The purpose of this study was to identify how internal and external coping resources influenced active coping in the process of stress-coping. The model was established theoretically by comparing and integrating the following theories : Stress-Coping, Self-Care, and Resourcefulness. The subjects consisted of sixty eight patients undergoing chemotherapy(experimental group 34, control group 34) at two general hospitals from January to July, 1995, The results were as follows : After self-care education, the active coping score of the experimental group was significantly higher than that of the control group. The active coping score of the high resourcefulness group was significantly higher than that of the low resourcefulness group. The interaction effect between self-care education and resourcfulness was not significant statistically. Specifically as to such scores of seeking social support, problem-oriented strategy and self care behavior, there were significantly higher in the experimental group and high resourcefulness group than in each of the other groups. Considering them both, self-care education and resourcefulness are effective nursing strategies to promote active coping including self-care. Consequently, the synthesis and testing of theories of stress-coping, self-care, and resoucefulness in this study are mostly proven to enhance the explanation and prediction of the change of active coping including self-care. Therefore the result of this study will contribute in the development of practice theory of nursing. A further study is necessary to reevaluate the interaction effect between self-care education and resourcefulness and to identify the difference between resourcefulness and self-efficacy.

Most patients having leukemia suffer severely from emotional turmoil due to the generalized perception that cancer will be fatal. The conventional chemotherapy results in side effects such as severe bone marrow depression which interfere with self-care management, vital for improvement in their condition. Bandura's theory of the self-efficacy suggests that self-efficacy can be enforced by performance attainments, vicarious experiences, verbal persuasion and the release of emotional arousal. Self-efficacy can be enforced by a program of vicarious experiences and verbal persuasion, while the emotional arousal can be relieved through a hope promotion program. If once self-efficacy increases, the patient's self-care behaviors and the quality of life will also increase. The purpose of this study was to empirically test the effects of a program, to promote self-efficacy and hope, on self-care behaviors and quality of life in patients having leukemia. In this study, three types of approaches to enhance self-efficacy and hope were used : 1) a 20-minute long slide/tape for vagarious experiences ; 2) a 10-minute long telephone call coaching for verbal persuasion ; and 3)two booklets for information about the symptoms of leukemia and treatment modalities and hope promotion. Thirsty one patients were recruited in the experimental group and 29 in the control group with a nonequivalent pretest-posttest design. The subjects were patients with leukemia undergoing chemotherapy. Sherer and Maddux's self-efficacy scale, Nowotny's hope scale, and Padilla's quality of life scale were employed with some modifications. A self-care behavior scale was developed by the researchers. Statistical analyses including paired t-test, Chi-square, ANCOVA and ANOVA, were used. The results are as follows : The levels of self-efficacy, self-care behavior and quality of life were higher in the experimental group than in the control group after four weeks of intervention(F=28.71, P=.0001 ; F=63.35, P=.0001 ; F=16.57, P=.0001). After ten weeks of intervention, all of the dependent variables(self-efficacy, self-care behavior, hope and quality of life) in the experimental group were higher than in the control group(F=74.12, P=.0001 ; F=108.34, P=.0001 ; F=13.11, P=.001 ; F=43.52, P=.0001). In conclusion, self-care behavior and quality of life increased mainly through an increase an increase in self-efficacy, while increases in hope took more time and effort.

The Study of the Development of Efficacy Expectation Promoting Program and it's Effect for Cervical Spinal Cord Injury Patients. This study was conducted to develop on Efficacy Expectation Promoting Program (EEPP) based on the Self-Efficacy Theory of Bandura for Cervical Spinal Cord Injury Patient(CSCIP), and invesgated it's effects. The research process of this study was done in three phases. The first phase was an analysis of the patient's life experience. The second phase was to develop an Efficacy Expectation Promoting VTR Tape Program(EEPP) that reflected the life experience of the CSCIPs. EEPP was composed Performance Accomplishment and Vicarious Experience with a home visitation program based on Verbal Persuation, which are all induction modes of efficacy expectation of Bandura. The third phase was an experimental stage. The experimental design was an AB Single Experimental Design. Research subjects were three CSCIPs(cer-vical area 5-7). The data was collected from 24th June to 22th Oct, 1995. The result of the experimentation showed great increase self-efficacy score, subject self-care score, all competence of daily living score, and social activities. In conclusion, it was found that an EEPP is an effective home nursing intervention technique for rehabilitation of CSCIPs.

