• Title/Summary/Keyword: 4D-Frame

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Evaluation of the Image Quality According to the Pre-set Method in PET/CT Image (PET/CT 영상 획득 시 사전설정법 차이에 따른 영상 질 평가)

  • Park, Sun-Myung;Lee, Hyuk;Hong, Gun-Chul;Chung, Eun-Kyung;Choi, Choon-Ki;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.41-46
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    • 2011
  • Purpose: The result of exam using an imaging device is very closely related with the image quality. Moreover, this image quality can be changed according to the condition of image acquisition and evaluation method. In this study, we evaluated the image quality according to the difference of pre-set method in PET/CT image. Materials & Methods: PET/CT Discovery STe16 (GE Healthcare, Milwaukee, USA), Chest PET phantom (Experiment 1) and 94 NEMA phantom (Experiment 2) were used. Phantom were filled with $^{18}F$-FDG maintaining hot sphere and background ratio to 4:1. In the case of experiment 1, we set the radio activity concentration on 3.5, 6.0, 8.6 kBq/mL. In the case of experiment 2, we set the radio activity concentration on 3.3, 5.5, 7.7, 9.9, 12.1, 16.5 kBq/mL. All experiments were performed with the time-set method for 2 minutes 30 seconds per frame and the count-set method with one hundred million counts in 3D mode after CT transmission scan. For the evaluation of the image quality, we compared each results by using the NECR and SNR. Results: In the experiment 1, both the NECR and SNR were increased as radioactivity concentration getting increased. The NECR was shown as 53.7, 66.9, 91.4. and SNR was shown as 7.9, 10.0, 11.7. Both the NECR and SNR were increased in time-set method. But the count-set method's pattern was not similar with the time-set method. The NECR was shown as 53.8, 69.1, 97.8, and SNR was shown as 14.1, 14.7 14.4. The SNR was not increased in count-set method. In experiment 2, results of both the NECR and SNR were shown as 45.1, 70.6, 95.3, 115.6, 134.6, 162.2 and 7.1, 8.8, 10.6, 11.5, 12.7, 14.0. These results were shown similar patten with the experiment 1. Moreover, when the count-set method was applied, the NECR was shown as 42.1, 67.3, 92.1, 112.2, 130.7, 158.7, and SNR was shown as 15.2, 15.9, 15.6, 15.4, 15.5, 14.9. The NECR was increased but SNR was not shown same pattern. Conclusion: Increment of administered radioactivity improves the quality of image unconcerned with the pre-set method. However, NECR was not influenced by increment of total acquisition counts through simple increasing scan duration without increment of administered activity. In case of count-set method, the SNR was shown similar value despite of increment of radioactivity. So, the administered activity is more important than the scan duration. And we have to consider that evaluation of image quality using only SNR may not be appropriate.

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Development of an Offline Based Internal Organ Motion Verification System during Treatment Using Sequential Cine EPID Images (연속촬영 전자조사 문 영상을 이용한 오프라인 기반 치료 중 내부 장기 움직임 확인 시스템의 개발)

  • Ju, Sang-Gyu;Hong, Chae-Seon;Huh, Woong;Kim, Min-Kyu;Han, Young-Yih;Shin, Eun-Hyuk;Shin, Jung-Suk;Kim, Jing-Sung;Park, Hee-Chul;Ahn, Sung-Hwan;Lim, Do-Hoon;Choi, Doo-Ho
    • Progress in Medical Physics
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    • v.23 no.2
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    • pp.91-98
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    • 2012
  • Verification of internal organ motion during treatment and its feedback is essential to accurate dose delivery to the moving target. We developed an offline based internal organ motion verification system (IMVS) using cine EPID images and evaluated its accuracy and availability through phantom study. For verification of organ motion using live cine EPID images, a pattern matching algorithm using an internal surrogate, which is very distinguishable and represents organ motion in the treatment field, like diaphragm, was employed in the self-developed analysis software. For the system performance test, we developed a linear motion phantom, which consists of a human body shaped phantom with a fake tumor in the lung, linear motion cart, and control software. The phantom was operated with a motion of 2 cm at 4 sec per cycle and cine EPID images were obtained at a rate of 3.3 and 6.6 frames per sec (2 MU/frame) with $1,024{\times}768$ pixel counts in a linear accelerator (10 MVX). Organ motion of the target was tracked using self-developed analysis software. Results were compared with planned data of the motion phantom and data from the video image based tracking system (RPM, Varian, USA) using an external surrogate in order to evaluate its accuracy. For quantitative analysis, we analyzed correlation between two data sets in terms of average cycle (peak to peak), amplitude, and pattern (RMS, root mean square) of motion. Averages for the cycle of motion from IMVS and RPM system were $3.98{\pm}0.11$ (IMVS 3.3 fps), $4.005{\pm}0.001$ (IMVS 6.6 fps), and $3.95{\pm}0.02$ (RPM), respectively, and showed good agreement on real value (4 sec/cycle). Average of the amplitude of motion tracked by our system showed $1.85{\pm}0.02$ cm (3.3 fps) and $1.94{\pm}0.02$ cm (6.6 fps) as showed a slightly different value, 0.15 (7.5% error) and 0.06 (3% error) cm, respectively, compared with the actual value (2 cm), due to time resolution for image acquisition. In analysis of pattern of motion, the value of the RMS from the cine EPID image in 3.3 fps (0.1044) grew slightly compared with data from 6.6 fps (0.0480). The organ motion verification system using sequential cine EPID images with an internal surrogate showed good representation of its motion within 3% error in a preliminary phantom study. The system can be implemented for clinical purposes, which include organ motion verification during treatment, compared with 4D treatment planning data, and its feedback for accurate dose delivery to the moving target.

