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

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.

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This study was done to describe health promoting lifestyle and determine affecting factors in elderly based on the Heath Promotion Model by Pender. Cognitive-perceptual factors that were included in this study were self-efficacy and hardiness. Modifying factors were demographic characteristics(sex, age, partner, previous illness, education level, income and religion). The specific purpose of this study was to examine the relationships of self-efficacy, hardiness and the demographic chasteristics to health promoting lifestyle and to determine causal factors affecting the elderly. The subjects were a volunteer sample of 98 elderly in one city in? The instruments for this study were Health Promoting Lifestyle Profile(47items, 4scale), Health Related Hardiness Scale(22items, 6scale), general Self-Efficacy Scale((13items, 5scale). Frequency, percentage, t-test, ANOVA, Pearson's correlation coefficient and Stepwise Multiple regression technique with SAS program were used to analyze the data. The Results of the study are follows ; 1) The average item score for the health promoting lifestyle was 2.63, the highest score on the subscales was interpersonal support(M=3.3), followed by self-actualization(M=2.9), nutrition (M=2.8), stress management(M=2.7), health responsibility(m=2.1) with the lowest being exercise(M=2.0). 2) A significant difference between education level, income, religion and health promoting lifestyle were found. 3) All of the subscales on health promoting lifestyle were positively related to total hardiness(r=0.330, p<0.001). The hardiness subscale of control was positively related to self-actualization(r=0.276, p<0.01), and commitment was positively related to self-actualization(r=0.315, p<0.001), exercise/nutrition(r=0.245, p<0.01), interpersonal support(r=0.278, p<0.01), stress management(r=0.250, p<0.01). Challenge was positively related to self-actualization(r=0.315, p<0.001), exercise/nutrition((r=0.245, p<0.01). There was no significant correlation between self-efficacy and all of the subscales of health promoting lifestyle. Self-efficacy showed a significant correlation only with control(r=0.469, p<0.001), committment(r=0.507, p<0.001), Challenge(r=0.489, p<0.001). 4) Committment, self-efficacy and income explained 25.01% of the variance for the total health promoting lifestyle. The results of this study show that commitment, self efficacy and income predicted the health promoting lifestyle of the elderly. So health promoting programs that increase committment and self-efficacy should be developed to promote a healthy lifestyle of the elderly, especially those who have low income.

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• Ego Integrity of the Elderly - Focusing on Mediator of Self-actualization -
  김고은, 신은주
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Most efforts to improve tuberculosis treatment adherence target the patient and his or her behavior. This study examined the effects of behavioral modification training for these patients. Based on Bandura's behavioral principles of modeling, intervention strategies using a video program were devised to elicit specific patient target behaviors considered to improve patients' adher ence to tuberculosis treatment regimens. A random assignment, two-group (experimental group and control group) research design including 81 subjects was used. The main outcomes measured were pill taking measured with the Medication Event Monitaring System(MEMS) Medication Cap, patients' self-efficacy, and their knowledge of tuberculosis. The findings are as follows: 1) There was a significant difference between the experimental group and the control group in patients' feelings of self-efficacy. That is, the patients who received the behavior modification program showed greater feeling of self-efficacy to initiate and change their behavior for the tuberculosis treatment regimen than the patients who did not receive the program(t=3.51, p=0. 01). 2) There was a significant difference between the experimental group and the control group in patients' knowledge of tuberculosis. That is, the patients who received the behavior modification program showed higher level of knowledge of tuberculosis than the patients who did not receive the program(t=2.15, p=0.03). 3) There was a significant difference between the experimental group and the control group in patients' adherence to tuberculosis treatment regimens. That is, the patients who received the behavior modification program showed greater adherence to the treatment regimens than the patients who did not receive the program(t=5.11, P=0.00). The study findings provided useful insights into nursing practice, particularly in planning intervention strategies aimed at enhancing patients' adherence in tuberculosis that may also be relevant to other chronic diseases with patient adherence problems.

