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Research Papers
Support Needs for Health Promotion of Community-Dwelling People with Disabilities: Perspectives of Operators Managing Disability Supportive Housing
Nam, Hye Jin , Lee, Haesun , Park, Han Nah , Lee, Sujin , Kim, Bohye , Yoon, Ju Young
J Korean Acad Nurs 2024;54(2):211-223.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.23143
AbstractAbstract PDF
Purpose
Recent studies have focused on policies aimed at supporting the independence of individuals with disabilities in communities. As part of this initiative, supportive housing, integrated care, and residential spaces offer tailored services based on individual needs and autonomy. The attitudes and knowledge of the administrators supporting supportive housing residents regarding health management can influence the well-being of individuals with disabilities. Therefore, this study aimed to explore the challenges faced by supporting housing workers in enhancing the self-management skills of individuals with disabilities.
Methods
In this qualitative study, focus group interviews were conducted in August 2023 with nine administrators working to support housing in Seoul. Qualitative content analysis was used to analyze the interview data.
Results
The needs and challenges in enhancing the self-management skills of individuals with disabilities were as follows: (1) the complexity of health management challenges, (2) bidirectional strategies for strengthening health management capabilities, and (3) support for systematic health management. Additionally, eight subthemes were derived.
Conclusion
By investigating the difficulties experienced and identifying the necessary support requirements for supportive housing workers, this study seeks to uncover insights and identifies areas for improvement and strategies for health management. This study acknowledges the educational and institutional support necessary to improve the health and quality of life of individuals with disabilities residing in supportive housing.
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Psychometric Properties of the Korean Version of Self-Efficacy for HIV Disease Management Skills
Kim, Gwang Suk , Kim, Layoung , Shim, Mi-So , Baek, Seoyoung , Kim, Namhee , Park, Min Kyung , Lee, Youngjin
J Korean Acad Nurs 2023;53(3):295-308.   Published online June 30, 2023
DOI: https://doi.org/10.4040/jkan.23016
AbstractAbstract PDF
Purpose
This study evaluated the validity and reliability of Shively and colleagues’ self-efficacy for HIV disease management skills (HIVSE) among Korean participants.
Methods
The original HIV-SE questionnaire, comprising 34 items, was translated into Korean using a translation and back-translation process. To enhance clarity and eliminate redundancy, the author and expert committee engaged in multiple discussions and integrated two items with similar meanings into a single item. Further, four HIV nurse experts tested content validity. Survey data were collected from 227 individuals diagnosed with HIV from five Korean hospitals. Construct validity was verified through confirmatory factor analysis. Criterion validity was evaluated using Pearson’s correlation coefficients with the new general self-efficacy scale. Internal consistency reliability and test-retest were examined for reliability.
Results
The Korean version of HIV-SE (K-HIV-SE) comprises 33 items across six domains: “managing depression/mood,” “managing medications,” “managing symptoms,” “communicating with a healthcare provider,” “getting support/help,” and “managing fatigue.” The fitness of the modified model was acceptable (minimum value of the discrepancy function/degree of freedom = 2.49, root mean square error of approximation = .08, goodnessof-fit index = .76, adjusted goodness-of-fit index = .71, Tucker-Lewis index = .84, and comparative fit index = .86). The internal consistency reliability (Cronbach’s α = .91) and test-retest reliability (intraclass correlation coefficient = .73) were good. The criterion validity of the K-HIV-SE was .59 (p < .001).
