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19 "Structural Model"
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Original Articles
Scale Development and Model Validation for the Process of Exercise Engagement for People with Prediabetes
Chang, Shu-Chuan , Yeh, Hsiu-Chen , Kuo, Yu-Lun
J Korean Acad Nurs 2020;50(2):298-312.   Published online April 30, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.2.298
AbstractAbstract PDF
Purpose
This study had two objectives: 1) to develop a scale for the process of exercise engagement (SPEE) for prediabetic individuals (PDIs); 2) to validate a structural model for the process of exercise engagement for PDIs.
Methods
A cross-sectional survey with simple random sampling was conducted from September 2013 to December 2015 (in Taiwan). A total of 310 PDIs were enrolled for scale development and model validation via item analysis, factor analyses, and structural equation modeling. The Kuo model was used as the basis for developing the Chinese version of the SPEE for PDIs.
Results
The SPEE contains five subscales with a total of twenty-one items that account for 54.9% to 65.9% of the total variance explained for assessing participants’ process of engagement during exercise. For Kuo model validation, the model measures indicated goodness of fit between the Kuo model and sample data. Analysis further revealed a direct effect between the creating health blueprints (CHB) stage and the spontaneous regular exercise (SRE) stage (b=.60).
Conclusion
The SPEE includes five subscales for assessing the psychological transition and behavioral expression at each stage of the process of exercise engagement for PDIs. The SPEE for people with prediabetes provides deeper insights into the factors of behavioral change stages that are required to initiate long-term health care outcomes and avoid developing diabetes. These insights are significant as they allow for patient- specific mapping and behavior modification to effect exercise.
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Testing a Model to Predict Problem Gambling in Speculative Game Users
Hyangjin Park, Suk-Sun Kim
J Korean Acad Nurs 2018;48(2):195-207.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.2.195
AbstractAbstract PDF
Abstract Purpose

The purpose of the study was to develop and test a model for predicting problem gambling in speculative game users based on Blaszczynski and Nower's pathways model of problem and pathological gambling.

Methods

The participants were 262 speculative game users recruited from seven speculative gambling places located in Seoul, Gangwon, and Gyeonggi, Korea. They completed a structured self-report questionnaire comprising measures of problem gambling, negative emotions, attentional impulsivity, motor impulsivity, non-planning impulsivity, gambler's fallacy, and gambling self-efficacy. Structural Equation Modeling was used to test the hypothesized model and to examine the direct and indirect effects on problem gambling in speculative game users using SPSS 22.0 and AMOS 20.0 programs.

Results

The hypothetical research model provided a reasonable fit to the data. Negative emotions, motor impulsivity, gambler's fallacy, and gambling self-efficacy had direct effects on problem gambling in speculative game users, while indirect effects were reported for negative emotions, motor impulsivity, and gambler's fallacy. These predictors explained 75.2% problem gambling in speculative game users.

Conclusion

The findings suggest that developing intervention programs to reduce negative emotions, motor impulsivity, and gambler's fallacy, and to increase gambling self-efficacy in speculative game users are needed to prevent their problem gambling.

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A Structural Model for Premenstrual Coping in University Students: Based on Biopsychosocial Model
Myung-Ock Chae, Hae Ok Jeon, Ahrin Kim
J Korean Acad Nurs 2017;47(2):257-266.   Published online April 28, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.2.257
AbstractAbstract PDF
Purpose

The aims of this study were to construct a hypothetical structural model which explains premenstrual coping in university students and to test the fitness with collected data.

Methods

Participants were 206 unmarried women university students from 3 universities in A and B cities. Data were collected from March 29 until April 30, 2016 using self-report structured questionnaires and were analyzed using IBM SPSS 23.0 and AMOS 18.0.

Results

Physiological factor was identified as a significant predictor of premenstrual syndrome (t=6.45, p<.001). This model explained 22.1% of the variance in premenstrual syndrome. Psychological factors (t=-2.49, p=.013) and premenstrual syndrome (t=8.17, p<.001) were identified as significant predictors of premenstrual coping. Also this model explained 30.9% of the variance in premenstrual coping in university students. A physiological factors directly influenced premenstrual syndrome (β=.41, p=.012). Premenstrual syndrome (β=.55, p=.005) and physiological factor (β=.23, p=.015) had significant total effects on premenstrual coping. Physiological factor did not have a direct influence on premenstrual coping, but indirectly affected it (β=.22, p=.007). Psychological factors did not have an indirect or total effect on premenstrual coping, but directly affected it (β=-.17, p=.036).