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It has been noted that a genetic alteration of cells influenced by unhealthy lifestyle in addition to a series of other carcinogens increases the incidence of various neoplasmic diseases. Therefore the importance of a lifestyle that minimizes such an impact on health should be emphasized. Since stomach cancer, the most common neoplasmic disease in Korea, is related to personal lifestyle and as there is a possibility of its recurrence, patients with stomach cancer need to lead a healthy lifestyle. Also the quality of life which patients experience is negatively affected by the side effects of treatments and the possibility of recurrence. Therefore an effective nursing intervention to enhance quality of life and encourage healthy lifestyle is needed. The purpose of this study is to provide a basis for nursing intervention strategies to promote health and thus enhance quality of life. A hypothetical model for this purpose was constructed based on Pender's Health Promotion Model and Becker's Health Belief Model, with the inclusion of some influential factors such as hope for quality of life and health promoting behavior. The aims of study were to: 1) evaluate the effectiveness of patient's cognitive-perceptual factors on health promoting behaviors and quality of life; 2) examine the causal relationships among perceived benefit, perceived barrier, perceived susceptibility and severity, internal locus of control, perceived health status, hope, health concept, self efficacy, self esteem, health promoting behaviors and quality of life; 3) build and test a global hypothetical model. The subjects for this study were 164 patients who were being treated for stomach cancer were approached in the outpatient clinic on a University Hospital. The data from the completed questionnaires were analyzed using Linear Structural Relationships (LISREL). The results of research are as follows: 1) Hypothetical model and the modified model showed a good fit to the empirical data, revealing considerable explanational power for health promoting behaviors(54.9%) and quality of life(87.6%) 2) Self efficacy and hope had significant effects on health promoting behaviors. Of these, hope was affected indirectly through self efficacy and self esteem. 3) Perceived health status, hope and self esteem had significant direct effect on the quality of life. Of these variables, perceived health status was the most essential factor affecting general satisfaction in life. 4) Self-efficacy, as a mediating variable, was positively affected by perceived benifit and hope. 5) Self-esteem, as a mediating variable, was positively affected by perceived health status and hope. 6) Hope was the main variable affecting self efficacy, self esteem, health promoting behaviors and quality of life. The derived model in this study could effectively be used as a reference model for further study and could suggests a direction for nursing practices.

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  Yoorin Cho, Yang Sook Yoo
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  Jeongok Park, Young Deuk Choi, Kyoungjin Lee, Miae Seo, Ahyoung Cho, Sejeong Lee, Keum-hee Nam
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• Posttraumatic Growth and Health Promotion Behavior in Patients with Cancer: The Mediating Effect of Spiritual Well-Being
  Shunji Piao, Pok Ja Oh
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• Factors Influencing Posttraumatic Growth of Gynecologic Oncology Patients Undergoing Chemotherapy
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  Jinho Choi, Sunyoung Lee, Byungduck An
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• A Predictive Model of Quality of Life for Stomach Cancer Patients with Gastrectomy
  Young Suk Kim, Young Sook Tae
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• The Effects of Posttraumatic Growth and Meaning in Life on Health Promotion Behavior in Cancer Patients
  Sun-Hee Jang, Hae-Rang Lee, Hyung-Nam Yeu, Soon-Ock Choi
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• The Influencing Factors on Quality of Life among Breast Cancer Survivors
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In an attempt to investigate the effect of a muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy and quality of life of patients with knee osteoarthritis, a pre-experiment, one group pre-test and post-test design, was planned. Muscle strengthening exercise was carried out from May 22 through August 14, 1995 at isokinetic exercise room in rehabilitation department of University Hospital in Taejon. The subjects were seven female clients conveniently sampled from University Hospital located in Taejon, between 39 and 61 years of age, who had a osteoarthritis in knee. Muscle strengthening exercise program was composed of three sessions per week, one isokinetic exercise at angular velocity of 60degrees and 180degrees with Cybex isokinetic dynamometer and two resistance home exercise sessions with elastic band. Data were analyzed with frequency, percentage of change, Friedman test, Duncan test using SAS program. Results were obtained as follows: 1) Flexion and extension muscle strength at angular velocity of 60degrees and 180degrees were increased after 12weeks' exercise than those of before experiment. But exept flexion muscle strength at angular velocity of 180degrees (F=3.34, P=0.0261), there was no statistically significant difference among muscle strengths, which is measured every 3 weeks. 2) Pain was decreased after 6weeks' exercise than that of before experiment, and after 12weeks' exercise than that of 6weeks' exercise. There was statistically significant difference(F=4.28, P= 0.0396). 3) Depression was increased after 6weeks' exercise than that of before experiment, and after 12weeks' execise than that of 6weeks' exercise. There was no statistically significant difference between before experiment and after 6weeks' exercise. But, there was statistically significant difference between after 6weeks' exercise and 12weeks' exercise (F=9.38, P=0.0035). 4) Self-efficacy was decreased after 6weeks' exercise than that of before exercise. But, it was increased after 12weeks' exercise than that of before exercise and after 6weeks' exercise. But there was no statistically significant difference (F=1.46, P=0.2706). 5) Quality of life was increased after Gweeks' exercise than that of before exercise, and after 6weeks' exercise than that of 12weeks' exercise. But there was no statistically significant differ-ence(F=1.06, P=0.3816). Thus, the significant of muscle strengthening exercise for the improvement of muscle strength, pain, depression, is verified. But, this study was a preexperiment with small size subjects. So, controlled experimental study is necessary to determine the effect of this muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy, and quality of life of patients with knee osteoarthritis.

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  Yena Bong, Wook Song
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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.

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.

