator effect of social support. METHOD: One thousand four hundred fifty-three undergraduate students were randomly selected from five universities located in the middle area of Korea. RESULT: The health behaviors of Korean undergraduates tend to have unhealthy patterns. In the case of the students living without family, experiencing more stressful life events and perceiving lower social support, health behaviors are poor. The relationship between perceived social supports, the frequency of the experienced stressful life events and the score of health behavior patterns is statistically significant. After controlling the effect of social support, the correlation coefficient between the frequency of experienced stressful life events and the score of health behavior patterns was slightly lower. The score of health behaviors between the group with an extremely high score of social support and the group with an extremely low score were statistically significantly different. CONCLUSION: Future studies need to be pursued to develop various strategies such as a health education programs and counseling programs for health maintenance and health promotion of undergraduates.

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A Study on Health Behavior Experience of Middle-aged Women in Rural Area
Jin Hyang Yang
Journal of Korean Academy of Nursing 2002;32(5):694-705.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.5.694
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PURPOSE: The purpose of this study is to describe the health behavior experience of middle-aged Korean women in rural areas, and to help understand their health practice, perceive their nursing needs and provide guidelines to developing appropriate nursing interventions. METHOD: The participants were 18 healthy middle-aged women living in rural areas, with no serious illness that require hospitalization. The data was collected through interviews and participant observation, analyzed by the grounded theory methodology of Strauss and Corbin(1997). The data collection period was from April to November of 2001. RESULT: Depending on the paradigm model, the central phenomenon was family-oriented pursuing of yangsaeng. The causal condition was less confidence on one's own health, responsibilities in caring for family. The contexts were cultural system. The intervening condition was information system, support system, limitation of approaching a medical institution. The action/ interaction strategies were yangsaeng through dietary practice, yangsaeng through promoting clothing and housing, yangsaeng through exercise, practice of folk therapy, yangsaeng through mental hygiene, and use of medical institution. The consequences were stabilization of body and mind, and stabilization of family. CONCLUSION: It is recommended for nurses to understand health behavior experience of middle-aged women, and provide nursing intervention with theoretical scheme and practical principles so that these women can pursue the family-oriented process of yangsaeng.

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The Relationship between Bathing and Health Status
Hee Jung Choi, Eun Ok Lee
Journal of Korean Academy of Nursing 2002;32(4):519-528.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.4.519
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PURPOSE: The purpose of this study was to test the relationship between health status and bathing. METHOD: The population of this study consisted of females, above age 20 in urban areas in order to control the effects of extraneous variables, resident areas, gender, and age. Four hundred and twenty-eight (428) women were interviewed with a structured questionnaire. Medical Outcomes Study Short Form (SF)-36 Health Survey assessed individual health status. Bathing behavior and attitudes toward bath have been measured with questionnaires designed by the authors. RESULT: The most popular bathing type was shower (46.8%). The preferred type of bath was related to health status. A common purpose of the tub-bath was relieving fatigue and hygiene, but the other purposes were different on the subjects health status. Persons with low health status took frequently tub-baths for health. Attitudes toward bath were related to health status. Women with low scores in physical health recognized more physical effects of bath than psychological effects or hygenic effects. CONCLUSION: Bathing included physical and psychological dimensions and was related to health status.

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Effects of Cardiac Rehabilitation Teaching Program on Knowledge Level and Compliance of Health Behavior for Patients with Myocardial Infarction
Hye Sun Jeong, Hee Seung Kim, Yang Sook Yoo, Jung Soon Moon
Journal of Korean Academy of Nursing 2002;32(1):50-61.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.1.50
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PURPOSE: The purpose of this study was to investigate the effects of cardiac rehabilitation teaching program on knowledge level and compliance of health behavior for the patients with myocardial infarction.
METHOD
The subjects were 47 patients 23 were assigned to the experimental group and 24 were for the control. The cardiac rehabilitation teaching program is a individualized teaching program which was delivered to the experimental group during hospitalization period by present researcher. Data were collected through questionnaire surveys for knowledge level and compliance of health behavior from September 15, 1999 to December 31, 2000. The collected data was analyzed by using the SAS program.
RESULTS
1. With regard to the knowledge scores 1) The total knowledge level in the experimental group was significantly higher than in the control group. 2) As to the knowledge domains, nature of disease, risk factors, diet, medication, exercise, and daily activities were significantly higher in score in the experimental group than in the control group. 2. With regard to the compliance of health behavior 1) The average compliance with good health behavior was significantly higher in the experimental group than in the control group. 2) As to the health behavior domains smoking cessation, diet, stress management, regular exercise, and other measures for lifestyle modification were significantly higher in score in the experimental group than in the control group. 3. The pre-treatment knowledge score was positively correlated to the post-treatment knowledge score and post-treatment knowledge score was positively correlated to the post-treatment compliance of health behaviors.
CONCLUSION
The above findings indicate that the cardiac rehabilitation teaching program for the experimental group was effective in increasing level of knowledge and improvement f compliance with good health behavior of patients with myocardial infarction.

