Factors related to health promotion activities and quality of life in Korean women with arthritis have not been clearly identified. Predictors of health pro motion might be identified that will enhance the well-being of this group. Accordingly, the findings of the study will contribute additional information about the relationship between health promotion and quality of life and will add to the research on quality of life of individuals with a leading cause of disability -arthritis. The purpose of the study was to examine the re lationship of selected background factors (years of illness, perceived severity of illness, uncertainty in illness), perceived self-efficacy, and health promoting behaviors to the quality of life of Korean women with arthritis. A cross-sectional descriptive design was used in this study to investigate relationships among the variables of interest. The sample was composed of 96 women who had arhtrits and visited large university hospital in Seoul for regular check up or prescription of medication. The purpose of a descriptive correlational design was to determine the absence or presence of relationships among variables that were measurable (Polit and Hungler, 1987, p. 147). The design of this study was appropriate because it yielded answers to the research questions and hypotheses regarding the relationships among the model variables the questionnaire contained demographic information, translated Mishel Uncertainty in Illness Scale-Community form (MUIS-C) (Mishel, 1987), translated and modified Disease Course Graphic Scale (DCGS) Which was developed by Braden (1990), translated Sherer, et al. 's General Self-Efficacy Scale (1982), The Health-Promoting Lifestyle Profile (HPLP), developed by Walker, Sechrist, and Pender (1987) and traslated to Korean by Ha, and quality of life was measured by Face Scale (Andrews, 1976). Several steps of verification for the translation process were carefully conducted. Data analysis included descriptive correlational statistics and multiple regression techniques. Health promotion was the only contributor to predict quality of life. Results showed that enabling cognitive perceptual factor (self-efficacy) mediates the disruptive force (uncertainty in illness) on achieving a health promoting self-help behavior. The findings of thi3 study also indicated that illness-related variable of severity of illness was mediated by health promotion, which buffered it's impact on quality of life.

The main purposes of the study were to develop and test a model which explains the dynamic relationship among factors reported as affecting to the quality of life of individuals with rheumatoid arthritis and to examine the relationship between self-help response and quality of life. Data for the study were collected from March 1996 to December 1996 from 153 female patients who regularly visited a clinic for people with rheumatism. The Patients were introduced to the investigators by nurses who worked at that clinic, and then the investigator interviewed the patients for 30 to 40 minutes to collect the data. Instruments used in the study were modified self-report questionnaires from the ones which were already developed in previous studies of from related literature. Data analysis were performed using LISREL(Lineal Structural Relations) 8 Program to test whether the proposed hypothesized model fit the collected data. To test fitablity of the hypothesized model both a general fit measure and a detailed fit measure were used. Based on the test results from the various fit measures, the hypothesized model was found to be well suited to the real data. As characteristics related to illness becomes severe, the feasibility for uncertainty about the illness tend to increase, but, the direct effects from the illness characteristics(such as level of physical symptoms, sense of social-psychologic change, limitations of action) as they are related to the other intrinsic variables(self-efficacy or self-help behavior and quality of life), were found to be not significant. It was found that uncertainty had a direct effect on self-efficacy but did not have a direct effect on self-help behavior or quality of life. Also, it is noted that self-efficacy had a positive effect on self-help behavior and quality of life and there was a bilateral relationship between self-efficacy and self-help behavior. Lastly, the hypothesis proposed from the theoretical model in this study was supported basis of the results that self-help behavior provides both direct and positive effects to quality of life. Particularity, since a bilateral relationship was also found between self-help behavior and quality of life in the modified model, as self-help behavior increased, so did quality of life. And, reversely, as quality of life increased, so did self-help behavior. In conclusion, the results of this study suggest that focusing on both acquirement and reinforcement of adjustment factors or self-help behavior is more efficient than focusing on the characteristics of illness in establishing the strategies for improving quality of life of individuals with rheumatoid arthritis.