PURPOSE: This study was to examine the relationships between knowledge, health belief and self-efficacy of osteoporosis with the women residents in an island. METHOD: The subjects were 64 women who lived in an island located in Incheon metropolitan city. Data collection was performed by using questionnaire that included Osteoporosis Knowledge Test, Osteoporosis Self-Efficacy Scale and Osteoporosis Health Belief Scale by Kim, Horan & Gendler (1991). The Data were analyzed using SAS computer program that included descriptive statistics, t-test, ANOVA, Pearson correlation coefficient. RESULT: 1) The mean of osteoporosis knowledge was 10.03 in the range of 0 to 24, shows the relatively lower score than mean score. The mean of osteoporosis health belief variables were susceptibility 18.95, seriousness 19.05, benefits of exercise 22.35, benefits of calcium 21.81, barriers to exercise 16.95, barriers to calcium 13.13, and health motivation 19.75 in every range of 6 to 30. The mean of osteoporosis self-efficacy was 37.95 in the range of 12 to 60, shows a relatively higher score than mean score. 2) There were statistically significant differences in the degree of osteoporosis knowledge according to age, education. But There was no significant difference in the degree of osteoporosis and self-efficacy according to general characteristics. There were statistically significant differences in the degree of susceptibility according to religion, family income. There were statistically significant differences in the degree of seriousness, health motivation according to family income. There was statistically significant difference in the degree of barriers to exercise according to education. 3) There were statistically significant positive correlations between osteoporosis knowledge and benefits to exercise, benefits of calcium intake. There was statistically no significant correlation between osteoporosis knowledge and osteoporosis self-efficacy. There was statistically a significant positive correlation between osteoporosis self-efficacy and barriers to exercise. There was statistically a significant negative correlation between osteoporosis self-efficacy and health motivation. CONCLUSION: According to the result, osteoporosis education program including exercise, calcium intake should be operated to increase benefits to exercise and calcium intake for osteoporosis prevention. In addition, the program of improving self-efficacy should be designed and operated to decrease the perception of barriers to exercise and to increase the perception of health motivation of women in island.

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• Development of an Osteoporosis Awareness Scale for Women
  Euysoon Choi, Juhu Kim, Miyoung Chung, Kyunghye Hwang
  Journal of Korean Academy of Nursing.2008; 38(6): 813.     CrossRef

The purpose of this study was to examine the correlation between self-efficacy and self -regulation behavior in obese college women. Subjects included 52 college women with a Body Mass Index (BMI) score above 25 at Gwang Ju Women's University. Data was analyzed using SPSS/PC. The frequency, percentage, mean, standard deviation, t-test, ANOVA, and Pearson Correlation Coefficient tests were used to describe the data and for statistical comparisons. Results of this study showed that the mean scores for general self-efficacy and specific self-efficacy of obese college women were 3.37(1 to 5 point scale) and 60.16 (10 to 100 point scale) respectively. Significant differences for general and specific self-efficacy based on economic status were seen. The mean score for self-regulation behavior of obese college women was 2.55(1 to 5 point scale) with significant differences seen for both economic status and obesity of the mother. General self-efficacy was positively correlated with specific self-efficacy (P=.009) and specific self-efficacy with self-regulation behavior (P=.000). This study revealed the level of self-efficacy and self-regulation behavior, and the positive correlation between specific self-efficacy and self-regulation behavior in obese college women. Intervention is needed to promote selfefficacy for self-regulation behavior of obese college women. Further research needs to focus on the role of health promotion, diet and stress management in developing self-efficacy programs for obese college women.

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• Impact of a University-based Program on Obese College Students' Physical Activity Behaviors, Attitudes, and Self-efficacy
  Melinda J. Ickes, Jennifer McMullen, Courtney Pflug, Philip M. Westgate
  American Journal of Health Education.2016; 47(1): 47.     CrossRef

PURPOSE: The purpose of this study is to identify the correlation that exists between quality of life and self-efficacy of schizophrenic patients, focusing on the influence of related factors on these varables. METHOD: The subjects of this study were 151 schizophrenic patients. The data were collected using questionnaires. The instruments used for this study were the general self-efficacy scale developed by Sherer & Maddex (1982), the specific self-efficacy scale modified and complemented by these co-researchers on the basis of the past studies and modified SIP by Voruganti (1996). The period of data collection was from July. 2000 to Jan. 2001. Data analysis was done by SPSS, t-test, ANOVA and the Pearson Correlation Coefficient. RESULT: 1. The level of self-efficacy showed a mean score of 60.0 and the level of quality of life, a mean score of 47.0. 2. The general characteristics affecting the self-efficacy of schizophrenic patients were staying with family (p=0.05) and employment (p=0.00). 3. The general characteristics affecting the quality of life of schizophrenic patients were staying with family (p=0.04), employment (p=0.05) and duration of illness (0.03). 4. A positive correlation was identified between self-efficacy and quality of life (r=-0.469, p=0.000). CONCLUSION: The study suggests that nursing intervention strategy should be worked out to develop a psychiatric rehabilitation program that can promote self-efficacy and thus enhance the quality of life of schizophrenic patients.