Conclusion

These findings suggest that strategies to control physiological factors such as menstrual pain should be helpful to improve premenstrual syndrome symptoms. When developing a program to improve premenstrual coping ability and quality of menstrual related health, it is important to consider psychological factors including perceived stress and menstrual attitude and premenstrual syndrome.

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Determinants of Health Promoting Behavior of Middle Aged Women in Korea
Sook Ja Lee, Eun Sook Park, Young Joo Park
Journal of Nurses Academic Society 1996;26(2):320-336.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.2.320
AbstractAbstract PDF

Health promoting behaviors of an individual are affected by various variables. Recently, there has been a growing concern over important health problems of the middle aged women. Physiological changes in the middle aged women and their responsibility for family care can result in physical and psychological burden experienced by middle aged women. This study was designed to test Pender's model and thus purpose a model that explains health promoting behaviors among middle-aged women in Korea. The hypothetical model was developed based on the Pender's health promoting model and the findings from past studies on women's health. Data were collected by self-reported questionnaires from 863 women living in Seoul, between 20th, April and 15th, July 1995. Data were analyzed using descriptive statistics and correlation analysis. The Linear Structural Relationship (LISREL) modeling process was used to find the best fit model which assumes causal relationships among variables. The results are as follows; 1. The overall fit of the hypothetical model to the data was good expect chi -square value (GFI=.96, AGFI=.91, RMR=.04). 2. Paths of the model were modified by considering both its theoretical implication and statistical significance of the parameter estimates. Compared to the hypothetical model, the revised model has become parsimonious and had a better fit to the data expect chi-square value (GFI=. 95, AFGI=.92, RMR=.04). 3. Some of modifying factors, especially age, occupation, educational levels and body mass index (BMI) are revealed significant effects on health promoting behaviors. 4. Some of cognitive -perceptual factors, especially internal health locus of control, self-efficacy and perceptive health status are revealed significant effects on health promoting behaviors. 5. All predictive variables of health promoting behaviors, especially age, occupation, educational levels, body mass index(BMI), internal health locus of control, self-efficacy and perceptive health status are explained 20.0% of the total variance in the model.

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Construct a Structural Model for Health Promoting Behavior of Chronic Illness
Sook Ja Lee, So In Kim, Pyoung Sook Lee, Soon Yong Khim, Eun Sook Park, Young Joo Park, Ho Shin Ryu, Sung Ok Chang, Kuem Sun Han
Journal of Korean Academy of Nursing 2002;32(1):62-76.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.1.62
AbstractAbstract PDF

PURPOSE: This study was designed to construct a structural model for health promoting behavior of patients with chronic disease. The hypothetical model was developed based on the literature review and Pender's health promotion model.
METHOD
Data was collected by questionnaires from 1748 patients with chronic disease in General Hospital from December 1999 to July 2000 in Seoul. The disease of subject were cardiac disease included hypertension peptic ulcer, pulmonary disease included COPD and asthma, DM, and chronic kidney disease. Data analysis was done with SAS 6.12 for descriptive statistics and PC-LISREL 8.13 Program for Covariance structural analysis.
RESULTS
1. The fit of the hypothetical model to the data was moderate, it was modified by excluding 4 path and including free parameters to it. The modified model with path showed a good fitness to the empirical data (x2=591.83, p<.0001, GFI=0.97, AGFI= 0.94, NNFI=0.95, RMSR=0.01, RMSEA=0.05). 2. The perceived benefits, perceived barriers, self-efficacy, self-esteem, and the plan for action were found to have significant direct effect on health promoting behavior of chronic disease. 3. The health concept, health perception, emotional state, social support were found to have indirect effects on health promoting behavior of chronic disease.
CONCLUSION
The derived model in this study is considered appropriate in explaining and predicting health promoting behavior of patients with chronic disease. Therefore, it can effectively be used as a reference model for further studies and suggested implication in nursing practice.

