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4 "Structural models"
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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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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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