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• Development and Evaluation of an Integrated Health Management Program for Psychiatric Patients with Metabolic Syndrome
  Yun Bock Kwak, Ji Young Kim
  Journal of Korean Academy of Nursing.2022; 52(3): 261.     CrossRef
• Factors Influencing Quality of Life in People with Mental Disabilities using Mental Health Centers
  Eun Kyung Byun, Seong-Sook Jun
  Journal of Korean Academy of Psychiatric and Mental Health Nursing.2011; 20(2): 157.     CrossRef
• The Effects of Psychosocial Rehabilitation Programs on the Levels of Self-Efficacy for Mentally Disabled Persons
  Hyun Sook Park, Sung-Woo Bae, Yi Young Kim
  Journal of Korean Academy of Nursing.2008; 38(5): 704.     CrossRef

PURPOSE: The exercise status in patients with rheumatoid arthritis, associations between exercise behavior and personal factors, and associations between exercise behavior and exercise-specific cognitions and their effects were assessed. METHOD: Four hundred thirty nine outpatients with rheumatoid arthritis were studied. The exercise status was measured by a single item. The intensity was multiplied by the frequency and duration of each exercise. The product of these intensity values for all exercises was defined as exercise behavior. Based on the Pender's revised health promotion model, exercise benefit, barrier, self-efficacy, enjoyment and social support were chosen as exercise specific cognitions and affect variables. Path analysis was used to identify the predictors of exercise behavior. Results: Compared to the duration before being diagnosed, the number of subjects who exercised regularly increased after being diagnosed. However over half of the subjects refrain from any sort of exercise and the type of exercise is very limited. Among the variables, exercise barrier, self-efficacy, and social support were found to be significant predictors of exercise behavior, and only previous exercise experience was found to be significant predictors of all behavior specific cognitions and affect variables. CONCLUSION: These findings suggest that studies should explore exercise behaviors and strategies to emphasize the cognitive-motivational messages to promote exercise behaviors.

When people undergo stressful situations such as a cancer diagnosis, they ask, "why me?" The causal attributions people make about cancer influence what kind of coping strategies are chosen. Weiner (1979) suggested three dimensions of causal attributions: focus of causality, stability, and controllability. The purpose of the present study was to test the relation between causal attributions and self-efficacy in patients with cancer. The subjects were 194 patients who had been diagnosed cancer one year ago and attended an outpatient clinic. 1. Each mean score of causal attribution dimensions (focus of control, stability, controllability) that each patient made about cancer was 2.47, 2.73, 2.86, 3.35, and 3.28. The mean score of self-efficacy was 71.03. 2. There was a significant negative correlation between self efficacy and controllability. Particularly, there was a significant negative relationship between self efficacy and external controllability. Based upon these results, it is recommended that the developing nursing interventions to change causal attribution and self-efficacy is necessary. A number of theoretical relationships and empirical finding are confirmed by this data, and future proposals in research is suggested.

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• Development and Validation of Self-Efficacy Scale for Self-Management of Breast Cancer (SESSM-B)
  Ran Lee, Soo Hyun Kim, Keun Sook Lee, Myung Kyung Seo
  Journal of Korean Academy of Nursing.2012; 42(3): 385.     CrossRef

Stress urinary incontinence is most common type in urinary incontinence. Most women had been suffering with stress urinary incontinence for more than a year in the community without seeking medical help. Under the assumption that stress urinary incontinence will be treated or improved by keeping PFM exercise with his/her continence confidence, this study was conducted. This study examined Continence self-efficacy effect on PFM exercise adherence. Subject were in 48 women aged 20 to 75 years with stress urinary incontinence and were recommended by their doctor to attempt PFM exercise as one treatment method.. Data were collected by self-administered report using Continence Self-Efficacy Scale, PFM exercise adherence check sheet. Telephone support was used as a method of CEIP to increase Continence self-efficacy. Continence self-efficacy score was higher in the intervention group than in control group (T=-3.23, P<.01), PFM exercise adherence was better in the intervention group than in control group (T=-4.03, P<.001). Through this research, it was also found that there were three types in attitude toward treatment; those who want to be treated completely, those who want to be relieved, and those who think urine loss is no problem. It can be concluded that to increase Continence self-efficacy was useful to the PFM exercise adherence of women with stress urinary incontinence.

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.