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A Structural Model for Health Promoting Behaviors in Patients with Chronic Respiratory Disease
Young Joo Park, So In Kim, Pyoung Sook Lee, Soon Yong Khim, Sook Ja Lee, Eun Sook Park, Ho Shin Ryu, Sung Ok Chang, Kuem Sun Han
Journal of Korean Academy of Nursing 2001;31(3):477-491.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.3.477
AbstractAbstract PDF

PURPOSE: This study was designed to construct a structural model for health promoting behavior in patients with chronic respiratory disease. A hypothetical model was developed based on the literature review. METHOD: Data was collected by questionnaires from 235 patients with chronic respiratory disease in a General Hospital in Seoul. Data analysis was done using SAS 6.12 for descriptive statistics and the PC-LISREL 8.13 Program for Covariance Structural Analysis. RESULT: The results are as follows : 1. The fit of the hypothetical model to the data was moderate. It was modified by excluding 2 path and including free parameters and 3 path to it. The modified model with path showed a good fitness to the empirical data(X2=80.20, P=0.05, GFI=0.95, AGFI=0.88, NNFI=0.95, NFI=0.96, RMSR=0.01, RMSEA =0.06). 2. The perceived benefits, self-efficacy, and a plan of action were found to have significant direct effects on the health promoting behavior in patients with chronic respiratory disease. 3. The health perception, self-esteem, and activity related to affect were found to have indirect effects on the health promoting behavior in patients with chronic respiratory disease. CONCLUSION: The modified model of this study is considered appropriate in explaining and predicting health promoting behavior in patients with chronic respiratory disease. Therefore, it can effectively be used as a reference model for further studies and suggested direction in nursing practice.

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A Structural Model Based on Pender's Model for Quality of Life of Chronic Gastric Disease
Eun Sook Park, So In Kim, Pyoung Sook Lee, Soon Yong Khim, Sook Ja Lee, Young Joo Park, Ho Shin Ryu, Sung Ok Chang, Kuem Sun Han
Journal of Korean Academy of Nursing 2001;31(1):107-125.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.1.107
AbstractAbstract PDF

This study was designed to construct a structural model for quality of life of chronic gastric disease. The hypothetical model was developed based on the literature review and Pender's health promotion model. Data were collected by questionnaires from 459 patients with chronic gastric disease in a General Hospital from July 1999 to August 2000 in Seoul. Data analysis was done with SAS 6.12 for descriptive statistics and PC-LISREL 8.13 Program for Covariance structural analysis. The results are as follows : 1. The fit of the hypothetical model to the data was moderate, thus it was modified by excluding 1 path and including free parameters and 2 path to it. The modified model with path showed a good fitness to the empirical data (Chi2=934.87, p<.0001, GFI=0.88, AGFI=0.83, NNFI=0.86, RMSR =0.02, RMSEA=0.07). 2. The perceived barrier, health promoting behavior, self-efficacy, and self-esteem were found to have significant direct effects on the quality of life. 3. The health concept, health perception, emotional state, and social support were found to have indirect effects on quality of life of chronic gastric disease. In conclusion, the derived model in this study is considered appropriate in explaining and predicting quality of life of chronic gastric disease. Therefore it can effectively be used as a reference model for further studies and suggested direction in nursing practice.

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Structural Model Of Delinquent Behavior Influencing by Media Violence
Hyun Sil Kim
Journal of Korean Academy of Nursing 2000;30(1):148-159.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.1.148
AbstractAbstract PDF