Conclusion
This study suggests that the K-HIV-SE is useful for efficiently assessing self-efficacy for HIV disease management.
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Validity and Reliability of Korean Version of Self-Care Chronic Obstructive Pulmonary Disease Inventory (SC-COPD) and Self-Care Self-Efficacy Scale (SCES-COPD)
Choi, Ja Yun , Yun, So Young
J Korean Acad Nurs 2022;52(5):522-534.   Published online October 31, 2022
DOI: https://doi.org/10.4040/jkan.22062
AbstractAbstract PDF
Purpose
This study examined the validity and reliability of the Korean version of the Self-Care in Chronic Obstructive Pulmonary Disease Inventory (SC-COPDI) and the Chronic Obstructive Pulmonary Disease Self-Care Self-Efficacy Scale (SCES-COPD). The SC-COPDI consists of the Self-Care Maintenance Scale (SCMES), Self-Care Monitoring Scale (SCMOS), and Self-Care Management Scale (SCMAS).
Methods
The original tool was translated using a back-translation process. Participants were 241 patients with COPD at the Chonnam National University Hospital in Korea. The construct validity was verified through confirmatory factor analysis, and reliability was verified using Cronbach’s α.
Results
The SCMES consisted of 10 items of three factors―one of four factors was deleted from the original tool. In the SC-MOS, there were six items of two factors after two items were deleted from the original tool. The SCMAS consisted of the original 10 items of three factors. The SCES-COPD consisted of six items of two factors, with one item removed from the original tool. The model fit indices of all tools were good, and the construct validity was confirmed. Cronbach’s α of SCMES was .72, SCMOS was .90, SCMAS was .81, and SCES-COPD was .85.
Conclusion
The Korean version of SC-COPDI and SCES-COPD are valid and reliable instruments for measuring selfcare in people with COPD. These instruments can be used in self-care studies of COPD patients in Korea.
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Influence of Self-care on Burnout in Primary Family Caregiver of Person with Dementia
Kwon, Jeong Hwa , Hong, Gwi-Ryung Son
J Korean Acad Nurs 2021;51(2):217-231.   Published online April 30, 2021
DOI: https://doi.org/10.4040/jkan.20274
AbstractAbstract PDF
Purpose
The purpose of this study was to identify the influence of self-care on burnout experienced by primary family caregivers of persons with dementia.
Methods
The subjects of the study were 156 primary family caregivers of persons with dementia at home in Korea. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression using IBM SPSS Statistics ver. 24.0 for Windows.
Results
The mean scores for self-care and burnout were 42.35 and 61.60, respectively. Self-care, subjective health status, living with a person with dementia, and behavioral and psychological symptoms of dementia were significant factors affecting burnout in family caregivers. Self-care was identified as the strongest factor affecting burnout, explaining 13.9% of burnout with controlling factors in caregivers and care receivers.
Conclusion
To prevent burnout in primary family caregivers of persons with dementia, self-care of family caregivers should be emphasized. In nursing education, family caregivers should be recognized and approached as nursing clients who are responsible for taking care of their health. In nursing practice and research, digital self-care or self-care improvement intervention programs should be designed to help family caregivers, and further studies on self-care centered on health of family caregivers should be conducted.
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Original Articles
The Effects of a Health Mentoring Program in Community-dwelling Vulnerable Elderly Individuals with Diabetes
Ki wol Sung, Hye Seung Kang, Ji Ran Nam, Mi Kyung Park, Ji Hyeon Park
J Korean Acad Nurs 2018;48(2):182-194.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.2.182
AbstractAbstract PDF
Abstract Purpose