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• Effects of Self-management Program applying Dongsasub Training on Self-efficacy, Self-esteem, Self-management Behavior and Blood Pressure in Older Adults with Hypertension
  Myoungsuk Kim, Misoon Song
  Journal of Korean Academy of Nursing.2015; 45(4): 576.     CrossRef
• Effects of Individual and Group Education Programs on Coping and Self-care Behaviors in Cancer Patients
  Young Mi Kim, Won Ock Kim, Sang Sook Han
  Journal of East-West Nursing Research.2014; 20(1): 1.     CrossRef
• Prediction of Hypertension Complications Risk Using Classification Techniques
  Wonji Lee, Junghye Lee, Hyeseon Lee, Chi-Hyuck Jun, Il-Su Park, Sung-Hong Kang
  Industrial Engineering and Management Systems.2014; 13(4): 449.     CrossRef
• Effects of a community‐based intervention on cardio‐metabolic risk and self‐care behaviour in older adults with metabolic syndrome
  Chun‐Ja Kim, Jee‐Won Park, Hyung‐Ran Park
  International Journal of Nursing Practice.2014; 20(2): 212.     CrossRef
• The Effect of Case Management Program for Hypertensive Patient
  Jung-Soon Chung, Sun-Ock Lee
  The Journal of Korean Academic Society of Nursing Education.2014; 20(2): 321.     CrossRef
• Self-management programs based on the social cognitive theory for Koreans with chronic disease: A systematic review
  Yeonsoo Jang, Hyera Yoo
  Contemporary Nurse.2012; 40(2): 147.     CrossRef
• Self-Care Behaviors and Depressive Symptoms of Low-Income Elderly Women with Hypertension
  Ki Wol Sung, Mi Han Kim
  Journal of Korean Academy of Nursing.2008; 38(4): 593.     CrossRef

The purpose of this study was to assess the perceived exercise self-efficacy and exercise benefits/barriers of Korean adults with chronic diseases, and the relationship between the two variables. For the study, 249 Korean adults with chronic diseases with ages ranging from 18 to 79 years were recruited from hospitals or health centers in five Korean cities and surrounding rural areas. The research instruments were the scales that researchers psychometrically verified the Exercise Self-Efficacy Scale, developed by Bandura (1997), and the Exercise Benefits/ Barriers Scale, developed by Sechrist, Walker, and Pender(1987). Results of descriptive analysis showed that Korean adults with chronic diseases perceived relatively low exercise self-efficacy and relatively high exercise benefits/ barriers. Exercise self-efficacy was significantly correlated with gender, education, regular exercise, and exercise benefits/barriers was significantly correlated with gender, regular exercise. Pearson correlation coefficient showed the significant relationship between the two variables. Further researches, which are a study to evaluate a causal structure for Pender's Health Promotion Model and an intervention study to increase physical activity of chronic patients, are recommended.

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• Factors Influencing Physical Activity after Discharge from Hospital for Total Hip Arthroplasty Patients
  Ju Young Kim, Mi Yang Jeon
  Physical Therapy Rehabilitation Science.2022; 11(4): 535.     CrossRef
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  Minjeong An, Eun-Shim Nahm, Marianne Shaughnessy, Carla L. Storr, Hae-Ra Han, JuHee Lee
  Journal of Neuroscience Nursing.2018; 50(6): 327.     CrossRef
• The Relationship between Health Belief and Exercise Compliance among Elderly Adults at Senior Centers
  Kyung Im Lee, Young Eun
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• Factors Influencing Exercise Behavior of the Male Manual Worker and Office Worker based on Health Promotion Model
  SeungKyoung Yang, Yeongmi Ha, Mi-Ra Jung
  Korean Journal of Occupational Health Nursing.2015; 24(3): 235.     CrossRef
• The Effects of Task-Oriented Training Program on Balance, Activities of Daily Living Performance and Self-Efficacy in Stroke Patients : A Pilot Study
  Jinuk Choi, Soonhee Kang
  Journal of The Korean Society of Integrative Medicine.2013; 1(4): 15.     CrossRef
• Influences of oral health behaviors according to oral health education experiences in middle school students
  Mi-Sook Cho, Min-Kyung Park, Kyeung-Ae Jang
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  Hee-Sook Jeong, Eun-Nam Lee, Sam-Sook Kim
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• A Predictive Model on Health Promotion Behavior in Women who Immigrate for Marriage
  Namok Jeong, Myung Ha Lee
  Journal of Korean Academy of Nursing.2010; 40(5): 695.     CrossRef
• Gender differences in physical activity and its determinants in rural adults in Korea
  Hyun Kyung Kim, Mi Ja Kim, Chang Gi Park, Hyeon Ok Kim
  Journal of Clinical Nursing.2010; 19(5-6): 876.     CrossRef
• Health Locus of Control, Exercise Self-efficacy, and Exercise Benefits/Barriers of Female College Students
  Ju Young Ha
  Korean Journal of Women Health Nursing.2010; 16(2): 116.     CrossRef
• Effects of the Exercise Self-Efficacy and Exercise Benefits/Barriers on doing Regular Exercise of the Elderly
  Eun-Hee Hwang, Yeo-Sook Chung
  Journal of Korean Academy of Nursing.2008; 38(3): 428.     CrossRef
• Exercise self-efficacy, exercise benefits and barriers, and commitment to a plan for exercise among Korean women with osteoporosis and osteoarthritis
  Yun Hee Shin, Hea Kung Hur, Nola J. Pender, Hee Jung Jang, Moon-Sil Kim
  International Journal of Nursing Studies.2006; 43(1): 3.     CrossRef
• Test of the health promotion model as a causal model of commitment to a plan for exercise among Korean adults with chronic disease
  YunHee Shin, SangKyun Yun, Nola J. Pender, HeeJung Jang
  Research in Nursing & Health.2005; 28(2): 117.     CrossRef

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.