PURPOSE: This study was to identify and clarify the relationship between perceived health, self-esteem, and self-care agencies for promoting self care among Korean adolescents. METHOD: Data were collected from 817 adolescents in schools located in Seoul, Kyungki-do, and Chuncheon from Sept, 16th to Sept, 28th, 1999, and from Mar 10th to Mar 25th, 2000. The instruments used for this study were the Health Self-Rating Scale, Self-Care Agency Assessment Questionnaire (Denyes, 1981), the Self-Esteem Questionnaire (Rosenberg, 1971). RESULT: 1) The mean perceived health status among Korean adolescents was 8.75 (SD=1.72) 2) The mean self-esteem was 27.27 (SD=4.64). 3) The mean self-care agency was 99.64 (SD=21.02) and the average self-care agency score was 3.99 (SD=0.84). In the subcategories, the highest degree was feelings towards health (4.15), followed by ego strength (4.06), attending to health (3.87), general health knowledge (3.56), and the lowest degree was specific health knowledge (3.20) 4) There was statistical significant differences between demographic factors and self-care agencies, expecially, gender (t=28.65), grade (F=3.79), pocket money (t=5.72), and height (F=9.82) 5) The statistical relationship between perceived health status, self-esteem, and self-care agencies were found to have a positive correlation. 6) Self-care agencies among adolescents was the highest factor predicting self-esteem (15%). CONCLUSION: The relationship between perceived health status, self-esteem, and self-care agencies revealed a significant positive correlation among adolescents. Therefore, nursing intervention for adolescents needs to develop self-esteem programs to increase self-care agencies.

This study was conducted to identify a effect of the comprehensive self-regulation program for hypertensives as a nursing intervention on self-care performance and the physiologic parameters in rural areas. For this purpose, a nonequivalent control group and a pre and post-test quasi- experimental design was used. Fifty-four were evaluated subjects from two Community Health Practitioner Posts in the suburbs of Taejon City. The subjects of the control and experimental groups were matched for age and sex. The self-regulation program developed by author given to the experimental group. The program consisted of group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring, recording of self-care activities, and encouraging and reinforcing self-efficacy. The whole program was carried out from September to November of 1999. The data were analyzed by repeated measure ANCOVA, t-test, and ANCOVA. The results were as follows; There was significant improvement in the scores on knowledge (F=.68, P=.004), perceived self-efficacy (F=26.39, P=.000), self-care performance (F=26.11, P=.000) of the experimental group compared with those of the control group. There was no significant change on the score of locus of control, perceived benefits and perceived barrier, blood cholesterol level, body weight between two groups (P>.05). From these results, it can be concluded that the self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives in rural area.

The purpose of this study is to develop self-efficacy promotion program and to test its effects on self-efficacy, self-care, physiologic index of hemodialysis patients after applying this program to them. Preliminary study was carried out to identify the levels and types of self-care, self-efficacy of hemodialysis patients. To develop self-efficacy promoting program, several discussions with nursing professors and nurse specialists on hemodialysis patients were made after in-depth literature review on the area. Through these processes, the self-efficacy promoting program including 20 minutes long videotape and other counciling documents were completed. This videotape consisted of specific self-care techniques for hemodialysis patients including management of fistula, measurement of blood presure and body weight, special diets, medications, exercise and rest, management of physical problems and social adjustment. Two group equivalent pre and post test quasai-experimental research design was used in this study. The total subjects were 34 hemodialysis patients who received hemodialysis three time per week at 1 university hospital. Seventeen experimental group subjects were matched with control group subjects in sex and age. Data were analysed with the SPSS window program. Homogeniety between experimental and control group pretest data was tested by 2 and t-test. There were no significanct differences in general characteristics, illness history, specific self-efficacy and self-care between the two groups. The differences of general self-efficacy of two groups were tested with the Repeated Measure ANCOVA because of significant differences of pretest data of general self efficacy between two groups. The differences of self-efficacy and self-care of two groups were tested with Repeated Measure ANOVA and the differences of physiologic indecies including blood potassium level and blood phosphorus level and interdialytic weight gain were tested by t-test. The results were as follows: 1. There was no significant difference in general self-efficacy between the two groups over four different time, and no interaction by groups and by time. 2. There was significant difference in specific self-efficacy between the two groups over four different time, and interaction by groups and by time. 3. There was significant difference in self-care between the two groups over four different time, and interaction by groups and by time. 4. There were no significant differences of blood potassium level and blood phosphorus level, but there was significant difference of interdialytic weight gain between the two groups. From the results above, it can be concluded that the self-efficacy promotion program for hemodialysis patients was effective to improve degree of specific self-efficacy and self-care and to decrease interdialytic weight gain. Considering results, the followings are recommended: 1) Repeated studies are needed for another hemodialysis patients. 2) This program can be used for improving degree of self-efficacy and self-care of hemodialysis patients by nurse practitioner and nurse educator.

