유방절제술을 받은 여성의 건강증진행위에 관한 연구

A Study on Health Promoting Behavior In Post-Mastectomy Patients

The purpose of this study was to examine the relationship among perceived health status, self-esteem, self-efficacy and health promoting behavior, and to determine the predictors of health promoting behavior in post-mastectomy patients. The study, a descriptive correlational study, was done with structural questionnaires. A total of 51 post-mastectomy subjects from C university hospital in Kwang-ju, South Korea completed mail-in self-reporting questionnaires during a three month period from March to June, 1999. The data were collected using Lawstone's(1982) perceived health status scale, Rosenberg's(1965) self-esteem scale, the modified self-efficacy scale(Shere et al, 1982), and the modified health promoting lifestyle profile (Walker et al, 1987). The data obtained were analyzed according to percentage, mean and standard deviation, principal component analysis, varimax rotation, t-test, ANOVA, Pearson's correlation, and stepwise multiple regression. The results were as follows: 1. The health promoting behavior measurement resulted in six factors. Each factor was labelled as follows: self-actualization, nutrition, stress management, exercise, health responsibility and interpersonal support. The total percent of variance explained by the six factors was 58.4%. 2. The mean score of health promoting behavior was 85.92(range 58~117). The scores of six factor were nutrition 3.20, self-actualization 2.59, stress management 2.58, interpersonal support 2.58, health responsibility 2.49, and exercise 2.34 on a four point scale. 3. When the score of health promoting behavior factors were compared by general characteristics. Factor I: self-actualization, differed significantly by the frequency of pregnancy (F=3.06, p=.037). Factor II: nutrition differed significantly by drinking experience(t=-2.26, p=.028) and the pre- or post stage of menopause(F=2.69, p=078). FactorIII: stress management differed significantly depending on regularity of mensturation(t=-2.12, p= .042). FactorIV: exercise differed significantly by type of religion (F=2.49, p=.072), marital status(F=5.03, p=.010), and feeding type (F=2.64, p=.036). Factor V: health responsibility differed significantly by regularity of mensturation(t=2.18, p=.037). 4. The total health promoting behavior score was significantly related to self-esteem and perceived health status(r=.610, p.006; r= .378, p=.006). The score of selfactualization also corresponded with selfesteem and perceived health status(r=.556, p=.001; r=.343, p=.013). 5. The predictor to explain the score of health promoting behavior was self-esteem, which accounted for 37.1% of the total variance. The predictor to explain the score of self-actualization was self-esteem, which accounted for 30.9% of the total variance. The score of nutrition was primarily affected by both premenopause and drinking experience, which accounted for 13.1% and 9.5% respectively. Finally, the score of exercise was dictated by marriage, Buddhism, no experience of breast feeding, which accounted for 17%, 9.8%, & 5.2% respectively. In conclusion, self-esteem is the main predictor for health promoting behavior in post-mastectomy women. These findings suggest a need for nursing strategies which promote self-esteem in such patients.