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• Health‐Related Quality of Life of Patients Undergoing Haemodialysis: A Structural Equation Modelling Approach
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• Effects of a mobile application on improving self‐management of adult patients receiving peritoneal dialysis: A randomized controlled trial
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• The Effects of Spiritual Well-being on Self-care Practices in People Undergoing Hemodialysis: The Mediating Effect of Hope
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• The Effect of Uncertainty on the Physiological Indexes of Hemodialysis Patients: Serial Mediating Effects of Uncertainty Appraisal and Self-care Behavior
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• The Effects of Tailored Dietary Education among Role Failure Hemodialysis Patients on Self-care Compliance, Self-efficacy and Physiologic Indices
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• Effects of a Mobile-App-Based Self-Management Support Program For Elderly Hemodialysis Patients
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• Effects of a Repeated Hemodialysis Diet Education Program for Older Adults
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• Psychometric Evaluation of Self-management Scale for Hemodialysis Patients with Arteriovenous Fistula
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• Effects of a Face-to-face Self-management Program on Knowledge, Self-care Practice and Kidney Function in Patients with Chronic Kidney Disease before the Renal Replacement Therapy
  Eun Sung Choi, Jia Lee
  Journal of Korean Academy of Nursing.2012; 42(7): 1070.     CrossRef

The purpose of this study was to develop the educational program based on the self-efficacy theory of Bandura(1986) and to identify the effect of the program among women. For this purpose a non-equivalent control group, and a pretest- posttest design was used between the experimental and the control group. The subjects in this study were female and were over the age 40, 37 in the experimental group and 46 in the control group. In this study, the educational program was developed to increase the level of osteoporosis self efficacy and to prevent osteoporosis. The program consisted of watching, videotapes, telephone contact, lectures, and small group discussions. This study was conducted to determine whether the 6 month educational program would increase osteoporosis self- efficacy, thus modifying life styles related to osteoporosis increas BMD. The instruments utilized in this study were the Lifestyle Questionnaire, and the Osteoporosis Self-Efficacy Scale. Also, bone marrow density (BMD) on the left wrist was measured by DTX-200. The findings are as follows: 1. A significant decrease in BMD was observed in the control group. By contrast, no significant change in BMD was observed in the experimental group. 2. The Osteoporosis Self-Efficacy was not significantly changed in both the experimental and control groups. 3. In the experimental group, the number of exercise participants and their exercise times were significantly increased. Also the amount of caffeine intake was significantly decreased.

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• A Study of Factors Influencing the Bone Mineral Density on Premenopausal Women: Using the 2011 Korean National Health and Nutrition Examination Survey Data
  Young-Mi Chun, Sun-Hee Lee
  Journal of the Korea Academia-Industrial cooperation Society.2013; 14(12): 6246.     CrossRef
• Structural Model for Osteoporosis Preventive Behaviors in Postmenopausal Women: Focused on their Own BMD Awareness
  Young Joo Park, Sook Ja Lee, Nah Mee Shin, Hyun Cheol Kang, Sun Haeng Kim, Tak Kim, Song I Jeon, In hae Cho
  Korean Journal of Adult Nursing.2013; 25(5): 527.     CrossRef
• Decreased Bone Mineral Density and Fractures in Low-Income Korean Women
  Kyunghee Yang, Beverly J. McElmurry, Chang G. Park
  Health Care for Women International.2006; 27(3): 254.     CrossRef

This study was designed to develop the life moking cessation program with multidisciplinary approach using the Bandura's theory of self-efficacy and confirm the effect of it on the self-efficacy and smoking amount in college students. For this purpose non-equivalent control group, pretest-posttest design was used. The participating subjects in this study were 46 male college freshmen, 23 in experimental and 23 in control group. The experimental group received the 8 sessions of lecture and small group discussions for 4 weeks and a telephone coaching program for a period of 8 weeks. The control group received 5 sessions of lecture without further treatments. The data was collected from March 15 to June 11, 1999, and analysed by SAS/PC program with X2 test, simple t, paired t test. The results were as follows. 1. The score of self-efficacy was significantly increased over time in the experimental group than those of the control group. 2. The amount of urine cotinine was decreased over time in the experimental group, number of cigarettes smoked a day were significantly decreased, and they were significantly less than those of the control group. In conclusion it was found that the Life Smoking Cessation Program with Multidisciplinary Approach was an effective nursing intervention for increasing self efficacy and reducing the amount of smoking in male college students. Therefore, future smoking cessation programs should always consider the concept of self-efficacy and ways to positively reinforce it.