The purpose of this study was to test the theoretical model designed to explain juvenile delinquency by media violence. Data were collected through questionnaire survey over a period of 3 months. Subjects served for this study consisted of 537 adolescents including 217 delinquent adolescents and 320 student adolescents in Korea, sampled from Korean student population and delinquent adolescent population confined in juvenile correctional institutions, using proportional stratified random sampling method. In this study, exogeneous variable was family dynamic environment and endogeneous variables were character of adolescent including need satisfaction/ frustration, sociability, antisocial personality tendency, complaints of psychosomatic symptoms and depressive trend, juvenile delinquent behavior and media violence themes including the extent of interest in and exposure and modelling impulsiveness and modelling to media violence themes. A total of 18 instruments were used to operationalized concepts in this model. A validation study indicated that internal consistencies for the 18 instruments which the researcher used were reliable. The one month test-retest correlation for these instruments ranged from 0.54 to 0.88. Statistical methods employed were descriptive statistics and covariance structural modelling. In summarized conclusion, it was found that media violence served as the most contributor to juvenile delinquency by direct effect of 0.64(t=10.18). That is, as the adolescents have to be the higher extent of interest in and exposure and modelling impulsiveness and modelling to media violence themes, they will show the more frequency of delinquent behavior. The single most powerful contributor by total effect of 0.73(t=7.90) (direct effect=0.19, indirect effect=0.54) to the development of delinquent behavior identified in this study was a construct defining family dynamic environment. That is, as the adolescents had to be more unstable family dynamic environment, they became more frustrated to their psychological need, and revealed the more maladaptive personality pattern, consequently they behaved the higher misconducts such as juvenile delinquency through media violence.

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A Model for Quality of Life of Family Caregivers with a Chronically Ill Patient
Eun Sook Park, Sook Ja Lee, Young Joo Park
Journal of Korean Academy of Nursing 1998;28(2):344-357.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.2.344
AbstractAbstract PDF

This study was designed to construct a model that predicts the quality of life of family caregivers with a chronically ill patient. The hypothetical model wad developed based on the findings from past studies on quality of life and on the family with a chronically ill patients. Data were collected by self-reported questionnaires from 200 family caregivers in Seoul and Kyung Gi-Do, from May 1 to July 21, 1997. Data were analyzed using descriptive statistics and correlation analysis. The Linear Structural Relationship(LISREL) modeling process was used to find the best fit model which predicts causal relationships among variables. The results are as follows: 1. The overall fit of the hypothetical model to the data was moderate [X2=31.54(df=23, p=.11), GFI=.96, AGFI=.91, RMR=.04]. 2. Paths of the model were modified by considering both its theoretical implication and the statistical significance of the parameter estimates. Compared to the hypothetical model, the revised model has become parsimonious and had a better fit to the data expect chi-square value(GFI=.95, AGFI=.91, RMR=.04). 3. Some of predictive factors, especially economic status, physical ability to perform daily-life activity, period after disease-onset, social support and fatigue revealed indirect effect on the quality of life of family caregivers with a chronically ill patient. 4. The factors, burden and role satisfaction revealed significant direct effects on the quality of life of family caregivers with a chronically ill patient. 5. All predictive variables of quality of life of family caregivers with a chronically ill patient, especially economic status, physical ability to perform daily-life activity, period after disease-onset, social support, fatigue, burden and role satisfaction explained 38.0% of the total variance in the model. In conclusion, the derived model in this study is considered appropriate in explaining and predicting quality of life of family caregivers with a chronically ill patient. Therefore it can effectively be used as a reference model for further studies and suggests direction in nursing practice.

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Prediction Model on Mental Health Status in Middle-aged Women of an Urban Area
Pyong Sook Lee, Jung Nam Sohn, Yong Mi Lee, Hyun Cheol Kang
Journal of Korean Academy of Nursing 2005;35(2):239-251.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.2.239
AbstractAbstract PDF
Purpose

This study was designed to construct a structural model for explaining mental health status in middle - aged women.

Methods

The data was collected by self - reported questionnaires from 206 middle - aged women in Seoul. Data analysis was done with the SAS pc program for descriptive statistics and a PC - LISREL Program for finding the best fit model which assumes causal relationships among variables.

Results

The overall fit of the hypothetical model to the data was good, but paths and variables of the model were modified by considering theoretical implications and statistical significances of parameter estimates. Thus it was modified by excluding 3 paths. The modified model showed was good fit to the data(χ2=177.55, p=.00), GFI=0.908, AGFI=0.860, RMR=0.013, NFI=0.972, NNFI=0.982). Perceived stress, anger expression method, and self -esteem were found to have direct effects on mental health status in middle - aged women. These predictive variables of mental health status explained 66.6% of the model.