In the last few years, psychiatric nurse practitioners have shown a growing an interest in community psychosocial rehabiliation, caring for chronic psychiatric patients as case manager in South Korea. The purpose of this study was to evaluate the effectiveness of a community psychiatric rehabilitation nursing program on self-care actively and quality of life and to suggest this program as an effective nursing intervention in a group of chronic home-based psychiatric patients in a poor town. A nonequivalent control group, pretest-posttest design was used . Of the twenty women that started the program, sixteen finished it. The data were analyzed by the Wilcoxon Rank Sum Test. The program included the process of case management which consisted of four phases: the first was an active case finding and pre-test, the second was home visiting and contracted by phone, the third was group activity therapy of 12 sessions, and the fourth phase was terminal and post-test. The effects of the program were assessed by quality of life and self-care activity. The quality of life and the self-care activity, especially, area of nutrition, elimination, dressing, leisure activity, and follow-up clinic visiting showed greater improvement than those of the control group. The results of this study suggest that this program was effective in improving the quality of life of chronic home-based psychiatric patients.

Diabetes mellitus, a universal and prevalent chronic disease, is projected to be one of the most formidable worldwide health problems in the 21st century. For those living with diabetes, there is a need for self-care skills to manage a complex medical regimen. Self-efficacy which refers to one's belief in his/her capability to monitor and perform the daily activities required to manage diabletes has found to be related to self-care. The concept of self-efficacy comes from social cognitive theory which maintains that cognitive mechanism mediate the performance of behavior. The literature cities several research studies which show a strong relationship between self-efficacy and self-care behavior. Meta-analysis is a technique that enables systematic review and quantitative integration of the results from multiple primary studies that are relevant to a particular research question. Therefore, this study was done using meta-analysis to quantitatively integrate the results of independent research studies to obtain numerical estimates of the overall effect of a self-efficacy with diabetic patient on self-care behaviors. The research proceeded in three stages : 1) literature search and retrieval of studies in which self-efficacy was related to self-care, 2) coding, and 3) calculation of mean effect size and data analysis. Seventeen studies which met the research criteria included study population of adults with diabetes, measures of self-care and measures of self-efficacy as a predictive variable. Computation of effect size was done on DSTAT which is a statistical computer program specifically designed for meta-analysis. To determine the effect of self-efficacy on self-care practice homogeneity tests were conducted. Pooled effect size estimates, to determine the best subvariable for composite variables, metabolic control variables and component of self-efficacy and self-care, indicated that the effect of self-efficacy composite on self-care composite was moderate to large. The weighted mean effect size of self-efficacy composite and self-care composite were +.76 and the confidence interval was from +.66 to +.86 with the number of subjects being 1,545. The total for this meta-analysis result showed that the weighted mean effect sizes ranged from +.70 to +1.81 which indicates a large effect. But since reliabilities of the instruments in the primary studies were studies were low or not stated, caution must be applied in unconditionally accepting the results from these effect sizes. Meta-analysis is a useful took for clarifying the status of knowledge development and guiding decision making about future research and this study confirmed that there is a relationship between self-efficacy and self-care in patients with diabetes. It, thus, provides support for nurses to promote self-efficacy in their patients. While most of the studies included in this meta-analysis used social cognitive theory as a framework for the study, some studies use Fishbein and Ajzen's attitude model as a model for active self-care. Future research is needed to more fully define the concept of self-care and to determine what it is that makes patients feel competent in their self-care activities. The results of this study showed that self-efficacy can promote self-care. Future research is needed with experimental design to determine nursing interventions that will increase self-efficacy.