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• The Effects of Knowledge about the Harmfulness of Smoking and Attitude Toward Smoking Temptation for Middle School Students
  Koung Oh Chang, Eun Kyung Byun, Nae Young Lee, So-Young Choi
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• Construction of the Structural Equation Model on Substance Use in Adolescents
  Jeongyee Bae, Panuncio Rosel
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  Mi Ja Kim, Hyang-In Cho Chung, Yang Heui Ahn
  Asian Nursing Research.2008; 2(1): 25.     CrossRef

The purpose of this study was to examine the effects of 6-wk low intensity exercise program on fatigue, perceived health state, exercise-related affect, perceived benefits, and exercise self-efficacy for female college student's. The subjects of the study consisted of thirty-four female college students. The research subjects were assigned to experimental and control group. The experimental group participated in 13-17 and 30-60 minute sesseions of exercise program over 6 weeks. Data analysis was done by t-test with SAS program. The results of this study are as follows. 1) The first hypothesis, "The fatigue of experimental group will be lower than control group", was supported. 2) The second hypothesis, "The perceived health state of experimental group will be higher than control group", was not supported. 3) The third hypothesis, "The exercise-related affect of experimental group will be higher than control group", was not supported. 4) The fourth hypothesis, "The benefits of exercise of experimental group will be higher than control group", was not supported. 5) The fifth hypothesis, "The self-efficacy for exercise of experimental group will be higher than control group", was supported.

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  Hee-Gerl Kim, Jinhwa Lee, Jiyun Kim, Hyunju Park, Hyun Sook Oh, Won Jae Lee, Eun Aae Kim, Hye Kyung Jung
  Journal of Korean Academy of Community Health Nursing.2013; 24(4): 451.     CrossRef

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.

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The purpose of the study was to test the effect of the health promotion program in middle women. The research design was a quasi experimental, nonequivalent control-group pretest-posttest design. The data were collected from February 24 to April 14, 1988. The subjects were midlife women, age 40 to 50 years who reside in Chonju city. The experimental group consisted of 41 subjects and the control group 40 subjects. The instruments used for the study were the Self Efficacy Scale and the Health Promotion Behavior Scale developed by Park(1995). The data was analyzed by SPSS/PC. The study result were as follows: Through the 7 week education program for health promotion, self efficacy and health behavior were effectively changed in middle-aged.

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The purpose of this study was to investigate the life style, self-efficacy, and bone marrow Density(BMD) in osteoporosis female patients. The subjects were recruited at the four Osteoporosis Clinics. A Convenience sample of 190 women completed a survey instrument which included the Osteoporosis Self-Efficacy Questionnaire, Life Style Questionnaire and demographic items. BMD of L4 was measured by Dual Photon Absor photiometry. The sample ranged in age from 40 to 82 years (Mean=60.28). Eighty-one percent were married and 14.9% were widowed. Forty-four percent lived with spouse and children. Excercise, diet, medication, alcohol consumption, and smoking were measured to investigate the life style. Fifty-seven percent of the subjects exercised regularly. Mountain climbing, brisk walking, and free gymnastics were frequently cited exercises by the subjects in the study. Sixty percent drank one cup of milk and 34.7% had 1.13 cups of coffee in a day. Thirty-nine percent used calcium supplements, 9.5% drank alcohol, and 3.2% smoked cigarettes. Economic status and education level were related to self-efficacy. Age, Economic status, and education level were related to BMD. As a life style, exercise, diet(milk, ice cream, and coffee), and medication(calcium) were associated with self-efficacy. The subjects who exercised regularly and took calcium supplements for a longer time had a higher level of self-efficacy that those who did not. Smoking and alcohol consumption had no relationship with self-efficacy. Excercise, Medication(calcium), and alcohol consumption were related to BMD. The subjects who took calcium supplements for a longer time had a higher level of BMD. Alcohol consumption was not related to self-efficacy but related to BMD. The subject who drank alcohol had a higher level of BMD than those who did not drink. The amount of alcohol consumption was positively related to BMD.