Conclusion

Programs to enhance mental health status in middle - aged women should include stress management skill, anger expression skill, and self-esteem enhancement skills to be effective.

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A Structural Model for Symptom Management of the Patients with Chronic Fatigue
Kuem Sun Han
Journal of Korean Academy of Nursing 2004;34(2):333-343.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.2.333
AbstractAbstract PDF
Purpose

This study was designed to construct a structural model for symptom management of life of the patients with chronic fatigue. The hypothetical model was developed based on the literature review and Self-regulating Model.

Method

Data were collected by questionnaires from 252 patients with chronic fatigue in the 8 community from December 2002 to April 2003 in Seoul. Data analysis was done with SAS for descriptive statistics and PC-LISREL Program for Covariance structural analysis.

Result

The fit of the hypothetical model to the data was moderate, thus it was modified by excluding 4 path and including free parameters and 3 path to it. The modified model with path showed a good fitness to the empirical data(χ2=318.11, p=0.0, GFI= .98, AGFI= .98, NNFI= .95, RMSR= .03, RMSEA= .05). The symptoms of stress, self-efficacy, and present fatigue level were found to have significant direct effect on symptom management of the patients with chronic fatigue. The ways of coping, perceived stress, and fatigue symptom were found to have indirect effects on symptom management of the patients with chronic fatigue.

Conclusion

The derived model is considered appropriate in explaining and predicting symptom management of the patients with chronic fatigue. Therefore, it can effectively be used as a reference model for further studies and suggested direction in nursing practice.

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Prediction on the Negative Outcomes of Anger in Female Adolescents
Young Joo Park, Kuem Sun Han, Hyun Jeong Shin, Hyun Chul Kang, Sook Hee Chun, So Hyun Moon, Young Sik Lee, Hun Soo Kim
Journal of Korean Academy of Nursing 2004;34(1):172-181.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.1.172
AbstractAbstract PDF
Purpose

This study was designed to construct a structural model for explaining negative outcomes of anger in female adolescents.

Method

Data was collected by questionnaires from 199 female adolescents ina female high school in Seoul. Data analysis was done with SAS for descriptive statistics and a PC-LISREL Program for Covariance structural analysis.

Result

The fit of the hypothetical model to the data was moderate, thus it was modified by excluding 7 paths and adding free parameters to it. The modified model withthe paths showed a good fit to the empirical data(χ2 =5.62, p=.69, GFI=.99, AGFI=.97, NFI=.99, NNFI=1.01, RMSR=.02, RMSEA=.00). Trait anger, state anger, and psychosocial problems were found to have a significant direct effect on psychosomatic symptoms. State anger, psychosocial problems, and learning behaviorswere found to have direct effects on depression of female adolescents.

Conclusion

The derived modelis considered appropriate for explaining and predicting negative outcomes of anger in female adolescents. Therefore, it can effectively be used as a reference model for further studies and is a suggested direction in nursing practice.

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Structural Equation Model for Caregiving Experience of Families Providing Care for Family Members with Mental Disorders
In Ohg Oh, Sunah Kim
J Korean Acad Nurs 2015;45(1):97-106.   Published online February 27, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.1.97
AbstractAbstract PDF
Purpose

This study was done to develop and test a structural model for caregiving experience including caregiving satisfaction and caregiving strain in families providing care for family members with a mental disorder.

Methods

The Stress-appraisal-coping model was used as the conceptual framework and the structural equation model to confirm the path that explains what and how variables affect caregiving experience in these families. In this hypothesis model, exogenous variables were optimism, severity of illness and uncertainty. The endogenous variables were self efficacy, social support, caregiving satisfaction and caregiving strain. Data were collected using structured questionnaires.

Results

Optimism and caregiving self-efficacy had significant direct and indirect effects on caregiving satisfaction. Optimism, severity of illness and uncertainty had significant direct and indirect effects on caregiving strain. The modified path model explained effects of optimism on caregiving self-efficacy with social support in the path structure as a mediator. Also, there were direct and indirect effects of optimism and uncertainty on caregiving satisfaction with social support and caregiving self-efficacy in the path structure as a mediators.

