This study was done to describe health promoting lifestyle and determine affecting factors in elderly based on the Heath Promotion Model by Pender. Cognitive-perceptual factors that were included in this study were self-efficacy and hardiness. Modifying factors were demographic characteristics(sex, age, partner, previous illness, education level, income and religion). The specific purpose of this study was to examine the relationships of self-efficacy, hardiness and the demographic chasteristics to health promoting lifestyle and to determine causal factors affecting the elderly. The subjects were a volunteer sample of 98 elderly in one city in? The instruments for this study were Health Promoting Lifestyle Profile(47items, 4scale), Health Related Hardiness Scale(22items, 6scale), general Self-Efficacy Scale((13items, 5scale). Frequency, percentage, t-test, ANOVA, Pearson's correlation coefficient and Stepwise Multiple regression technique with SAS program were used to analyze the data. The Results of the study are follows ; 1) The average item score for the health promoting lifestyle was 2.63, the highest score on the subscales was interpersonal support(M=3.3), followed by self-actualization(M=2.9), nutrition (M=2.8), stress management(M=2.7), health responsibility(m=2.1) with the lowest being exercise(M=2.0). 2) A significant difference between education level, income, religion and health promoting lifestyle were found. 3) All of the subscales on health promoting lifestyle were positively related to total hardiness(r=0.330, p<0.001). The hardiness subscale of control was positively related to self-actualization(r=0.276, p<0.01), and commitment was positively related to self-actualization(r=0.315, p<0.001), exercise/nutrition(r=0.245, p<0.01), interpersonal support(r=0.278, p<0.01), stress management(r=0.250, p<0.01). Challenge was positively related to self-actualization(r=0.315, p<0.001), exercise/nutrition((r=0.245, p<0.01). There was no significant correlation between self-efficacy and all of the subscales of health promoting lifestyle. Self-efficacy showed a significant correlation only with control(r=0.469, p<0.001), committment(r=0.507, p<0.001), Challenge(r=0.489, p<0.001). 4) Committment, self-efficacy and income explained 25.01% of the variance for the total health promoting lifestyle. The results of this study show that commitment, self efficacy and income predicted the health promoting lifestyle of the elderly. So health promoting programs that increase committment and self-efficacy should be developed to promote a healthy lifestyle of the elderly, especially those who have low income.

This study was undertaken in order to examine the relationship of self-efficacy, control, perceived health status, self-esteem, social support, and demographic characteristics to health promoting lifestyle of college students, and to determine factors affecting health promoting lifestyle of college students. The subjects were 92 students of one university in Taejon. The instruments used for this study were a survey of general characteristics, health promoting lifestyle(44 items), self-efficacy (28 items), self-esteem(10 items), control(8 items), perceived health status( 1 item), and social support(12 items) Analysis of data was done by use of mean, percentage, t-test, ANOVA, Pearson correlation coefficient and stepwise regression with SAS program. The results of this study are as follows. 1) The average item score for the health promoting lifestyles was low at 2.30. n the sub-categories, the highest degree of performance was interpersonal support(2.90), and the lowest degree was exercise(1.67). 2) Male students showed a significant higher score in exercise subscale than female students. Students who had more income had higher scores in self actualization subscale. Students who's family had experienced severe disease had higher scores in health responsibility and interpersonal support subscale. Students who had experienced exercise had higher scores interpersonal support, and stress management subscale. 3) Significant correlation between perceived health status and self-efficacy, perceived health status and self-esteem, control and self-efficacy, control and self-esteem, control and social support, self-esteem and self-efficacy was found. 4) Self-efficacy and control revealed significant correlations with total health promoting lifestyle and all subscales of health promoting lifestyle except self actualization. A significant correlation between perceived health status and self actualization subscale was found. Self-esteem revealed significant correlations only with self actualization and interpersonal support subscale. 5) Significant correlations were found between most of the subscales of total health promoting lifestyle. 6) Self-efficacy was the highest factor predicting health promoting lifestyles of college students (30.55%). Self-efficacy and control accounted for 36.55% in health promoting lifestyle of college students.