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• Prevalence of osteoporosis according to nutrient and food group intake levels in Korean postmenopausal women: using the 2010 Korea National Health and Nutrition Examination Survey Data
  Young-Suk Lim, Sang-Wha Lee, Zuunnast Tserendejid, So-Yeon Jeong, Gyeongah Go, Hae-Ryun Park
  Nutrition Research and Practice.2015; 9(5): 539.     CrossRef
• Association of Anthropometric and Biochemical Factors with Bone Mineral Density in Korean Adult Women Data from the Fourth (2008~2009) and Fifth (2010~2011) Korea National Health and Nutrition Examination Surveys (KNHANES IV & V)
  Soon-Nam Choi, Kwang-Hyun Jho, Nam-Yong Chung
  Journal of the Korean Dietetic Association.2014; 20(3): 157.     CrossRef
• Influence of Knowledge and Subjective Health Status on Health Promoting Behavior About Osteoporosis in Industrial Workers
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Breast self-examination is the most effective and easiest way for women to increase the responsible consciousness about their health. The purpose of this study was to test the variables impacted to promote breast self-examination practice. The research design used in this study was a nonequivalent control group of a non-synchronized design. The sample that was assembled consisted of 124 women. A purposive sample consisted of 124 omen. Each subject was given to assessed on the following the demographic data relate to the breast self-examination, knowledge of self-examination, accuracy, in performing self-examination, self-efficacy about breast cancer and breast self-examination, and the number of subjects who found a mass. The result of this study may be summarized as follows : 1. To examine the theoretical model fit to the data, chi square test statistics and goodness of fit index were identified(x2=2.30, df=2, GFI=0.99, AGFI=0.94 RMSR=0.02, NFI=0.99, NNFI=0.99, Critical Number=439). 2. The direct effects of education of breast self- examination were knowledge, self-efficacy, accuracy, number finding a mass. But the indirect effect of education in breast self-examination was frequency of breast self-examination. 3. Knowledge, as direct paths to the breast self-examination practices, was removed in the theoretical model. The parsimonious best fit model included self-efficacy, accuracy, the number finding mass, frequency of breast self-examination practices. 4. The final model produced a chi-square=5.58(p=0.35) with df=5, and GFI=0.99 AGFI=0.94, NFI=0.03, NFI=0.99, NNFI=0.99, CN=339 indicating very a good fit. Based on the result of this study, education of breast self-examination is very effective for increasing the competency of the breast self-examination through the knowledge and self-efficacy. Resources to promote self-examination may be helpful to increase the frequency of self-examination because self-efficacy is a direct effort on it. These findings suggest the need t develop nursing strategy to promote the self- efficacy of breast self-examination.

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  SoMi Park, ChaeWeon Chung, Barbara B. Cochrane
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• Effects of breast health education conducted by trained breast cancer survivors
  Myungsun Yi, Eun Young Park
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  Hea Kung Hur, So Mi Park, Chang Hee Kim, Jong-Ku Park, Sang Baek Koh, Gi Yon Kim
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This study was conducted to investigate whether exercise therapy applied in an efficacy expectation promoting program based on the self-efficacy theory of Bandura(1977) would increase self-efficacy and metabolism in NIDDM patients. The study design was a nonequivalent control group pre-test post-test quasi-experimental design. The exercise therapy applied in the efficacy expectation promoting program was composed of a staged exercise program, a small booklet relating personal experience with diabetes mellitus and a telephone coaching program on performance accomplishment, vicarious experience and verbal persuasion, which are all induction modes of efficacy expectation. The subjects of the study were twenty eight NIDDM patients who received follow-up care regularly through the out-patient department of endocrine medicine in one general hospital which had a diabetic clinic. Fourteen were assigned to the experimental group and fourteen to the control group. The experimental group participated in the exercise therapy applied in the efficacy expectation promoting program from three to five times per week for four weeks and the control group did not have the program. The collected data were analyzed using the x2-test, t-test, paired t-test, and Cronbach's Alpha using SPSS/PC+. The results are summarized as follows : 1. Experimental group had higher efficacy score than control group(t=5.98, p=.00). And, There was a significant different in the efficacy score before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(t=-6.42, p=.00). 2. Experimental group did not have lower level of glucose metabolism than control group(FBS : t=.32, p=.75, HbA1C : t=.60, p=.55, pc 2hrs. glucose : t=-.29, p=.78). But, There was a significant different in the amount of glucose metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(FBS : t=3.63, p=.003, HbA1C : t=4.20, p=.00 2hrs . glucose : t=1.93, p=.001). 3. Levels of lipid metabolism were partly a significant different between Experimental group and control group(triglyceride : t=-1.87, p=.07, HDL cholesterol : t=-.29, p=.77, body weight : t=1.78, p=.09, Total cholesterol : t=-2.17, p=.04). And, There was partly a significant different in the amount of lipid metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(triglyceride : t=2.50, p=.03, HDL cholesterol : t=-.43, p=.67, body weight : t=5.34, p=.00, Total cholesterol : t=2.26, p=.04). In conclusion, it was found that exercise therapy applied in an efficacy expectation promoting program was an effective nursing intervention for increasing self-efficacy and metabolism.

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PURPOSE: This study was conducted to understand the degree of vitality, meaning in life and self-efficacy and to elucidate the factors influencing this vitality in the nurses of Korea. METHOD: A cross-sectional survey of nurses from 4 hospitals was conducted by convenience sampling. Data collection was conducted through the use of questionnaires which were constructed to include a Vitality Self Test, Purpose in Life Test and Self-efficacy Scale. RESULTS: The degree of vitality in nurses was in the middle range. The nurses of this study had few goals towards meaning in life, and an existential vacuum state. A positive relationship was found between vitality and the research variables. The significant predictors influencing vitality in nurses were meaning in life, self-efficacy, and clinical career, and these variables accounted for 28.7% of the variance in vitality. CONCLUSIONS: This results support that vitality is an important link with meaning in life and self-efficacy. There should be a comprehensive study in the future for in-depth understanding of the vitality of nurses.

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