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The Influencing Factors on Health Behavior of Patients with Coronary Artery Disease
Young Whee Lee, Hwa Soon Kim, Eui Young Cho
Journal of Korean Academy of Nursing 2002;32(1):40-49.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.1.40
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PURPOSE: The purpose of this study was to investigate the influencing factors on health behavior among patients with coronary artery disease.
METHOD
The subjects were 95 patients who visited the out-patient department of a university hospital for follow-up. The four health belief concepts (motivation, benefit, barrier, seriousness), general self-efficacy, health behaviors on medication, diet, exercise, stress management, smoking, and drinking were measured.
RESULT
There were significant differences in the health behavior scores of subjects according to family support and the experience of surgical procedure. Subjects were found to have a high degree of compliance in taking medication. However subjects reported the lowest degree of compliance in regular exercise. In the multiple regression analysis, surgical procedure and motivation were significant predictors to explain diet. Motivation and barrier were significant predictors to explain exercise. Self-efficacy, motivation and family support were significant predictors to explain stress management. Family support and seriousness explained 16% of variance in drinking. Also, family support explained 30% of variance in smoking.
CONCLUSION
Since predicting factors on each health behavior indicator were different, then nurses should consider these differences to construct strategy enhancing patient's recovery.

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A Study on Physiological Parameters, Health Perception, and Health Behavior of Adults in Kyungi Province Area
Ae Kyung Han, Dong Sook Cho
Journal of Korean Academy of Nursing 2001;31(4):631-640.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.4.631
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PURPOSE: The purpose was to investigate the physiological parameters and health perception of adults in Kyungi province area, and the correlation between these variables. The subjects were 95 adults who participated voluntarily in the health examination program.
Methods
The instruments for this study were physiological parameters, which were composed of blood pressure, blood sugar, and body fat. The health perception scale developed by Ware (1976), and the health practice performance scale developed by Chang et al. (1999). Results: The average blood pressure was 137/85mmHg, the average blood sugar was 108.56mg/dl, and the average body fat arm sunt was 27.08% in males, and 30.07% in females. There were significant negative correlation between health perception and blood sugar (r=-2.36, p=.01), and body fat (r= -2.77, p=.001). There were significant positive correlations between blood pressure and health behavior (r=2.76, p=.001). However a significant correlation between health perception and health behavior was not found. Of the sociodemographic characteristics, sex (F=5.42, p=.01), and marital status (F=3.29, p=.04) were related to blood pressure. Also sex (F=4.17, p=.04) was related to body fat, and sex (t=4.04, p=.03) was related to health perception and disease status (t=4.33, p=.040). Thus having a relationship with health behavior.
CONCLUSION
It is suggested that health perception provide important information about health status. However, this study has not shown a correlation between health perception and health behavior. Therefore further research is needed to find the other variables related to health behavior.