It has been noted that a genetic alteration of cells influenced by unhealthy lifestyle in addition to a series of other carcinogens increases the incidence of various neoplasmic diseases. Therefore the importance of a lifestyle that minimizes such an impact on health should be emphasized. Since stomach cancer, the most common neoplasmic disease in Korea, is related to personal lifestyle and as there is a possibility of its recurrence, patients with stomach cancer need to lead a healthy lifestyle. Also the quality of life which patients experience is negatively affected by the side effects of treatments and the possibility of recurrence. Therefore an effective nursing intervention to enhance quality of life and encourage healthy lifestyle is needed. The purpose of this study is to provide a basis for nursing intervention strategies to promote health and thus enhance quality of life. A hypothetical model for this purpose was constructed based on Pender's Health Promotion Model and Becker's Health Belief Model, with the inclusion of some influential factors such as hope for quality of life and health promoting behavior. The aims of study were to: 1) evaluate the effectiveness of patient's cognitive-perceptual factors on health promoting behaviors and quality of life; 2) examine the causal relationships among perceived benefit, perceived barrier, perceived susceptibility and severity, internal locus of control, perceived health status, hope, health concept, self efficacy, self esteem, health promoting behaviors and quality of life; 3) build and test a global hypothetical model. The subjects for this study were 164 patients who were being treated for stomach cancer were approached in the outpatient clinic on a University Hospital. The data from the completed questionnaires were analyzed using Linear Structural Relationships (LISREL). The results of research are as follows: 1) Hypothetical model and the modified model showed a good fit to the empirical data, revealing considerable explanational power for health promoting behaviors(54.9%) and quality of life(87.6%) 2) Self efficacy and hope had significant effects on health promoting behaviors. Of these, hope was affected indirectly through self efficacy and self esteem. 3) Perceived health status, hope and self esteem had significant direct effect on the quality of life. Of these variables, perceived health status was the most essential factor affecting general satisfaction in life. 4) Self-efficacy, as a mediating variable, was positively affected by perceived benifit and hope. 5) Self-esteem, as a mediating variable, was positively affected by perceived health status and hope. 6) Hope was the main variable affecting self efficacy, self esteem, health promoting behaviors and quality of life. The derived model in this study could effectively be used as a reference model for further study and could suggests a direction for nursing practices.

PURPOSE: The purpose of this study was to identify the burden, health promotion behavior and health status and to describe the relationship of the burden, health promotion behavior and health status of the family caregivers of intensive care unit patients. METHOD: The subjects were 48 family caregivers of ICU patients in a University Hospital. Data were collected between June, 1 and July, 31, 2000 using structured questionnaires. Research tools used were Suh and Oh's Burden Scale, Revised Walker, Sechrist, and Pender's HPLP(1987) ; Revised Nam's Health State Scale(1965). RESULT: The mean score of burden of family caregiver was 3.01(full score was 5). The mean score of health promotion behavior of family caregiver was 2.52 (full score was 4). And the mean score of health status of family caregiver was 0.68(full score was 1.00). The score of psychological health state was a little higher than the physiological one. In correlational analysis, the burden and the health status of caregivers were reversely correlated . The correlation between the burden and the health promotion behavior, and the health behavior and health status were not significant. CONCLUSION: The more burden caregivers of ICU patients felt, the worse their health status. So nurses need to understand the family caregiver's burden and apply nursing care that can reduce burden, in order to improve the health status of family caregivers.

PURPOSE: This study was conducted to evaluate the process & outcome of a Health promotion program(Growing Younger & More Active) for the community resident older adults from March to December, 2001. METHOD: A quasi experimental research(one group pretest-posttest design) was used in this study. The subjects were 82 older adults(but 40 older adults 4 weeks after the program). Program had 5 sessions(10 hours) once a week. Data were collected before the program, immediately after & 4 weeks after the program and were analyzed with paired t-test. RESULT: The levels of Satisfaction, Interest & Understanding of the Program were high. Significant differences were found in health knowledge, health promoting behaviors, perceived health status and life satisfaction between before program and immediately after program as well as between before program and 4 weeks after program, but no significant differences in Health attitude. Self efficacy has significant difference only between before program and immediately after program , but no significant differences between before program and 4 weeks after the program. CONCLUSION: This results suggest that a Health promotion program for the community resident older adults developed this study is effective. So this program can be recommended as an effective nursing intervention for the health promotion of the older adults living in community.