In this paper, the study model, which presents the patterns of how the changing mechanisms are adopted to the changing stages of smoking cessation, was developed modifying the integrative model of Prochaska et al.(1983) with including seven changing mechanisms which were identified by Oh and Kim(1996). Then the developed study model was exploratively tested with 155 University student between 20 and 29 years of age subjects. According to the study results, among the five mechanisms, which are significant in explaining the differences between stages, DUNCAN post-comparison showed that the least applied ones were Stimulus Control, Self Determinism, Cognitive Restructuring in the precompletion stage, and Reinforcement and Dramatic Relief, in the relapsed stage. In the contemplation stage, it was observed that Dramatic Relief is used most frequently and that the other two mechanisms, Information Management and Cognitive Restructuring, showed different results from those inferred in the study hypothesis. In the case of Information Management, it was excluded from the analysis it was not included in explaining significant difference among changing stages, but Cognitive Reconstruction turns out to be a more frequently used mechanism in the action stage rather than in the contemplation stage. Helping Relationship was also excluded in the post-comparison analysis since it was not included in explaining significant difference among changing stages and Reinforcement was a more frequently used mechanisms in the contemplation stage. Stimulus Control turns out to be the connecting mechanism which was most frequently used in both the contemplation and action stages. Self Determination was most frequently used in the action stage rather than in both the contemplation stage and action stage, differing from the presumption of the model. Lastly, subjects in the relapsed stage were utilizing Stimulus Control and Self Determination at the same level as subjects in the precontemplation stage, and the utilization of both Reinformcement and Dramatic Relief was lower than that of the precontemplation stage, that is at the lowest level. Only Cognitive Restructuring was used of the same level as the contemplation stage. The relapsed stage in this study did not represent the preparation for action stage as presumed in the model of Prochaska et. al.(1983) but did show a pattern similar to the initial stage of smoking cessation, However, since this interpretation about the relapser was based on only a small number of relapsers(n=5), this conclusion may not be reliable.

The average smoking rate for Adults' in our country is 40.6%: It is 74.2% for men and 5.0% for women. Particularly, the smoking rate for men is reported higher than that of men in U. S. A. or Japan. Since the first report on the association between smoking and cancer appeared, 370 thousand smokers have succeeded in smoking cessation and over 90% of them have responded that they depended on a self-help smoking cessation approach. Despite this positive evidence about self-help approaches for smoking cessation, most studies on smoking cessation have focused on evaluation of formal treatment programs that are provided by clinics. Reports on the smoking cessation process used by smokers in our country could not be found. However, it is believed that the situation in our country would be quite similar to that in U.S.A. as far as approaches to successful smoking cessation are concerned. This study was conducted to classify the smoking stage to which they smoker belong and which changing mechanisms could be included at each changing stage (precontemplation stage, comtem-plation stage, action stage) with a sample of 155 college students between 20 and 29 years old. And it also identified which variables related both to smoking pattern and to health, which ones were significantly discriminating in the changing stages. From the results of the data analysis it was found that Self-Determination is the most influential variable as one of the changning mechanisms which can discriminate three changing stages. And as the next significant mechanisms were Reinforcement, Dramatic Relief, Cognitive Restructuring, Helping Relationship, and Information Management in that order. Among variables related to the smoking pattern, years of regular smoking, whether smoking is continued or not even when they are sick, the number of attempts to stop smoking, number of cigarettes smoked per day, and whether they have smoked over 100 cigarettes up to now, but not the time of the first cigarette after waking-up, were the significant factors to descriminate changing stages. It was confirmed that among variables related to health that, perceived control for health, confidence of health maintence ability, and self confidence in smoking cessation, were significant variables in determinating changing stages. The most influential variables among them was self-confidence in smoking cessation. Conclusively, it was shown that smoking cessation is the process of attempting to change smoking habits through the various changing processes. Also it can be shown that a few factors smoking habit, self-confidence of smoking cessation, and belief in self control of his/her health, were influential in discriminating the changing stages of the smoking habit.

Smoking is considered to be one of the important risk factors associated with various health problems. Thirty seven million people in America quit smoking in the past decade, with 90% quitting on their own(Americal Heart Association, 1986). According to McAlister(1975), 70% of smokers reported that they adopted a self-help smoking cessation approach rather than a formal treatment program. In our country, although, auccessful exsmokers have used, are not available, concerns about smoking cessation have increased, recently, due to changes in social and political attitudes to health promotion. This study was conducted to help smokers who had made a decision to adopt a self-helf smoking cessation approach instead of depending on a formal treatment program. It provided a structurd way for sucessful smoking cessation by identifying change mechanism factors which have been commonly used by smokers. The subjects selected for this study were 155 university students between 20 and 29. Years of age the results from the analysis of the collected data showed that seven factors in the self-help change processes significant, and they are named, Stimulus Control, Self-Determination, Information Management, Reinforcement Management, Helpful Relationships, Dramatic Relief and Cognitive Restructuring. All of the factors except Self-Determination represent the same change mechanisms which are proposed by Prochaska et al. (1988). Self-Determination uniformly includes items belonging to various change processes. Therefore, it might be an transitional factor including strategies related to both cognitive and behavioral dimensions. In spite of this, noted that one item which gives meaning of Self-Determination shows the highest factor loading, it is named Self-Determination.

