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12 "Rhayun Song"
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Original Articles
Structural Equation Modeling on Successful Aging in Elders with Chronic Obstructive Pulmonary Disease Based on Selection-Optimization-Compensation Strategy
Young Mi Jang, Rhayun Song
J Korean Acad Nurs 2017;47(4):488-498.   Published online August 31, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.4.488
AbstractAbstract PDF
Purpose

The focus of the study was on the selection-optimization-compensation (SOC) strategy to predict successful aging mediated by dyspnea symptoms in older adults with chronic obstructive pulmonary disease. The model was constructed based on the hypotheses that coping strategy and social support of the elders predict successful aging through the SOC strategies.

Methods

Participants were 218 outpatients with chronic obstructive pulmonary disease recruited for the study. Data collection was done from March 25 to September 11, 2015, and analyzed using SPSSWIN 22.0 and AMOS 21.0.

Results

The hypothetical model appeared to be fit to the data. Seven of eight hypotheses selected for hypothetical model were statistically significant. The SOC strategy has only significant indirect effects through dyspnea symptoms on successful aging. Coping strategy, social support, SOC strategies and dyspnea symptoms explained 62% of variance in successful aging.

Conclusion

The SOC strategies with social support and dyspnea symptoms significantly explained successful aging among patients with chronic obstructive pulmonary disease. Nursing strategies should be focused on social support and coping strategies to optimize SOC strategies so that older adults with chronic obstructive pulmonary disease are able to manage dyspnea symptoms and eventually achieve successful aging.

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Psychometrics of Task Self-Efficacy Scale for Korean Elderly
Young Rhan Um, Rhayun Song, Yean Ok Suh, Kyung Ja June, Beverly L Roberts
Journal of Nurses Academic Society 1997;27(4):831-842.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.4.831
AbstractAbstract PDF

The purpose of the study was to test the reliability and validity of the Korean version of Task Self-Efficacy Scale for activities of daily living(ADL). The Task Self-Efficacy Scale was developed by Roberts(1996) for low-intensity exercise study with older people to predict their performance of ADL. The scale was translated and back translated by bilingual persons, and then was modified to resolve variations in the translations. The Korean version of Self-efficacy Scale of ADL was then administered to 193 elderly people including 95 hospitalized patients and 98 outpatients or healthy people. Face to face interview was used to fill out the structured questionnaire, and each interview took approximately 30 minutes. The subjects for the study were 80 women and 112 men with an age range of 65 to 95 years(M=71 years) of whom 82.6% classified themselves as moderate or quite active. Most subjects(80.2%) had an education level of elementary school or less. The Self-Efficacy Scale for ADL is measured on a 0 to 10 VAS, assessing three areas of ADL : self care activities, household tasks, and motor tasks. The higher the score is the higher person's confidence in performing ADL. Psychometric testing revealed that the scale was found to be internally consistent, showing a Cronbach's alpha of .97. The scale was significantly correlated with subjects' level of activity and subjective assessment of their health status. Moderate correlation with health-related hardiness scale also supported the validity. Factor analysis was performed to confirm whether the scale represents the three sub-areas as suggested in the literature. The results of the factor analysis led to a three factor solution according to Kaiser's criterion, but the items were not strongly and cleanly loaded for the third factor. This can be explained in that, among the three sub-ADL ares of the self-efficacy scale, the areas of self care activities and household tasks seem to have similar levels of difficulty in performance with not enough differences for the self-efficacy scale to distinguish between the two areas. Therefore, one factor solution was suggested since ADL can be seen a unit of activities as similar level of difficulty in performance. One factor solution explained 68.1% of variance of the 19-item scale and all items all correlated over .6 with the factor, showing that the selected factor solution fits the model. The results indicated that the Korean version of Task Self-Efficacy Scale for ADL was reliable and valid in producing useful information to evaluate the effects of various interventions toward promoting health and quality of life for elderly people.