PURPOSE: The purposes of this study was to evaluate an occupational health promotion program for the prevention of cardiovascular disease. METHOD: This study employed a quasi-experimental non-equivalent pre and post test to evaluate the program. The subjects of this study were 48 employees selected by convenience sampling who were suspected of having hypertension and hyperlipidemia in routine physical examinations and who were working in A University Hospital in Suwon. 25 subjects were assigned to the experimental group and 23 to the control group. Data collection was done using questionnaries before and after the subjects used the program. RESULTS: The results of this study showed that systolic blood pressure, ALT, gamma-GTP in the experimental group was lower than that of the control group. There were significant differences between two groups in the percentage of 'irregularity of diet' and in health behavior compliance. There were significant differences between the two groups in the number of complaints of symptoms after using the program. CONCLUSION: This study shows that there were no obvious differences between the two groups in all areas, but this program had a positive effect on health behavior changes. It is expected that employees' lifestyles can be changed through continuous health promotion programs.

PURPOSE: This study was to identify activities and related problems on health promotion of public health nurses, and to investigate basic data proposed to revise strategies of Health Promotion Nurse Specialists (HPNS).
METHOD
The subjects of this study were 787 public health nurses sampled by clustering of the entire nation of Korea. Data were collected by focus group studies and cross-sectional survey during April to October of 1999.
Results
13.3% of public health nurses took responsibility for health promotion projects and 45.9% were involved in health promotion work with in home care or other routine activities. Also, the factors public health nurses perceived as barriers to implement activities for health promotion were time limitation, lack of ability for planning projects, insufficient time for specialties, inadequate understanding about health promotion project.
CONCLUSION
According to the study, they need to have special education and further technical support. These results have important implications for the establishment for the role of Health Promotion Nurse Specialist. Also, in developing systems and curriculums for Health Promotion Nurse Specialist, the major factors described above need to be considered carefully.

BACKGROUND: The purpose of this study was to describe breastfeeding policies and practices among hospitals in South Korea and the degree to which the hospitals are implementing the WHO/UNICEF Baby Friendly Hospital Initiative.
METHODS
A cross-sectional survey of 34 hospitals was used to collect data. Quantitative and qualitative information and insights into current breastfeeding policies and practices were derived from responses of maternal and child health personnel at each hospital. One questionnaire per hospital was completed with personnel from all sections of maternity services, labor and delivery, nursery, and postpartum, contributing information needed to create a composite picture of the hospital's breastfeeding policies and practices.
RESULTS
Most hospitals were classified as either high or moderately high implementers on four of the Ten Steps: printed information distributed to breastfeeding mothers, oral breastfeeding instruction given to mothers, infant supplementation, and infant feeding schedules. The remaining steps, including key practices like staff instruction, breastfeeding initiation, rooming-in, and hospital postpartum support are being partially implemented by the majority of hospitals in this study.
CONCLUSIONS
Areas identified as needing the greatest attention by hospitals were health care staff training, breastfeeding initiation, supplementation, rooming-in, breastfeeding policy, and postpartum support for the breastfeeding mother.