This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes.

Methods

A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0.

Results

Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups.

Conclusion

These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population.

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The Effects of an Empowerment Education Program for Kidney Transplantation Patients
Sung Hee Kim, Hye Sook You
J Korean Acad Nurs 2017;47(4):445-455.   Published online August 31, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.4.445
AbstractAbstract PDF
Purpose

This study was conducted to develop an Empowerment Education Program (EEP) for kidney transplant patients and to test the program's effects on uncertainty, self-care ability, and compliance.

Methods

The research was conducted using a nonequivalent control group with a pretest-posttest design. The participants were 53 outpatients (experimental group: 25, control group: 28) who were receiving hospital treatment after kidney transplants. After the pre-test, patients in the experimental group underwent a weekly EEP for six weeks. The post-test was conducted immediately after, and four weeks after the program's completion in the same manner as the pre-test. For the control group, we conducted a post-test six and ten weeks after the pre-test, without and program intervention. A repeated measure ANOVA was performed to compare the change scores on main outcomes.

Results

Uncertainty was significantly lower in the experimental group than in the control group, both immediately after (t=-3.84, p=<.001) and 4 weeks after (t=-4.51 p=<.001) the program, whereas self-care ability (t=5.81, p=<.001), (t=5.84, p=<.001) and compliance (t=5.07, p=<.001), (t=5.45, p=<.001) were significantly higher.

Conclusion

Kidney transplant patients who underwent an EEP showed a decrease in uncertainty and an improvement in self-care ability and compliance. Thus, our findings confirmed that an EEP can be an independent intervention method for improving and maintaining the health of kidney transplant patients.

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The Effect of Structured Patient Education on Knowledge and Behavior about Selfcare in Hemodialysis Patients
Young Ran Jeong
Journal of Nurses Academic Society 1997;27(1):120-127.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.120
AbstractAbstract PDF

The purpose of this study was to identify the effect of structured patient education on knowledge and behavior about selfcare in hemodialysis patients, and to find the strategy to promote their selfcare behavior. In conclusion, structured patient education in hemodialysis patients was improved the level of knowledge and behavior about selfcare. But there was a little relationship between the knowledge and behavior about selfcare. That is ; structured patient education is the effective nursing intervention to improve their selfcare knowledge and behavior, but further research is needed to find the factor to increase selfcare behavior in hemodialysis patients.

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The Effect of a Self Regulation Education Program for the Promotion and Maintenance of Self Care Behavior in the Chronically ill patients: For Diabetic Patients
Mee Ock Gu
Journal of Nurses Academic Society 1996;26(2):413-427.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.2.413
AbstractAbstract PDF

This study was conducted to test the effect of a self regulation education program as a nursing intervention with chronically ill patients. A quasi experimental research (non equivalent control group pretest-posttest design) was used in this study. The subjects were 30 non insulin dependent diabetic patients (experimental group: 14 patients, control group: 16 patients). The study was carried out from May, 1995 to February, 1996. Data were collected before the education program, immediately after and 2 months later and were analyzed with repeated measure ANCOVA, paired t-test and t-test. The results are as follows: 1. There was a significant difference in self efficacy between the two groups(F=27.61, P=0.000). There was a significant difference according to experimental stages(F=33.09, P=0.000) and interaction between education and experimental stages(F=30.21, P=0.000), 2. There was a significant difference in self care behavior between the two groups (F=27.05, P=0. 000). There was a significant difference according to experimental stages(F=31.14, P=0.000) and interaction between education and experimental stages(F=28.88, P=0.000), 3. There was a significant difference in glycemic control between before the education program and 2 months later in the experimental group (t=2.88, P=0.013). But there was no significant difference between before the education program and 2 months later in the control group. These results suggest that a self regulation education program is effective in promoting and maintaining self care behavior and in improving glycemic control. Thus this program can be recommended as an effective nursing intervention for chronically ill patients including diabetic patients.

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The Effects of Problem Solving Nursing Counseling and Intensified Walking Exercise on Diabetic Self-care, Coping Strategies, and Glycemic Control among Clients with DM Type II
Hae Jung Lee, Kyung Yeon Park, Hyeong Sook Park, In Joo Kim
Journal of Korean Academy of Nursing 2005;35(7):1314-1324.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.7.1314
AbstractAbstract PDF
Purpose

The purpose of the study was to identify the effects of problem solving nursing counseling and intensified walking exercise on diabetic self-care, coping strategies, and glycemic control among older adults with DM type II.

Methods

Ninety nine DM patients who were older than 50 were recruited from DM clinics or public health centers and conveniently assigned into three groups: the Polar(n=41), counseling(n=30) and control groups (n=28). Participants in both Polar and counseling groups attended weekly problem solving nursing counseling for 12 weeks. Polar heart rate monitors were used in the Polar group to intensify walking exercise. Data was collected from November 2003 to August 2004 and analyzed by ANOVA or ANCOVA using the SPSS WIN program.