Development of a prototype simulator for dental education (치의학 교육을 위한 프로토타입 시뮬레이터의 개발)

  • Mi-El Kim;Jaehoon Sim;Aein Mon;Myung-Joo Kim;Young-Seok Park;Ho-Beom Kwon;Jaeheung Park
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.4
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    • pp.257-267
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    • 2023
  • Purpose. The purpose of the study was to fabricate a prototype robotic simulator for dental education, to test whether it could simulate mandibular movements, and to assess the possibility of the stimulator responding to stimuli during dental practice. Materials and methods. A virtual simulator model was developed based on segmentation of the hard tissues using cone-beam computed tomography (CBCT) data. The simulator frame was 3D printed using polylactic acid (PLA) material, and dentiforms and silicone face skin were also inserted. Servo actuators were used to control the movements of the simulator, and the simulator's response to dental stimuli was created by pressure and water level sensors. A water level test was performed to determine the specific threshold of the water level sensor. The mandibular movements and mandibular range of motion of the simulator were tested through computer simulation and the actual model. Results. The prototype robotic simulator consisted of an operational unit, an upper body with an electric device, a head with a temporomandibular joint (TMJ) and dentiforms. The TMJ of the simulator was capable of driving two degrees of freedom, implementing rotational and translational movements. In the water level test, the specific threshold of the water level sensor was 10.35 ml. The mandibular range of motion of the simulator was 50 mm in both computer simulation and the actual model. Conclusion. Although further advancements are still required to improve its efficiency and stability, the upper-body prototype simulator has the potential to be useful in dental practice education.

A Study on History and Archetype Technology of Goli-su in Korea (한국 고리수의 역사와 원형기술의 복원 연구)

  • Kim, Young-ran
    • Korean Journal of Heritage: History & Science
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    • v.46 no.2
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    • pp.4-25
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    • 2013
  • Goli-su is the innovative special kind of the embroidery technique, which combines twining and interlacing skill with metal technology and makes the loops woven to each other with a strand. The loops floating on the space of the ground look like floating veins of sculpture and give people the feeling of the openwork. This kind of characteristic has some similarities with the lacework craft of Western Europe in texture and technique style, but it has its own features different from that of Western Europe. It mainly represents the splendid gloss with metallic materials in the Embroidered cloth, such as gold foil or wire. In the 10th century, early days of Goryo, we can see the basic Goli-su structure form of its initial period in the boy motif embroidery purse unearthed from the first level of Octagonal Nine-storied Pagoda of Woljeong-sa. In the Middle period of Joseon, there are several pieces of Goli-su embroidered relic called "Battle Flag of Goryo", which was taken by the Japanese in 1592 and is now in the Japanese temple. This piece is now converted into altar-table covers. In 18~19th century, two pairs of embroidered pillows in Joseon palace were kept intact, whose time and source are very accurate. The frame of the pillows was embroidered with Goli-su veins, and some gold foil papers were inserted into the inside. The triangle motif with silk was embroidered on the pillow. The stitch in the Needle-Looped embroidery is divided into three kinds according to comprehensive classification: 1. Goli-su ; 2. Goli-Kamgi-su ; 3. Goli-Saegim-su. From the 10th century newly establishing stage to the 13th century, Goli-su has appeared variational stitches and employed 2~3 dimensional color schemes gradually. According to the research of this thesis, we can still see this stitch in the embroidery pillow, which proves that Goli-suwas still kept in Korea in the 19th century. And in terms of the research achievement of this thesis, Archetype technology of Goli-su was restored. Han Sang-soo, Important Intangible Cultural Heritage No. 80 and Master of Embroidery already recreated the Korean relics of Goli-su in Joseon Dynasty. The Needle-Looped embriodery is the overall technological result of ancestral outstanding Metal craft, Twining and Interlacing craft, and Embroidery art. We should inherit, create, and seek the new direction in modern multi-dimensional and international industry societyon the basis of these research results. We can inherit the long history of embroidering, weaving, fiber processing, and expand the applications of other craft industries, and develop new advanced additional values of new dress material, fashion technology, ornament craft and artistic design. Thus, other crafts assist each other and broaden the expressive field to pursue more diversified formative beauty and beautify our life abundantly together.