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

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

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

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

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Effects of a Sun-style Tai Chi Exercise on Arthritic Symptoms, Motivation and the Performance of Health Behaviors in Women with Osteoarthritis
Rhayun Song, Eun Ok Lee, Paul Lam, Sang Cheol Bae
Journal of Korean Academy of Nursing 2007;37(2):249-256.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.2.249
AbstractAbstract PDF
Purpose

Tai Chi exercise, an ancient Chinese martial art, has drawn more and more attention for its health benefits. The purpose of the study was to identify the effects of a Sun-style Tai Chi exercise on arthritic symptoms (joint pain and stiffness), motivation for performing health behaviors, and the performance of health behaviors among older women with osteoarthritis.

Methods

Total of 72 women with the mean age of 63 years old were recruited from outpatients clinic or public health centers according to the inclusion criteria and assigned randomly to either the Tai Chi exercise group or the control. A Sun-style Tai Chi exercise has been provided three times a week for the first two weeks, and then once a week for another 10 weeks. In 12 weeks of study period, 22 subjects in the Tai Chi exercise group and 21 subjects in the control group completed the posttest measure with the dropout rate of 41%. Outcome variables included arthritic symptoms measured by K-WOMAC, motivation for health behavior, and health behaviors.

Results

At the completion of the 12 week Tai Chi exercise, the Tai Chi group perceived significantly less joint pain (t=-2.19, p=0.03) and stiffness (t=-2.24, p=0.03), perceived more health benefits (t=2.67, p=0.01), and performed better health behaviors (t=2.35, p=0.02), specifically for diet behavior (t=2.06, p=0.04) and stress management (t=2.97, p=0.005).

Conclusion

A Sun-style Tai Chi exercise was found as beneficial for women with osteoarthritis to reduce their perceived arthritic symptoms, improve their perception of health benefits to perform better health behaviors.

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Symptom Management to Predict Quality of Life in Patients with Heart Failure: A Structural Equation Modeling Approach
Ja Ok Lee, Rhayun Song
J Korean Acad Nurs 2015;45(6):846-856.   Published online December 15, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.6.846
AbstractAbstract PDF
Abstract Purpose

The focus of this study was on symptom management to predict quality of life among individuals with heart failure. The theoretical model was constructed based on situation-specific theory of heart failure self-care and literature review.

Methods

For participants, 241 outpatients at a university hospital were invited to the study from May 19 to July 30, 2014. Data were collected with structured questionnaires and analyzed using SPSSWIN and AMOS 20.0.

Results

The goodness of fit index for the hypothetical model was .93, incremental fit index, .90, and comparative fit index, .90. As the outcomes satisfied the recommended level, the hypothetical model appeared to fit the data. Seven of the eight hypotheses selected for the hypothetical model were statistically significant. The predictors of symptom management, symptom management confidence and social support together explained 32% of the variance in quality of life. The 28% of variance in symptom management was explained by symptom recognition, heart failure knowledge and symptom management confidence. The 4% of variance in symptom management confidence was explained by social support.

Conclusion

The hypothetical model of this study was confirmed to be adequate in explaining and predicting quality of life among patients with heart failure through symptom management. Effective strategies to improve quality of life among patients with heart failure should focus on symptom management. Symptom management can be enhanced by providing educational programs, encouraging social support and confidence, consequently improving quality of life among this population.

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Effects of Tai Chi on Fall Risk Factors: A Meta-Analysis
Moonkyoung Park, Rhayun Song
J Korean Acad Nurs 2013;43(3):341-351.   Published online June 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.3.341
AbstractAbstract PDF
Purpose

This study was done to analyze the effects of Tai Chi on fall-related risk factors through meta-analysis of randomized clinical trials published in English and Korean between 2000 and 2010.

Methods

Using health related database and hand search of references and Google, 28 randomized studies were collected from doctoral dissertation and published peer reviewed articles. The Comprehensive Meta-analysis version 2.0 was used for the analysis.

Results

The effect sizes for Tai Chi for 3 months were significant with ES=0.54 for static balance, ES=0.24 for dynamic balance, ES=0.69 for balance measured by scale, and ES=0.40 for flexibility, ES=0.48 for muscle strength, ES=0.71 for ADL, and ES=0.37 for fear of falling. Also, the effect sizes of Tai Chi for 6 months were significant for most fall-related variables. The 6 month data for flexibility was not analyzed since only one study was published.