Results

After a 12 week intervention, participants in both the Polar and counseling groups reported increased diabetic self care behaviors and decreased blood glucose levels, which is significantly different from those in the control group. There were no distinctively different program effects between the Polar and counseling groups.

Conclusion

Based on the findings, we concluded that problem solving counseling alone could have positive effects on diabetic self care and glycemic controls for older adults with DM. Future research is needed to identify long-term effects of the program.

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The Effect of an Internet Community on Knowledge, Self-efficacy and Self Care Behavior in Workers with Hypertension
Jung Ok Yu, Young Bok Cho
Journal of Korean Academy of Nursing 2005;35(7):1258-1267.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.7.1258
AbstractAbstract PDF
Purpose

This study was aimed to evaluate the effect of an internet community on knowledge, self-efficacy, and self-care behavior in workers with hypertension.

Methods

The research design used was a nonequivalent control group pre-test and post-test design. Sixty hypertensive workers participated in this study(Exp.=29, Cont.=31). The data was collected from the 3rd of November 2003 to the 27th of February 2004 using an interview with questionnaires. Information related to hypertension was provided on the internet community weekly and an e-mail newsletter was sent in order to increase participation in the internet community. We used a tool developed by Park Young-Im(1994) that measured knowledge related to hypertension and self-efficacy. A tool developed by Jung Mi-Young(2001) was used for self-care behavior. The collected data was analyzed with an chi2-test and t-test using the SPSS WIN 10.0 program.

Results

The internet community helped workers with hypertension to increase their knowledge related to hypertension, as well as increasing their self-efficacy and self-care behavior.

Conclusion

An internet community could be applied as hypertensive nursing intervention.

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Self Care Activity, Metabolic Control, and Cardiovascular Risk Factors in accordance with the Levels of Depression of Clients with Type 2 Diabetes Mellitus
Hae Jung Lee, Kyung Yeon Park, Hyeong Sook Park
Journal of Korean Academy of Nursing 2005;35(2):283-291.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.2.283
AbstractAbstract
Purpose

The purpose of this study was to explore the levels of depression experienced by clients (N=152) with Type 2 Diabetes Mellitus(DM), and to compare the levels of self care activity, metabolic control and cardiovascular risk factors between depressed and non-depressed clients.

Method

Participants aged 50 and above were conveniently recruited in B city. The levels of depression, self-care activity, metabolic control of glucose and lipids, and cardiovascular risk factors of the participants were measured by using questionnaires and blood tests from November, 2003 to June, 2004. Data was analyzed with descriptive statistics, Pearson correlation, Spearman rho and t-test using the SPSS WIN 10.0 program.

Result

The prevalence of depression(CES-D=16) among the participants was 44.1%. The levels of self-care activities(p=.012), glucose(p=.019), total cholesterol(p=.022), LDL(.007) and cardiovascular risk factors(p=.012) were significantly higher in the depressed group than those in the non-depressed group.

Conclusion

Based on the findings, we concluded that many DM patients experience depression and the depression of type 2 DM clients is significantly related with self care activities, diabetic control, and cardiovascular complications. However, this study did not address causality among these variables. Therefore, further research, such as a longitudinal cohort study, is needed to identify causality among these variables.

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The Effects of a Diabetic Educational Program for Coping with Problem Situation on Self-efficacy, Self care behaviors, Coping and Glycemic Control in Type 2 Diabetic Patients
Choun Hee Ko, Mee Ock Gu
Journal of Korean Academy of Nursing 2004;34(7):1205-1214.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.7.1205
AbstractAbstract PDF
Purpose

This study was conducted to develop and to test the effects of an educational program for coping with problem situations as a nursing intervention in the diabetic patient.