This study was performed to evaluate the effect of 7-week comprehensive health promotion program for RA patients (CHPPRA) on changes in pain and depression. In addition, it was also examined that this effect was generated by changes in patients' health promoting strategies (positive self-image, positive thinking, problem solving, communication, pain management, stress management, exercise, and knowledge about RA) learned through CHPPRA. Twenty-eight out-patients of RA clinic in a university hospital participated for this study. The results are as followers. Changes in exercise, self-concept, positive thinking, problem solving, depression, and pain management were significant predictors to explain relieving pain level. Since all of these variables had positive standardized beta weights (betas), it can be interpreted that increasing level of these health promoting strategies may induce pain improvement. Changes in positive thinking, communication skill, exercise, self-concept, pain management, and knowledge about the disease were significant predictors to explain positive change in depression. Since all of the significant variables except the change in knowledge about the disease had positive standardized beta weights (betas), it can be interpreted that increasing level of these health promoting strategies may induce improving depression level. However, our results showed that the higher level of the knowledge about the disease was, the worse depression was.

The purpose of this study was to suggest directions for developing a Health Promotion Program for the elderly in Korea for the future. For this, twenty previously developed & implemented health promotion programs were reviewed and analyzed in terms of target population of the program, components of the program, measurement variables for effects of program, the effects of the program. The results were as follows. 1. Most of the target populations were older adults living independently in the community. 2. Components of the program were health education, health assessment and counseling and exercise program. - Health education was done in most of programs. The topics of health education that were often included in the programs were life style changes, medical knowledge, independent living, the concept of health promotion and changes related to aging. - In health assessment and counseling, health professionals discovered their health problems through health assessment or health risk appraisal. Then they developed health recommendations on each health problem and encouraged the elderly to implement the recommendations. 3. Variables measuring the direct effects of the program were health behavior, knowledge, attitude, skill, use of medical/health reference book. Variables measuring the indirect effects, biometric outcome, health status, functional status, medical service utilization, medical cost and wellbeing. 4. The analysis showed that health education was effective for changing health behaviors, improving knowledge, skill and attitude in the elderly. Those results were suggested to be used as guidelines for developing a health promotion program for the elderly in Korea for the future.

Every year the number of the elderly increases in Korea thanks to the improvement of social and economical levels and the development of medicine. However, many problems such as insufficent care and the isolation of the elderly have been commonplace. This trend exists not only because of increased lifespan but also the changing social structure of the nuclear family. Accordingly, inspite of the development of medicine, geriatric diseases including circulatory diseases are increasing in proportion of elderly population, as well as the severity. Therefore, it is important to emphasize that health care programs provide the best possible health care and functional capacities in terms of healthy elderly lifestyles. Especially, the phenomena of aging and geriatric diseases taking place with the elderly naturally are affected by lifestyle and the drastic changes in exercise patterns. This study aims to improve geriatric health by introducing a rhythmic movement program for the elderly to estabilish a health-promoting self-care system and by developing quality of life, perceived health status, their physical and physiological functions and emotional state. The theoretical framework used in this dissertation is derived from the Health-Promoting Self-Care System Model (Simmons, 1990), which integrates the Self-Care Deficit Nursing Theory (Orem, 1985), the interaction model of Client Health Behavior (Cox, 1982) and the Health Promotion Model (Pender, 1987). As a quasi-experimental design, the nonequivalent control group pretest-posttest design is utilized for this study. The subjects of this study consist of 64 people, over 65 years old who live in 2 nursing homes for the aged located in S city , Kyong-gi province and volunteered for this study from July, 12, 1999 to September, 17, 1999. They are divided into two groups: 33 in the experimental group and 31 in the control group. The experimental group particpated in the Rhythmic Movement Program at the nursing home, which was comprised of 45 minutes a session, 5 sessions a week during 9 weeks. In order to measure the results of the Rhythmic Movement Program, aspects of perceived health status, balance, flexibility, grip strength, leg strength, heart rate, blood pressure, depression, anxiety and the quality of life were measured before and after participating in the Rhythimic Movement Program for the experimental group after 9 weeks, as well as the control group. The collected data were processed by SPSS PC+ and analyzed by the X2 test, t-test, ANCOVA and the Pearson Correlation Coefficient. The results of this study are as follows: 1. The perceived health status conditions in the experimental group show statistically significant improvement when compared to the control group (F=17.51, p=.000). 2. The physical and physiological functions, that is, balance (F=17.51, p=.000), flexibility (F=8.01, p=.006), grip strength (F=3.21, p=.018) and leg strength (F=25.78, p=.000) in the experimental group are higher than the control group. The vital signs, that is, the number of heart rate (F=.022, p=.884), systolic pressure (F=1.73 p=.193), and diastolic pressure (F=2.74, p=.103) in the experimental group compared to the control group decreased, but doesn't show statistically significant differences. Immune responses (F=5.13, p=.003) showed statistically significant increases in the experimental group when compared to the control group. 3. The emotional state are improved, that is, degree of depression (F=11.56, p=.001) and degree of anxiety (F=9.14, p=.004) in the experimental group showed statistically significant decreases. 4. The quality of life in the experimental group (F=3.03, p=.037) showed statistically significant differences compared to the control group. 5. The observations of the relationships among the perceived health status, emotional state , the quality of life, the relationships between the perceived health status, the degree of depression (r=-.653, p=.000) and the degree of anxiety (r=-.786, p=.000) were in contrary propotions, while the relationships between the perceived health status and the quality of life (r=.234, p=.008) were in direct propotion. In conclusion, the Rhythmic Movement Program used in this study for geriatric nursing care is simple and safe for application to the elderly and shows significant effects by implementing 5 sessions a week for 9 weeks. The Rhythmic Movement Program improves the quality of life, maintains as well as improves the physical and physiological fuctions and emotional state, therefore this program is strongly recommended for positive applications for independant geriatric nursing health care.