Conclusion

The analysis of studies of randomized clinical trials indicate that Tai Chi is effective in improving balance, flexibility, muscle strength, activities of daily living, and fear of falling when applied for 3 or 6 months. The findings provide the objective evidence to apply Tai Chi as a fall preventive intervention.

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Effects of Passive Upper Arm Exercise on Range of Motion, Muscle Strength, and Muscle Spasticity in Hemiplegic Patients with Cerebral Vascular Disease
Dong Soon Shin, Rhayun Song, Eun Kyung Shin, Sung Ju Seo, Jeong Eun Park, Seung Yeon Han, Hoi Yong Jung, Choon Ji Ryu
J Korean Acad Nurs 2012;42(6):783-790.   Published online December 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.6.783
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the effects of passive upper arm exercise on range of motion, muscle strength, and muscle spasticity in hemiplegic patients with cerebral vascular disease.

Methods

A quasi-experimental design with nonequivalent control group was utilized. According to inclusion criteria, 25 patients were assigned to the control group with routine care, followed by 25 to the intervention group with passive exercise for 30 minutes per session, twice a day for 2 weeks. Eighteen patients in the intervention group and 17 in the control group completed the posttest measurement, including range of motion for upper arm joints, manual muscle test, and Modified Ashworth Scale for muscle spasticity.

Results

The intervention group had a significantly improved range of motion in the shoulder and wrist joints. No interaction effect was found for the elbow joint. No significant differences were found in muscle strength or muscle spasticity between the groups.

Conclusion

Results of the study indicate that passive exercise safely applied for two weeks improves range of motion in joints of the upper arm in these patients. Further study with long-term follow-up is needed to verify the role of passive exercise in preventing muscle spasticity in this population.

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Effects of Tai Chi Exercise on Cardiovascular Risk Factors and Quality of Life in Post-menopausal Women
Rhayun Song, Sukhee Ahn, Hee Young So, In Sook Park, Hyun Li Kim, Kyung Ok Joo, Jong Sung Kim
J Korean Acad Nurs 2009;39(1):136-144.   Published online February 17, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.1.136
AbstractAbstract PDF
Purpose:

Natural menopause resulting in the decline in endogenous estrogen concentrations is responsible for an increased risk of coronary heart disease in postmenopausal women. The purpose of the study was to examine the effects of a 6-month Tai Chi exercise program on cardiovascular risk factors and quality of life in post-menopausal women.

Methods:

A quasi-experimental design with pretest and posttest measures was used. The participants in the study, 29 women in the Tai Chi group and 31 in the control group, were enrolled for 6 months.

Results:

After 6 months of Tai Chi exercise, total cholesterol (M=213 to 185), LDL-cholesterol (M=135 to 128), and their 10 yr cardiovascular disease risk (M=2.62 to 2.27) had improved significantly for the Tai Chi participants compared to the control group. Total scores for quality of life along with the sub-dimensions of health perception and mental functioning were also significantly higher in the Tai Chi participants.

Conclusion:

Tai Chi exercise favorably affected cardiovascular health and quality of life in post-menopausal women after 6 months. Additional rigorous studies are needed to examine long term effects on the prevention of cardiovascular disease in this population.

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Factors explaining Quality of Life in Individuals with Coronary Artery Disease
In Sook Park, Rhayun Song, Sukhee Ahn, Hee Young So, Hyun Li Kim, Kyung Ok Joo
J Korean Acad Nurs 2008;38(6):866-873.   Published online December 31, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.6.866
AbstractAbstract PDF
Purpose

The study was done to compare quality of life by gender, and to identify factors which explain quality of life in individuals with coronary artery disease.

Methods

For the survey, 91 individuals (53 men and 38 women) agreed to participate in the study. Cardiovascular risk factors, systolic blood pressure, body mass index, total cholesterol, triglyceride, high density lipoprotein-cholesterol, and low density lipoprotein-cholesterol, health behavior as well as quality of life, were measured. Descriptive statistics, t-test, correlation and hierarchical multiple regression with SPSS WIN 12.0 were used to analyze the data.