Method

A non-equivalent control group pretest-posttest design was used in this study. Data were collected from January to March, 2002. The subjects of the study consisted of 31 diabetic patients(experimental group : 17 patients, control group : 14 patients). The intervention of an educational program for coping with problem situations was applied to the experimental group for 4weeks(total 8 hours). Data were collected before the educational program, immediately after and 1 months later and were analyzed with repeated measures ANOVA, t-test, and paired t-test.

Result

1. There was a significant difference in self efficacy between the experimental and control groups (F=13.793, p=0.001). 2. There was a significant difference in self care behavior between the experimental and control groups (F=4.583, p=0.041). 3. There was a significant difference in coping behavior of the problem situation between the experimental and control groups (F=62.018, p=0.000). There was a significant difference according to experimental stages(F=4.546, p=0.015) and interaction between education and experimental stages(F=12.039, p=0.000). 4. There was a significant difference in glycemic control between the experimental and control groups (t=-3.112, p=0.004).

Conclusion

These results support that a diabetic educational program for coping with problem situations is effective in promoting and maintaining self efficacy, self care behavior, problem coping behaviors and in improving glycemic control. Thus this program can be recommended as an effective nursing intervention of in-depth education for diabetic patient.

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The Effects of a Foot-Reflexo-Massage Education Program on Foot Care in Diabetic Patients
Young Hee Lee
Journal of Korean Academy of Nursing 2003;33(5):633-642.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.5.633
AbstractAbstract PDF
Purpose

This study was conducted to evaluate the effects of foot care education program using foot-reflexo-massage in diabetic patients.

Method

A convenience sample of non-equivalent control group time series design was used. It provided foot care education to diabetic patients through small book for both group. For the experimental group, foot-reflexo-massage was taught by a researcher and research assistants. Analysis was done by Repeated Measured ANOVA.

Result

There was significant increase in foot care knowledge, self care behavior, between the experimental group and the control group over three different times. There was significant in skin temperature and pulse of foot over three different times and interaction by groups or over time, but there was no significant difference between groups. There was no significant difference in blood flow volume and capillary filling time over three different times, between groups, but there was interaction by groups or over time. But there was significant difference in discrimination in change of dosalis pedis artery blood flow.

Conclusion

Findings indicate that this study may contribute to develop nursing intervention for foot care of diabetic patients.

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Structural Equation Modeling of Self-Management of Liver Transplant Recipients
Mi-Kyeong Jeon, Yeon-Hwan Park
J Korean Acad Nurs 2017;47(5):663-675.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.5.663
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to construct and test a structural equation model of self-management of liver transplant recipients based on self-determination theory.

Methods

Participants were 275 outpatients who received liver transplantation. A structured self-report questionnaire was used to assess health care providers’ autonomy support, transplant-related characteristics, illness consequence perception, autonomy, competence, family relatedness, depression and self-management. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0 program.

Results

The modified model showed a good fitness with the data: GFI=.96, RMSEA=.06, CFI=.96, NFI=.93, TLI=.93, PGFI=.43, PNFI=.49. The health care providers’ autonomy support, competence, family relatedness and depression were factors with a direct influence on the self-management of liver transplant recipients. The health care providers’ autonomy support and illness consequence perception had an indirect influence through competence, family relatedness and depression. However, the transplant-related characteristics and autonomy did not have a significant effect on self-management. This model explained 59.4% of the variance in self-management.

Conclusion

The result suggests that continuous education must be done to promote the competence of liver transplant recipients and to encourage the patient to positively perceive their current health condition with a view that enhances one's self-management. Additionally, the liver transplant recipients should be screened for depression, which would affect self-management. Most of all, health care providers, who have the most influence on self-management, should improve therapeutic communication and try to form a therapeutic relationship with the liver transplant recipients.

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Effects of Education about Action Plans according to Self-Monitoring on Self-Management Adherence, Knowledge, Symptom Control, and Quality of Life among Adult Asthma Patients: A Randomized Controlled Trial
Ja Yun Choi, Young-Ran Kweon
J Korean Acad Nurs 2017;47(5):613-623.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.5.613
AbstractAbstract PDF
Abstract Purpose

This study was conducted to identify the effects of education regarding action plans according to a self-monitoring program on self-management adherence, knowledge, symptom control, and health-related quality of life (HRQoL) among adults with asthma.