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.

The purpose of this study is to identify health promotion behavior, self-efficacy and role stress of family caregivers who care for hospitalized cancer patient, The results would be used to provide the necessary basic data for promoting healthy behavior of the family caregivers to the cancer patient. The results were as follow : 1) The level of health promotion behavior was significantly different depending on the existence of care givers religion and type of help from family members. There was a positive relationship between the performance level of health promotion behavior and perceived health status or age. There was a negative correlation between the performance level of health promotion behavior and time cared for. 2) The level of self-efficacy was significantly different depending on gender and if the subject was employed. There was a positive relationship between perceived health status and intimacy with patient. 3) The level of role stress was significantly different in genders and relationships with patients. 4) There was a positive relationship between health promotion behavior and self-efficacy.

The purpose of the study was to test the effect of the health promotion program in middle women. The research design was a quasi experimental, nonequivalent control-group pretest-posttest design. The data were collected from February 24 to April 14, 1988. The subjects were midlife women, age 40 to 50 years who reside in Chonju city. The experimental group consisted of 41 subjects and the control group 40 subjects. The instruments used for the study were the Self Efficacy Scale and the Health Promotion Behavior Scale developed by Park(1995). The data was analyzed by SPSS/PC. The study result were as follows: Through the 7 week education program for health promotion, self efficacy and health behavior were effectively changed in middle-aged.

In this study, domains, contents, and effects of pre-existed intervention programs for individuals with arthritis were meta-analyzed to develop arthritis health promotion program based on Holistic Model. The developed program includes strategies of cognition, environment, and behavior, and also generates positive changes in the physical, psychological, and social demensions. Then needs assessment on conveniently selected 153 women who visited a university hospital in Seoul or in Inchon are conducted to identify the objective domains of arthritis health promotion program. According to the study results, target health problems of the arthritis health promotion program were shown as pain, disability, depression, and role impediment in social domain. These objectives could be achieved by including the strategies of changing cognition, the strategies of changing behavior through learning the skill related to the health promoting behavior, and the strategies of changing environment in the health promotion program. That is, it is analyzed that the contents of program are not exclusive one another in physical, psychological, and social demensions, and also are not exclusive one another in aspect of cognition, behavior, and environment. The necessary methods to achieve the desired objectives for the developed arthritis health promotion program and evaluation subjects are as follows : (1) In the arthritis health promotion program, knowledge on management of arthritis, efficacy related to arthritis management, skill for pain management, skill for exercise, establishment of positive self-concept, enhancement of positive thinking, stress management, skill for problem solving, skill for setting goals, skill for requesting help, and skill for communication are all included. Through the improvement of all those strategies, intermediate objectives, such as "joint protection, and maintenance of pain management behavior", "maintenance of regular exercise", and "promotion of coping skill in psychosocial dimension" are achieved. (2) These intermediate objectives are also the methods for achieving objectives in next stage. It implies that through the intermediate objectives, the final objectives such as "minimization of physical symptoms and signs", "maximization of psychological function", and "maximization of role performance in social domain" could be achieved. Each of these final objectives reflects the different dimension of quality of life, respectively. When these objectives are achieved, the quality of life that client perceives is improved. Therefore, through evaluation of these final objectives, the level of achieving final outcome of arthritis health promotion such as quality of life is determined.