PURPOSE: This study was conducted to develop and test the hypothetical model which explains smoking cessation behavior was established based on the Triandis' interpersonal behavior theory.
METHOD
The data were collected from the 400 university student smokers enrolled in the universities located in Seoul and Kyung-In province. The study was analyzed by path analysis with LIESREL 8 program.
RESULTS
All of the fit statistics, except the Chi-square value, it showed the hypothetical model was well fitted to the data. Benefit, affect, and social influences related to smoking cessation behavior had significant direct effect on intention to smoking cessation as shown in the study of the hypothetical model. Perceived barrier and the physiologic arousal related to smoking cessation had significant direct effects on performing smoking cessation behavior, whereas numbers of previous attempts to quit smoking and intention to smoking cessation did not.

PURPOSE: This study was to examine the rate of recovery from the consciousness impairment from two sessions of comprehensive consciousness stimulation program. Which was developed for this study, was higher than the one which was obtained naturally with only conventional care.
METHOD
The subjects were selected among the patients who were admitted in the Intensive Care Unit or in the Sub-Intensive Care Unit in one of the university hospital, located in Inchon. For the treatment of the deterioration of his/her consciousness level resulting from neurological causes.
RESULTS
The effect of the first intervention on consciousness state began to appear two weeks the intervention initiation and to disappear two weeks after the end of the intervention. The significant effect of the second session of the consciousness stimulation program also began to appear two weeks the second intervention initiation and persisted until 4 months after intervention was terminated.
CONCLUSION
It appeared that the first intervention effect had gradual onset and gradual decay, while the second intervention effect had gradual onset and permanent duration.

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.

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.

This study was performed to examine the effect of a 7-week comprehensive health promotion program for improving pain, depression, and disability by employing a quasi-experimental design. The subjects were regular out-patients of a RA aclinic in an University Hospital in Inchon from November 11. 1998 to December 24. 1998. The Experimental group included 18 patients who participated in an arthritis health promotion program, and the control group included 18 patients who did not. The 7-week health promotion program, which had the objective to enhance health promoting skills, was provided to patients. The effects of this program on the patients' pain, depression, and functional disability were examined. According to the study results, a significant group difference was found on these dependent variables (Hotelling's T =.30, F=3.11, p=.04). To examine which dependent variables had significant effects, one-way ANOVAs were performed. There were significant group differences in pain (F=4.35, p=.05) and in depression (F=4.22, p=.05) However, no significant group differences on functional disability (F=.04, p=.84) were found. Conclusively, the arthritis health promotion program, which was designed to enhance 11 health promoting skills, can be evaluated as successfully achieving the ultimate goal of enhancing the patients' quality of life. It can also be contended that the improvement of the patients' quality of life was enabled by relieving pain and reducing depression.

The purpose of this study was to clarify the dynamic relationships among risk factors of arteriosclerosis and to develop and examine a model which could explain this relationship clearly. Data were collected from medical records of 400 male clients who visited a university hospital located in Inchon for physical examinations, from May 1996 to December 1996. Data were analyzed using the LISREL (Linear Structural Relationship) 8 program. To test the fitness of the hypothesized model, chi-square, RMSR (root mean square residual), GFI (goodness of fit index), CN (critical number) and Q-plot were used. Most of the fitness measurements, except the chi-square showed that the hypothesized model complimented the real data. According to the results, there were trends that obesity and hyperlipidemia were prevalent in heavier smokers, higher alcohol intakers, and groups who excercised less. Also, hypertension was more prevalent in older age, higher alcohol intaker, and higher serum lipid level groups. In contrast to the hypothesis, alcohol intake did not significantly affect serum lipid levels. This might be due to the serum lipid measurements (total cholesterol and trigryceride) used in this study to estimate hyperlipidemia. The direct effect of smoking on hypertension was not significant. However, the total effect of smoking on the hypertension was significant since indirect effects of smoking on hypertension, such as obesity and hyperlipidemia, were significant. The total effect of obesity on hypertension was significant since the indirect effect of obesity on hypertension via hyperlipidemia was significant, although the direct effect of smoking on hypertension was not significant. The degree of explaining hyperlipidemia with smoking, exercise, and obesity was high (60%), however, the degree of explaining obesity with age, smoking, alcohol intake, and exercise was very low (7%). On the basis of these results, high risk factors of arteriosclerosis such as hypertension, hyperlipidemia, or obesity are either directly or indirectly correlated each other. Therefore, it is difficult to predict outcomes for increasing or decreasing the risk factors by simply modulating a factor. Smoking, alcohol, and exercise both directly and indirectly affected major risk factors of arteriosclerosis. Therefore, correcting these variables is required to decrease risk factors. Finally, the relationship among other risk factors which have been known to be related with arteriosclerosis (diet, stress or hereditary) should be clarified in further studies.

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.