Methods

Thirty-four patients were randomly assigned to the intervention group and thirty-two to the control group in this study. A tailored 50-minute intervention based on the contents of self-monitoring and action plans developed by the National Heart Lung and Blood Institute was provided to the intervention group. Structured and well developed questionnaires were used to measure the dependent variables.

Results

There were no differences in all general and clinical characteristics, and the dependent variables between two groups in the pre-test. In the post-test, there were differences in the level of self-management adherence (t=4.41, p<.001), knowledge (t=2.26, p=.027), symptom control (t=-2.56, p=.013), and total HRQoL (t=2.14, p=.036) between the two groups, although there was a difference only in the sub-domain of emotion (t=2.03, p=.047) in HRQoL.

Conclusion

This study found that action plans according to self-monitoring that enhance a participatory interaction in the treatment and care could help patients with moderate to severe asthma to engagead equately in self-care, to control their symptoms, and to improve their HRQoL. Further studies are still needed to identify longitudinal effects of this program.

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Structural Equation Modeling on Self-Care Behavior and Quality of Life in Older Adults with Diabetes Using Citizen Health Promotion Centers
Songheun Lee, Hyunli Kim
J Korean Acad Nurs 2017;47(4):514-525.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.4.514
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to construct and test a structural equation model for Diabetes self-management (DSM) behavior and Quality of life (QoL) in older adults with diabetes who use Citizen Health Promotion Centers. The theory used this study was a combination of the Information-Motivation-Behavioral Model (IMB) and Self-Determination Theory (SDT) to reflect autonomous characteristics of participants.

Methods

Data were collected from April 20 to August 31, 2015 using a self-report questionnaire. The sample was 205 patients with type 2 Diabetes who regularly visited a Citizen Health Promotion Center. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factor affecting the participants’ DSM behavior and QoL.

Results

The supported hypotheses were as follows; 1) The variable that had a direct effect on QoL was health behavior adherence (γ=.55, p=.007). 2) The variables that had a direct effect on DSM behavior were DSM information (γ=.15, p=.023), DSM confidence (γ=.25, p<.001), and autonomous motivation (γ=.13, p=.048). 3) The variable that had a direct effect on DSM confidence was autonomy support (γ=.33, p<.001).

Conclusion

The major findings of this study are that supporting patient's autonomous motivation is an influential predictor for adherence to DSM behavior, and integrative intervention strategies which include knowledge, experience and psychosocial support are essential for older adults with diabetes to continue DSM behavior and improve QoL.

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Development and Effects of a Motivational Interviewing Self-management Program for Elderly Patients with Diabetes Mellitus
Hye-Yeon Kang, Mee Ock Gu
J Korean Acad Nurs 2015;45(4):533-543.   Published online August 31, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.4.533
AbstractAbstract PDF
Purpose

This study was conducted to develop and test the effects of a motivational interviewing self-management program for use with elderly patients with diabetes mellitus.

Methods

A non-equivalent control group pretest-posttest design was used. The participants were 42 elderly diabetic patients (experimental group: 21, control group: 21). The motivational interviewing self-management program for elders with diabetes mellitus developed in this study consisted of a 12-week program in total (8 weeks for group motivational interviewing and education and 4 weeks for individual motivational interviewing on the phone). Data were collected between February 13 and May 3, 2013 and were analyzed using t-test, paired t-test, and repeated measure ANOVA with SPSS/WIN 18.0.

Results

For the experimental group, significant improvement was found for self-efficacy, self-care behavior, glycemic control and quality of life (daily life satisfaction, influence of disease) as compared to the control group.

Conclusion

The study findings indicate that the motivational interviewing self-management program is effective and can be recommended as a nursing intervention for elderly patients with diabetes mellitus.