Conclusion

Results suggest the need to improve caregiving self-efficacy of these families, establish support systems such as a mental health professional support programs for caregiving self-efficacy. Optimism, severity of illness and uncertainty perceived by families need to be considered in the development of support programs in order to increase their effectiveness.

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A Structural Equation Modeling on Premenstrual Syndrome in Adolescent Girls
Jung-hee Jeon, Sun-kyung Hwang
J Korean Acad Nurs 2014;44(6):660-671.   Published online December 31, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.6.660
AbstractAbstract PDF
Purpose

The aims of this study were to construct a hypothetical structural model which explains the premenstrual syndrome (PMS) in adolescent girls and to test the fitness with collected data.

Methods

The participants were 1,087 adolescent girls from 3 high schools and 5 middle schools in B city. Data were collected from July 3 to October 15, 2012 using self-reported questionnaires and were analyzed using PASW 18.0 and AMOS 16.0 programs.

Results

The overall fitness indices of hypothetical model were good (χ2 =1555, p<.001), χ2/df=4.40, SRMR=.04, GFI=.91, RMSEA=.05, NFI=.90, TLI=.91, CFI=.92, AIC=1717). Out of 16 paths, 12 were statistically significant. Daily hassles had the greatest impact on PMS in the adolescent girls in this model. In addition, PMS in adolescent girls was directly affected by menarche age, Body Mass Index (BMI), amount of menstruation, test anxiety, social support, menstrual attitude and femininity but not by academic stress. This model explained 27% of the variance in PMS in adolescent girls.

Conclusion

The findings from this study suggest that nursing interventions to reduce PMS in adolescent girls should address their daily hassles, test anxiety, menstrual attitude and BMI. Also, social support from their parents, friends, and teachers needs to be increased.

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A Structural Model for Primiparas' Breastfeeding Behavior
Hyun-Joo Yang, Ji-Min Seo
J Korean Acad Nurs 2013;43(3):399-408.   Published online June 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.3.399
AbstractAbstract PDF
Purpose

The study was done to construct and test a structural model to explain primipara breastfeeding behavior.

Methods

The participants were 213 primiparas on postpartum wards. Data were analyzed using the PASW 18.0 and AMOS 19.0 programs.

Results

Fitness statistics for the hypothetical model were appropriate (χ2 =38.50, p=.070, GFI=.96, RMSEA=.05, AGFI=.93, NFI=.95, TLI=.97, CFI=.98, PNFI=.57, χ2/df=1.43). Breastfeeding behaviors were directly influenced by intention to breastfeed, perceived effectiveness of breastfeeding, and the amount of supplementary feeding. The amount of supplementary feeding had the largest direct impact on breastfeeding behavior. The largest total effect on breastfeeding behavior was intention to breastfeed. The environment of the maternity hospital indirectly influenced breastfeeding behavior. These factors explained 18.9% of variance in the primipara breastfeeding behavior.

Conclusion

The results of the study indicate that in order to promote primipara breastfeeding the amount of supplementary feeding immediately after the birth should be limited and an environment that encourages exclusive breastfeeding in the hospital should be provided. The results also suggest it is necessary to provide nursing interventions that increase the intention to breastfeed and the perceived effectiveness of breastfeeding.

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A Structural Model for Quality of Life of Infertile Women
Ju Hee Kim, Hye Sook Shin
J Korean Acad Nurs 2013;43(3):312-320.   Published online June 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.3.312
AbstractAbstract PDF
Purpose

The purpose of this study was to test a model for quality of life among infertile women. This model was based primarily on the concept of the Fertility Quality of Life by Boivin et al. (2011) and the Infertility Resilience Model by Rindenour (2009).

Methods

Fifteen measurable variables were used to estimate quality of life. They included endogenous variables such as fertility quality of life and resilience, and exogenous variables such as infertility related stress, depression, marital adjustment, and family support. Data sets (n=203) used for analysis were collected in a general hospital which had, on average, 400 assisted reproductive technologies per month.