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Development of a Health Behavior Assessment Scale of Patients with Rheumatoid Arthritis
Kae Hwa Jo, Won Oak Oh, Jung Yoon Choe
Journal of Korean Academy of Nursing 2000;30(5):1333-1346.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.5.1333
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This study is a methodical research to develop a health behavior assessment scale for patients with rheumatoid arthritis, and to test the validity and reliability of the instrument. The research procedure was as follows; 1) The first step was to develop conceptual framework based on a comprehensive review of the literature, in-depth interviews patients with rheumatoid arthritis. This conceptual framework was organized in eight dimensions; pain management, exercise, rest, diet control, active committment, self-management, positive thinking, interpersonal maintenance. Initially 56 items were selected from 164 statement. 2) These items were reviewed by panel of eight specialists and the Index of Content validity (CVI) was calculated, and forty six items were selected which met more than 70% on the CVI. 3) 174 rheumatoid arthritis pateints were interviewed, and data was gathered from Jan. 25 to Feb. 18, 1999 for test reliabilities and validities of the scale. The item analysis was carried out and 40 items were selected. Factor analysis by varimax rotation was carried out to test construct validity. The internal consistency by chronbach's alpha was calculated. The findings were as follows; 1) Item analysis and factor analysis were carried out to test the validity of the health behavior assessment scale. The item analysis was based on the corrected item`s to total correlation coefficient (.30 or more), and information about the alpha estimate. However, this was only if this item was deleted from the scale. As a result of the item analysis, forty items were selected. Thirty items were selected by a initial factor analysis by varimax rotation, and ten items were deleted because of factor complexity. In the secondary factor analysis, eight factors were labled as 'positive thinking', 'exercise', 'rest', 'pain management', 'active committment', 'self-management', 'diet control', and 'interpersonal maintenance', each similar with the conceptual framework. 2) Chronbach's alpha coefficient to test reliability of the scale was. 903 for total the thirty items. The Scale for assessing health behavior developed in this study was identified to be a tool with a high degree of reliability and validity. Therefore this scale can be effectively utilized for assessment in the health behaviors of the patients with rheumatoid arthritis.

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The Analysis of the Effects of Comprehensive Health Promotion Program for RA on Changes in Health Promotion Strategies, Knowledge, and Health Status
Hyun Soo Oh
Journal of Korean Academy of Nursing 2000;30(3):619-631.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.3.619
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This study was conducted to test whether a comprehensive health promotion program for rheumatoid arthritis (CHPRRA) affected patients' health promotion strategies and knowledge about the disease, thus leading to the improvement of health status by using repeated measure of quasi- experiment design. Eighteen RA patients who visited the RA clinic of an university hospital located in Inchon were invited to participate in the CHPPRA. According to the study results, it was shown that the CHPPRA had significant effects on the patients' health status such as pain, depression, and functional disability. Also, that the improvement of health status was achieved by a positive change in the four health promotion strategies, which consisted of goal setting, positive thinking, exercise, and knowledge about the disease. Goal setting, positive thinking, and knowledge about the disease could also affect the patients' depression. Thus it can be interpreted that the improvement of these strategies may result in a remarkable decrease of depression. In addition, alleviation of functional disability may be due to increase of exercise. However although the strategies which were directly associated with pain management were not significantly improved, pain was significantly reduced. On the other hand, the study result showed that the other health promotion strategies included in CHPPRA such as pain management, positive thinking, stress management, asking for assistance and communication were not significantly increased. although the health status such as pain, depression, and functional disability, which are final goals of the program, were significantly improved through the exposition of patients to those health promotion strategies.

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The Effects of a Cardiac Rehabilitation Program on Health Behavior Compliance, Cardiovascular Function, and Quality of Life for the Patients with Ischemic Heart Disease
Hyun Sook Jo, Kwang Joo Kim
Journal of Korean Academy of Nursing 2000;30(3):560-570.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.3.560
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This study is aimed at developing a cardiac rehabilitation program and enlightening the effects of the program on patient's health behavior compliance, cardiovascular functional capacity, and quality of life. Using a quasi-experimental approach the nonequivalent control group pretest - posttest design was accepted for this study. The subjects of this study consisted of 55 patients with ischemic heart disease at the Cardiac Center of 'G' Hospital located in Inchon from May 1, 1998 to April 30, 1999. The patients were divided into two groups: the experimental group, which participated in the cardiac program with 30 patients and 25 patients of a control group were not involved in the program. There were two phases in the cardiac rehabilitation program: the first phase was a team approach education. It focused on reducing the risk of ischemic heart problems. The second phase was individual training by using a home based exercise program, which was comprised of 8 weeks, three sessions per week, 40-60 minutes per session, and followed by consultation. Every session involved 20-40 minutes of aerobic exercise at 40-60% of heart rate reserve, 11~13 RPE and 10 minutes of warm-up and 10 minutes of cool-down exercises. The experimental tools for the study were the health behavior compliance scale developed by Lee, Yoon-hee (1992), and quality of life scale developed by McGirr et al.(1990). RPPsubmax were measured by the treadmill. The collected data was processed by SPSS and analyzed by X2test and t-test. The results of this study were as follows: 1. The health behavior compliance in experimental group was significantly increased (t=5.091, p=.000) when compared to the control group. 2. RPPsubmax also decreased significantly in the experimental group when compared to the control group(t=-2.109, p=.040). 3. The quality of life significantly improved in the experimental group (t=3.853, p=.000) as compared to the control group. As the above results of this study revealed, the effectiveness of the cardiac rehabilitation program of the study was confirmed. It increased the health behavior compliance for reducing the risk of further coronary events, enhanced the cardiovascular functional capacity, and eventually improved the patient's quality of life.