This is a descriptive study on quality of life(QOL) and related factors of ostomates to provide a basic data for development of nursing interventions. The subjects were 110 ostomates who were members of the Daegu or Daejon branches of the Korean Ostomy Association. Data collection was performed between March 1st and April 6th, 1998. Measurements of QOL, self-care, family support, self-esteem, and hope were used as the study tools. Data were analyzed with the SAS program by using t-test, ANOVA, Pearson correlation and stepwise multiple regression. The results are as follows : 1) The score on the QOL scale ranged from 97 to 226 with a mean of 164.53(+/-28.29). 2) The score of QOL on the general and ostomate-related characteristic showed significant differences according to monthly income, monthly participation in ostomate meetings, combined treatments after operation, types of evacuation management, problems of ostomy, help in caring for the ostomy, length of time since ostomate surgery, and presence or absence of readmission after discharge. 3) There were significant positive correlations between quality in life and other factors ; self-esteem(r=0.7107, P<0.001), hope(r=0.6584, P<0.001) family support(r=0.6191, P<0.001), perception of health condition(r=0.6017, P<0.001), and self-care(r=0.2286, P<0.05). 4) The variables that affected the quality of life of the subjects were self-esteem, level of family support, perception of health condition, monthly participation in ostomate meetings, combined treatments after operation, monthly income, level of hope, and age in that order. The variance of quality of life was R2=77.20 percent by calculating the sum of those variables. In conclusion, it is necessary for nursing intervention to promote self-esteem, family support, and hope in the care of ostomates in order to improve QOL.

The purpose of this study was to examine the correlation between self-efficacy and self-care of hemodialysis patients. The subjects consisted of 140 hemodialysis patients who underwent hemodialysis at 2 university hospital. The data were collected by used the self-efficacy tool developed by Kim Ju Hyune(1995) and the self-care tool developed by literature review and indepth open openended questions to 10 patients. Also, the questionnaire in cluded phusiologic data which collected through review of the patients' charts. The statistical analysis was used the SPSS program for frequency, mean, t-test, ANOVA and Pearson correlation. The results were as follows: 1. The mean score for general self-efficacy of hemodialysis patients was 3.103(1-4point) and there were significant differences according to perceived health. The mean score for specific self-efficacy of hemodialysis patients was 3.113 (1-4point) and there were significant differences according to perceived health, side effects and complications which related hemodialysis. 2. The mean score for self-care of hemodialysis patients was 3.822(1-5point) and there were significant differences according to marital status and economic level. 3. The relationship between general self-efficacy and self-care was a positive correlation(P=.000). The relationship between specific self-efficacy and self-care was a positive correlation(P=.000). In conclusion, this study revealed the level of self-efficacy and self-care, and the positive correlation between self-efficacy and self-care on hemodialysis patients. Therefore, intervention is needer to promote self-efficacy for self-care of hemodialysis patients. Considering the vulnerable self-care area same as checking blood pressure and weight, fluid restriction, social adjustment, exercise and rest, further studies should develop self-efficacy promoting programs for self-care of hemodialysis patients.

This study was performed to analyse the tendency of the self-care studies, to investigate the variables related to self-care, which could be applied for the data establishing the theory of self-care. to accomplish the objectives of this study, the researchers analyzed 83 studies, available that contained the area of self-care, which was published in local and foreign areas between 1981 and Feb. 1997. The findings of this study are as follows: 1) Studies published in Korea were about twice more than foreign studies. According to the statistics, the number of studies in this study tended to increase year by year. Between 1991 and 1995 were most. Analysis on the subject of this studies showed, that they were most dealt with chronic diseases an adults. 2) The theoretical definition of self-care were most referred to Orem's self-care. For the main concept of studies, self care performance was the most. 3) The correlational study was most often used design and experimental study is tended to increase. The questionnaires were the most often used data collection method. There was lots of different variable measuring technique to evaluate main concepts. 4) In the results of analysis on the propositions related to the self-care performance, a client's education, social support, self-efficacy, and level of knowledge as a causal variable were found. Also, the physiological index improved and quality of life were fond to be significant effective variables.

To determine factors affecting self-care behavior if diabetics, the relationships of hardiness, family support, demographic and medical variables to self-care behavior were investigated in 180 samples with non-insulin dependent diabetes mellitus. In stepwise multiple regression analysis, 26.76% of the variance in self-care behavior was accounted for by family support(15.52%), age(7.76%), and clinical history(2.07%). To compared the magnitude of predictor's significance by gender, stepwise multiple regression was conducted separatively by gender group. In the male sample 25.22% of the variance in self-care behavior was accounted for by family support, age, and challenge. In the female sample family support, age, and committment were significant predictors in self-care behavior with 28.82% of the variance. The results highlight the value of family support in self-care behavior in diabetics regardless of gender difference. According to the finding of this study, family support is the most significant predictor of self-care behavior in NIDDM. This implicates that in future diabetic care, a family member should be encouraged to participate in the patient education process. Also as hardiness is not supported by a unidimensional construct, more empirical studies are recommended to differentiate the conceptual traits for the three subconcept of hardiness.