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Influence of Uncertainty and Uncertainty Appraisal on Self-management in Hemodialysis Patients
Hyung Suk Jang, Chang Suk Lee, Young Hee Yang
J Korean Acad Nurs 2015;45(2):271-279.   Published online April 30, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.2.271
AbstractAbstract PDF
Purpose

This study was done to examine the relation of uncertainty, uncertainty appraisal, and self-management in patients undergoing hemodialysis, and to identify factors influencing self-management.

Methods

A convenience sample of 92 patients receiving hemodialysis was selected. Data were collected using a structured questionnaire and medical records. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlations and multiple regression analysis with the SPSS/WIN 20.0 program.

Results

The participants showed a moderate level of uncertainty with the highest score being for ambiguity among the four uncertainty subdomains. Scores for uncertainty danger or opportunity appraisals were under the mid points. The participants were found to perform a high level of self-management such as diet control, management of arteriovenous fistula, exercise, medication, physical management, measurements of body weight and blood pressure, and social activity. The self-management of participants undergoing hemodialysis showed a significant relationship with uncertainty and uncertainty appraisal. The significant factors influencing self-management were uncertainty, uncertainty opportunity appraisal, hemodialysis duration, and having a spouse. These variables explained 32.8% of the variance in self-management.

Conclusion

The results suggest that intervention programs to reduce the level of uncertainty and to increase the level of uncertainty opportunity appraisal among patients would improve the self-management of hemodialysis patients.

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Development and Evaluation of the Empowering A Self-Efficacy (EASE) Program for Children with Epilepsy
Hana Yoo, Hee-Soon Kim
J Korean Acad Nurs 2015;45(1):54-63.   Published online February 27, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.1.54
AbstractAbstract PDF
Purpose

The purpose of this study was to verify effects of the Empowering A Self-Efficacy (EASE) program on self-efficacy, self-management, and child attitude toward illness in children with epilepsy.

Methods

This was a quasi-experimental study with a non-equivalent control group pre-post test design. Participants were 10 to 15 year old children with epilepsy (11 in the experimental group and 10 in the control group) who were registered at one hospital in S city. The experimental group received the EASE program for 3 weeks. In the first week, a group meeting lasting 570 minutes was conducted on a single day. Over the next two weeks, telephone counselling was conducted twice a week. Data were analyzed using SPSS 18.0.

Results

There was a significant difference of pre-post evaluation of the epilepsy self-management scores in the experimental group. However, differences between the experimental group and the control group for seizure self-efficacy and child attitude toward illness were not significant.

Conclusion

This is the first study in Korea to develop and evaluate an intervention program for children with epilepsy. Further studies are needed to confirm the effects of the EASE program.

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Effectiveness of a Self-management Program using Goal Setting based on a G-AP for Patients after a Stroke
Min Gyeong Park, Yeongmi Ha
J Korean Acad Nurs 2014;44(5):581-591.   Published online October 31, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.5.581
AbstractAbstract PDF
Purpose

This study was conducted to develop a self-management program using goal setting for patients after a stroke. The program was based on a theory-based Goal setting and Action Planning framework (G-AP), and the effectiveness of the program was examined.

Methods

A non-equivalent control group pretest-posttest design was used. The experimental group (n=30) received the self-management program using goal setting based on the G-AP over 7 weeks. The education was delivered individually with a specifically designed stroke workbook. The control group (n=30) received only patient information leaflets about stroke.

Results

There were significant differences between the two groups. Stroke knowledge, self-efficacy, and health behavior compliance were significantly higher (all p<.001), and hospital anxiety (p<.001) and depression (p<.001) were significantly lower in the experimental group compared to the control group.

Conclusion

This self-management program using goal setting based on a G-AP was found to be useful and beneficial for patients in stroke rehabilitation settings.