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Effects of the Inpatient Cardiac Rehabilitation Program on Behavioral Modification and Quality of Life in Patients with Coronary Artery Disease
Rha Yun Song, Hae Jung Lee
Journal of Korean Academy of Nursing 2000;30(2):463-475.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.2.463
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The purpose of the study was to identify the effects of inpatient cardiac rehabilitation programs on motivation, the performance of health behavior, and quality of life in patients with coronary artery disease. The subjects consisted of 31 patients who participated in the rehabilitation program during their hospital stay, and were compared with 34 patients who did not participate. The study results are as follows: 1. The mean of cardiac risk factor scores for the subjects was 22.5 (SD = 5.5) at the level of low to moderate risk with some possibility to improve. The physiological and behavioral risk factors for the subjects were also in the normal range or slightly above the normal range. 2. The motivation level to preform health behaviors for both groups was improved after discharge. Also, perceived self-efficacy was significantly higher for the program participants than for the comparison group at the post-test. 3. The performance of cardiac related health behaviors improved for both groups after discharge, but there were no significant differences between the two groups. The program participants reported better performance in most health behaviors at the post-test, but the results failed to reach a statistical significant level. 4. As for motivation and health behavior, the subjects in the both groups showed an improved quality of life after the discharge. In addition, the program participants produced significantly higher scores in health and functioning dimension than the comparison group during the post-test. In conclusion, the study partially supported the effects of the inpatient cardiac rehabilitation program to motivate and improve the quality of life, and provide the need to apply early rehabilitation interventions for the patients after cardiac events. Further study with a longitudinal design is also suggested to verify the effect of cardiac rehabilitation program from hospitalization to discharge and subsequently to fully recover to the level of pre-hospitalized state.

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Health Belief and Performance of Health Behaviors of some University Students in Korea
Byung Sook Lee, Mi Young Kim, Mi Hyun Kim, Sun Kyung Kim
Journal of Korean Academy of Nursing 2000;30(1):213-224.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.1.213
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Health belief is an important factor influencing the performance of health behaviors. Young adulthood is a critical period to establish health beliefs and behaviors for a healthy life. As health professionals, nurses can help young people establish more positive health beliefs and carry out health behaviors more effectively. But before attempting to help them, it is necessary to identify their health beliefs and behaviors. The purpose of this study was to identify the health beliefs and health behaviors of university students in Korea. Subjects for this study were 2000 students from 10 universities, but data from only 1605 subjects was included in the analysis. Data were collected from May 5th, 1998 to June 21th, 1998. Instruments used in this study were two tools to measure 'health beliefs' and 'performance of health behaviors' that had been developed and used in previous research. Cronbach's alphas were .8737 for the tool for health beliefs and .8385 for the tool for health behaviors. The results of this study are as follows. (1) Average score of the subjects was 117.68 for health belief and 95.15 for performance of health behaviors. (2) There was a significant correlation between the health belief and the performance of health behaviors(r= .419). (3) School year, major, health status, and experience of disease in the students were important factors in the explanation of health belief(28.8%). (4) Health belief, major, health status, school year, sex, age, experience of disease in family members were important factors in the explanation of the performance of health behaviors (21.2%).

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