The purpose of this study was to use meta-analysis to analyze result of 17 studies which investigated the effects of integrated programs, and 11 studies which examined the effects of exercise programs on pain, depression, and disability. The 28 studies analyzed in this work were selected from the following sources: MEDLINE Search, bibliographies of related studies, main academic journals of nursing in Korea, and journals on arthritis issues. For the analysis of the data, homogeneity of effect sizes which were calculated based on data in the 28 studies was tested and its average effect size was computed by using meta analysis software package which was developed by Song(1992, 1998). the results can be summarized as follows: 1) Homogeneity tests were conducted on integrated programs on pain. In the preliminary homogeneity tests on effect size of all 17 studies, no homogeneity was found. When homogeneity tests on the effect size of the remaining 15 studies were performed, excluding two studies which had extremely larger effect size compared to other studies, the 15 studies were found to be homogeneous(Q=16.38, p=.23). The obtained average effect size, D(Mean Standardized Difference Between Means), was .25. When homogeneity tests on effect size on pain was conducted for the exercise programs, effect size for all nine studies wee found to be homogeneous(Q=7.42, p=.49) and the average effect size D=.30. Therefore, Hypothesis 1 was rejected from the results, that an average effect size of the integrated programs in pain was not significantly different from that of the exercise programs in pain. 2) Since only two studies investigated the effect of exercise programs n depression, comparison between the average effect size of integrated programs on depression could not be tested. Thereby, only the average effect size of integrated programs in depression was obtained. Eight studies wee tested to be positive on the homogeneity of effect sizes(Q=18.31, p=.02) at alpha <.01 and its average effect size was D=.11. 3) For the analysis of integrated program on disability, 13 studies, except for four which had an extremely large effect size compared to the others were found to be homogeneous at alpha <.01(Q=22.30, p=.04) and the average effect size on disability was D=.16. for analysis of the exercise programs on disability, eight studies, except for one which had an extremely large effect size compared to others, were found to be homogeneous(Q=7.87, p=.34) and the average effect size on disability was D=.60. Therefore, Hypothesis 3 was accepted from the results that an average effect size of exercise programs n disability was significantly larger than that of integrated programs in disability.

The purpose of this study was evaluate the usefulness of variables which were known to be related to blood pressure for discriminating between hypertensive and normotensive groups. Variables able such as smoking, alcohol, exercise, and stress, and demographic variables such as age, economical status, and education. The data were collected from 400 male clients who visited one university hospital located in Incheon, Republic of Korea, from May 1996 to December 1996 for a regular physical examination. Variables which showed significance for discriminating systolic blood pressure in this study were age, serum lipids, education, HDL, exercise, total smoking(in order of significance). By using the combination of these variables, the possibility of proper prediction for a high-systolic pressure group was 2%, predicting a normal-systolic pressure group was 70.3%, and total Hit Ratio was 70%. Variables which showed significance for discriminating diastolic blood pressure were exercise, triglyceride, alcohol, smoking, economical status, age and BMI(in order of significance). By using the combination of these variables, the possibility of proper prediction for a high-diastolic pressure group was 71.2%, predicting a normal-diastolic pressure group was 71.3%, and total Hit Ratio was 71.3%. Multiple regression analysis was performed to examine the association of systolic blood pressure with life style-related variables after adjustment for obesity, serum lipids, and demographic variables. First, the effect of demographic variable alone on the systolic blood pressure was statistically significant(p=.000) and adjusted R2 was 0.09. Adding the variable obesity on demographic variables resulted in raising adjusted R2 to 0.11(p=.000) ; therefore, the contribution rate of obesity on the systolic blood pressure was 2.0%. On the next step, adding the variable serum lipids on the obesity and demographic variables resulted in raising adjusted R2 to 0.12(p=.000) : therefore, the contribution rate of serum lipid on the systolic pressure was 1.0%. Finally, adding life style-related variables on all other variables resulted in raising the adjusted R2 to 0.18(p=.000) ; therefore, the contribution rate of life style-related variables on the systolic blood pressure after adjustment for obesity, serum lipids, and demographic variables was 6.0%. Multiple regression analysis was also performed to examine the association of diastolic blood pressure with life style-related variables after adjustment for obesity, serum lipids, and demographic variables. First, the effect of demographic variable alone on the diastolic blood pressure was statistically significant(p=.01) and adjusted R2 was 0.03. Adding the variable obesity on demographic variables resulted in raising adjusted R2 to 0.06(P=.000) ; therefore, the contribution rate of obesity on the diastolic blood pressure was 3.0%. On the next step, adding the variable serum lipids on the obesity and demographic variables resulted in raising the adjusted R2 to 0.09(p=.000) ; therefore, the contribution rate of serum lipid on the diastolic pressure was 3.0%. Finally, adding life style-related variables on all other variables resulted in raising the adjusted R2 to 0.12(p=.000) ; therefore, the contribution rate of life style-related variables on the systolic blood pressure after adjustment for obesity, serum lipids, and demographic variables was 3.0%.