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Evaluation of a Community Health Practitioner Self-care Program for Rural Korean Patients with Osteoarthritis
Chung Yul Lee, Yoon Hee Cho
J Korean Acad Nurs 2012;42(7):965-973.   Published online December 12, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.7.965
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to evaluate a self-care program for elders with osteoarthritis managed by primary health care workers, Community Health Practitioners (CHPs), in rural Korea.

Methods

The self-care program, consisting of 7 areas, was evaluated with a randomized experimental study for patients over age 60 with osteoarthritis in which 150 participants in the experimental group and 140 in the control group were compared. The self-care program was implemented for six weeks, 2 hours per week, at community health posts by CHPs. Data were collected using an interview questionnaire given by the CHPs and laboratory tests before and after the intervention for both groups. Propensity score matching analysis was done to test effectiveness after controlling for confounding variables.

Results

The intervention group showed a significant decrease in the number of painful joints (p<.001) and a significant increase in self-care ability (p<.05) compared to the control group.

Conclusion

Study results indicate that training and utilizing primary health care workers in rural areas is valuable in increasing the generalization and continuity of intervention programs. As arthritis should be managed life-long, CHP directed self-care programs are useful interventions for rural elders with arthritis to learn self-care management.

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Development and Evaluation of a Program to Promote Self Management in Patients with Chronic Hepatitis B
Jin-Hyang Yang
J Korean Acad Nurs 2012;42(2):258-268.   Published online April 30, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.2.258
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the effects of the program to promote self management for patients with chronic hepatitis B.

Methods

The research was a quasi-experimental design using a non-equivalent control group pre-post test. The participants were 61 patients, 29 in the experimental group and 32 in the control group. A pretest and 2 posttests were conducted to measure main variables. For the experimental group, the self-management program, consisting of counseling-centered activities in small groups, was given for 6 weeks. Data were analyzed using χ2, t-test, and repeated measures ANOVA with PASW statistics program.

Results

There were statistically significant increases in knowledge, self-efficacy, active ways of coping, and self-management compliance but not in passive ways of coping in the experimental group compared to the control group over two different times.

Conclusion

The results of this study indicate that the self-management program is effective in increasing knowledge, self-efficacy, active ways of coping, and self-management compliance among patients with chronic hepatitis B. Therefore, it can be usefully utilized in the field of nursing for patients with chronic disease as a nursing intervention for people with chronic hepatitis B.

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Effects of Community-based Case Management Program for Clients with Hypertension
Ae-Young So, Yun-Mi Kim, Eun-Young Kim, Chang-Yup Kim, Cheol-Hwan Kim, Hee-Gerl Kim, Eun-Young Shin, Weon-Seob Yoo, Ggod-Me Yi, Kyung-Ja June
J Korean Acad Nurs 2008;38(6):822-830.   Published online December 31, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.6.822
AbstractAbstract PDF
Purpose

The purpose of this study was to analyze effects of a community-based case management program for clients with hypertension living in the community.

Methods

The research design was a one group pre and post-test design with 30 participants with hypertension who agreed to participate in the 8-12 week case management program provided by case managers from the National Health Insurance Corporation in 2002. Data were collected three times, before and after the case management services, and 6 months later. Outcomes included changes in blood pressure, knowledge of hypertension and daily life practices, including alcohol consumption, smoking, exercise, and medication adherence.

Results

Repeated-measures ANOVA and post-hoc tests of means revealed significant differences before and after service for systolic blood pressure, daily life practices (monitoring body weight and BP, low salt and cholesterol and high vegetable diet, and stress-relief practices), and exercise. The goal for medication adherence was attained after service. Significant improvements from baseline to 6 months after service were observed in measures of salt and vegetables in diet. There were no significant differences on hypertension knowledge, alcohol consumption or smoking behavior between before service and after, and at 6 months.

Conclusion

The findings provide preliminary evidence that case management intervention can have positive outcomes on BP control, daily life practices, exercise, and medication adherence for clients with hypertension. However, additional interventions are needed to sustain long-term effects.

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J Korean Acad Nurs : Journal of Korean Academy of Nursing
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