Results

Significant gender differences were found for education, smoking status, chronic disease, perceived health status, and quality of life within sub-dimensions. Hierarchical regression analysis showed gender (men), age, perceived health status, cardiovascular risk scores, and health behaviors together explained 40.2% (adjusted R2) of variance in quality of life.

Conclusion

As the factors explaining quality of life in individuals with coronary artery disease have been identified as gender (men), age, perceived health status, and health behaviors, health promotion programs designed for this population should focus on these factors for effective behavioral modification, and consequent improvement in quality of life.

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Factors Influencing Quality of Life in Patients with Gastrointestinal Neoplasms
Eun Ok Lee, Aeyong Eom, Rhayun Song, Young Ran Chae, Paul Lam
J Korean Acad Nurs 2008;38(5):649-655.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.649
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the factors influencing quality of life after analyzing the relationship between depression, health promotion and quality of life in patients with gastrointestinal neoplasms.

Methods

The subjects of this study were 63 people who underwent treatments from 2 general hospitals in Seoul and Daejeon and had no recurrence in stages I & II of gastrointestinal neoplasms. Data was collected from March 1 to April 30, 2006. A questionnaire consisting of Center for Epidemiologic Studies Depression (CES-D), Health Promoting Lifestyle Profile II (HPLP II) and Functional Assessment of Cancer Therapy-Colorectal (FACT-C) was given. The collected data was analyzed with the SPSS program which was used for descriptive statistics, Pearson correlation coefficients and hierarchical multiple regression.

Results

The major findings of this study were as follows: 1) There was a significant relationship between depression (r=-.639, p=.000), health promotion (r=.407, p=.001) and quality of life. 2) Significant factors were depression (F=-4.091, p=.000) and health promotion (F=2.375, p=.021) that explained 46% of quality of life (F=10.022, p=.000).

Conclusion

Cancer patients experienced extreme depression which led to a negative effect on quality of life. Health promotion was an important variable to the quality of life and it gave the patients motivation for having a will and belief for better health.

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Development and a Psychometric Evaluation of Cardiovascular Disease-Specific Quality of Life Scale for Koreans
Eun Hyun Lee, Seong Jai Tahk, Jun Han Shin, Young Whee Lee, Rhayun Song
Journal of Korean Academy of Nursing 2007;37(3):313-323.   Published online April 30, 2007
DOI: https://doi.org/10.4040/jkan.2007.37.3.313
AbstractAbstract PDF
Purpose

Health-related quality of life (HRQOL) in patients with cardiovascular disease in Korea has rarely been studied, mostly due to the lack of a psychometrically validated disease-specific instrument. The purpose of this study was to develop and validate a cardiovascular specific-HRQOL questionnaire (CD-QOL).

Method

The CD-QOL was developed and validated as follows; item generation, pilot study, and psychometric tests. Patients were recruited from three-university hospitals. The patients were asked to complete the preliminary questionnaire comprising the content-validated items, SF-36, and CES-D. The NYHA and KASI classifications were used to classify the functional performance of the patients. The data was analyzed using correlation, factor analysis, multidimensional scaling, multitrait/multi-item matrix, ANOVA, and Cronbach's alpha.

Result

Preliminarily, thirty-nine items were generated. Factor analysisextracted a five-factor solution with a total of twenty-two items. One item was deleted based upon the MDS. The remaining items were moderately correlated with the subscales of the SF-36 and associated with depression measured with the CES-D. The mean scores of patients in NYHA and KASI class I were significantly higher than those in NYHA and KASI class II or/and III, which suggested patients with better functional performance were likely to have a better HRQOL. Cronbach's alphas of the total and subscales were all greater than 0.70.

Conclusion

The CD-QOL is a easily applicable instrument with excellent psychometric properties of content, criterion, factorial, convergent, and known-groups validity, and internal consistency reliability in Korean patients with cardiovascular disease.

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