PURPOSE: This study was performed to measure expectations regarding aging among community-residing older adults, identify sociodemographic characteristics associated with the level of expectations regarding aging, and examine whether expectations regarding aging were associated with health-promoting behaviors. METHODS: Data was collected by using questionnaires of a short version of the Expectations Regarding Aging Survey (ERA-18) and Health Promoting Lifestyle Profile II (HPLP II) from 99 older adults who resided in the community of Kyunggi, Daegu, and Kyungpook province. RESULTS: More than 75% of the participants reported that it was an expected part of aging to have more aches and pains, to become depressed, and to become more forgetful. The mean score of expectations regarding aging was 23.15+/-17.80 (possible range 0-100). The old-old, women, those with less education, less monthly allowance and poor health status had lower expectations regarding aging than other elderly. After controlling for sociodemographic characteristics and perceived health, expectations regarding aging were independently associated with health-promoting behaviors in older adults. CONCLUSION: The findings demonstrate that older Korean adults have low expectations regarding aging, and expectations regarding aging influence health-promoting behaviors.

PURPOSE: This study was done to develop and examine the effects of a self-management program (SMP) on physical, psychological functions, and symptoms in patients with Parkinson's disease(PD). METHODS: In a two-group pre-and post-test design, a total of 40 patients were assigned to the experimental group(21) or the control group (19). The experimental group received eight weekly 2-hour sessions for 10-15 literate adults of all ages, while the control group did not receive any intervention. RESULTS: The experimental group showed significant improvements in muscle strength, balance, self-efficacy, depression, quality of life(QL), quality of sleep, and discomfort of constipation. It also reduced the number of participants using assistive walking devices. There were no significant changes in fear of falling and duration of sleep. CONCLUSION: The eight week SMP in patients with PD was found to be significantly effective in enhancing muscle strength, balance, self-efficacy, QL, and quality of sleep. It also decreased depression, discomfort of constipation, and assistive walking devices. These results suggest that a SMP can have effects on physical, psychological functions and symptoms in patients with PD. Further research with a larger sample and for a longer follow up period is needed to expand our understanding of the effects of a SMP for patients with PD.

PURPOSE: The role of sex role identity types and health promoting behaviors in relation to premenstrual symptoms and interrelatedness among the three variables were examined. METHODS: A cross sectional descriptive study was employed with 327 female university students. KSRI, HPLP, and MDQ were used as measurement tools. RESULTS: Four types of sex role identities were classified; undifferentiated(33.7%), androgyny (32.7%), masculinity(16.8%), and femininity(16.8%) in order. Premenstrual symptoms(F=3.11, p= .027) and health promoting behaviors(F=12.74, p= .000) were significantly different by sex role identity types. As determinants of premenstrual symptoms, health promoting behaviors for all subjects, stress coping for the feminine type, and interpersonal relationships for the undifferentiated type were identified. In discriminating between the feminine type and undifferentiated type, premenstrual symptoms and self responsibility were shown as significant factors. CONCLUSION: Interrelatedness among sex role identity, health promoting behaviors and premenstrual symptoms imply the importance of a psychosocial aspect in premenstrual symptoms. Therefore, these three variables should be applied more specifically for nursing assessment and management of women having premenstrual symptoms.