Results

The assessment of the modified model indicated acceptable fit, with χ2/d.f=2.07, GFI=.90, AGFI=.89, NFI=.89, CFI=.91, RMSEA=.07. Depression, infertility related stress, marital adjustment, resilience, and family support had direct influences on quality of life.

Conclusion

The results of this study should contribute to the development of nursing intervention programs to enhance quality of life using factors that affect fertiQol (fertility quality of life) of infertile women.

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Structural Equation Modeling on Successful Aging in Elders - Focused on Selection · Optimization · Compensation Strategy -
Doo Nam Oh
J Korean Acad Nurs 2012;42(3):311-321.   Published online June 29, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.3.311
AbstractAbstract PDF
Purpose

This study was designed to construct and test a structural equation modeling on specific domain health status and the Selection · Optimization · Compensation (SOC) strategy affecting successful aging in elderly people.

Methods

The model construction was based on the SOC model by Baltes and Baltes. Interviews were done with 201 elderly people aged 65 or older. Interview contents included demographics, functional health status, emotional health status, social health status, SOC strategies, and successful aging. Data were analyzed using SPSS 15.0 and AMOS 7.0.

Results

Model fit indices for the modified model were GFI=.93, CFI=.94, and RMSEA=.07. Three out of 7 paths were found to have a significant effect on successful aging in this final model. Functional health status had a direct and positive effect on successful aging. Emotional health status influenced successful aging through SOC strategies.

Conclusion

This study suggests that interventions for improving functional health status and for strengthening SOC strategies are critical for successful aging. Continuous development of a variety of successful aging programs using SOC strategy is suggested.

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A Structural Model for Psychosocial Adjustment in Patients with Early Breast Cancer
Hye Young Kim, Hyang Sook So
J Korean Acad Nurs 2012;42(1):105-115.   Published online February 29, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.1.105
AbstractAbstract PDF
Purpose

This study was done to propose a structural model to explain and predict psychosocial adjustment in patients with early breast cancer and to test the model. The model was based on the Stress-Coping Model of Lazarus and Folkman (1984).

Methods

Data were collected from February 18 to March 18, 2009. For data analysis, 198 data sets were analyzed using SPSS/WIN12 and AMOS 7.0 version.

Results

Social support, uncertainty, symptom experience, and coping had statistically significant direct, indirect and total effects on psychosocial adjustment, and optimism had significant indirect and total effects on psychosocial adjustment. These variables explained 57% of total variance of the psychosocial adjustment in patients with early breast cancer.

Conclusion

The results of the study indicate a need to enhance psychosocial adjustment of patients with early breast cancer by providing detailed structured information and various symptom alleviation programs to reduce perceived stresses such as uncertainty and symptom experience. They also suggest the need to establish support systems through participation of medical personnel and families in such programs, and to apply interventions strengthening coping methods to give the patients positive and optimistic beliefs.

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Model Construction of Sexual Satisfaction in Patients with a Colostomy
Seungmi Park, Keum-Soon Kim
J Korean Acad Nurs 2009;39(4):539-548.   Published online August 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.4.539
AbstractAbstract PDF
Purpose

This study was designed to construct and test the structural equation model on sexual satisfaction in patients with a colostomy.

Methods

The model construction was based upon Roy's adaptation model. Stoma-related discomfort (SRD), age, frequency of sexual intercourse, treatment modality, and gender affect sexual satisfaction and are mediated by physical, psychosocial, and interdependence modes. Each mode was conceptualized as sexual function, body image/depression, and marital intimacy. The patients were 112 colostomates with colorectal cancer who were asked to complete a mail-back survey on their demographic data, SRD, body image, depression, marital intimacy, sexual function, and sexual satisfaction. Data were analyzed using SPSS WIN 15.0 and AMOS WIN 7.0.

Results

Significant variables for sexual satisfaction in the final model were body image affected by SRD, depression affected by body image and SRD, marital intimacy affected by depression, and sexual function affected by marital intimacy.

Conclusion

The results of this study suggest that specific guidelines for SRD are necessary to improve sexual satisfaction among colostomates. Nurses should be vigilant in monitoring depression and body image disturbance, and providing appropriate interventions to increase marital intimacy. Treatment modality, gender, and age should be considered in developing education programs pertaining to sexuality.

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