Usefulness of Dynamic $^{18}F-FDG$ PET Scan in Lung Cancer and Inflammation Disease (폐암과 폐 염증성질환의 동적양전자방출단층검사 (Dynamic $^{18}F-FDG$ PET)의 유용성)

  • Park, Hoon-Hee;Roh, Dong-Wook;Kim, Sei-Young;Rae, Dong-Kyeong;Lee, Min-Hye;Kang, Chun-Goo;Lim, Han-Sang;Oh, Ki-Back;Kim, Jae-Sam;Lee, Chang-Ho
    • Journal of radiological science and technology
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    • v.29 no.4
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    • pp.249-255
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    • 2006
  • Purpose: The diagnostic utility of fluorine-18 2-deoxy-D-glucose positron emission tomograhpy ($^{18}F-FDG $PET) for the non-invasive differentiation of focal lung lesions originated from cancer or inflammation disease by combined visual image interpretation and semi-quantitative uptake value analysis has been documented. In general, Standardized Uptake Value(SUV) is used to diagnose lung disease. But SUV does not contain dynamic information of lung tissue for the glucose. Therefore, this study was undertaken to hypothesis that analysis of dynamic kinetics of focal lung lesions base on $^{18}F-FDG$ PET may more accurately determine the lung disease. So we compared Time Activity Curve(TAC), Standardized Uptake Value-Dynamic Curve(SUV-DC) graph pattern with Glucose Metabolic Rate(MRGlu) from Patlak analysis. Methods: With lung disease, 17 patients were examined. They were injected with $^{18}F-FDG$ over 30-s into peripheral vein while acquisition of the serial transaxial tomographic images were started. For acquisition protocol, we used twelve 10-s, four 30-s, sixteen 60-s, five 300-s and one 900-s frame for 60 mins. Its images were analyzed by visual interpretation TAC, SUV-DC and a kinetic analysis(Patlak analysis). The latter was based on region of interest(ROIs) which were drawn with the lung disease shape. Each optimized patterns were compared with itself. Results: In TAC patterns, it hard to observe cancer type with inflammation disease in early pool blood area but over the time cancer type slope more remarkably increased than inflammation disease. SUV-DC was similar to TAC pattern. In the result of Patlak analysis, In time activity curve of aorta, even though inflammation disease showed higher blood activity than cancer, at first as time went by, blood activity of inflammation disease became the lowest. However, in time activity curve of tissue, cancer had the highest uptake and inflammation disease was in the middle. Conclusion: Through the examination, TAC and SUV-DC could approached the results that lung cancer type and inflammation disease type has it's own difference shape patterns. Also, it has outstanding differentiation between cancer type and inflammation in Patlak and MRGlu analysis. Through these analysis methods, it will helpful to separation lung disease.

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PRC Maritime Operational Capability and the Task for the ROK Military (중국군의 해양작전능력과 한국군의 과제)

  • Kim, Min-Seok
    • Strategy21
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    • s.33
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    • pp.65-112
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    • 2014
  • Recent trends show that the PRC has stepped aside its "army-centered approach" and placed greater emphasis on its Navy and Air Force for a wider range of operations, thereby reducing its ground force and harnessing its economic power and military technology into naval development. A quantitative growth of the PLA Navy itself is no surprise as this is not a recent phenomenon. Now is the time to pay closer attention to the level of PRC naval force's performance and the extent of its warfighting capacity in the maritime domain. It is also worth asking what China can do with its widening naval power foundation. In short, it is time to delve into several possible scenarios I which the PRC poses a real threat. With this in mind, in Section Two the paper seeks to observe the construction progress of PRC's naval power and its future prospects up to the year 2020, and categorize time frame according to its major force improvement trends. By analyzing qualitative improvements made over time, such as the scale of investment and the number of ships compared to increase in displacement (tonnage), this paper attempts to identify salient features in the construction of naval power. Chapter Three sets out performance evaluation on each type of PRC naval ships as well as capabilities of the Navy, Air Force, the Second Artillery (i.e., strategic missile forces) and satellites that could support maritime warfare. Finall, the concluding chapter estimates the PRC's maritime warfighting capability as anticipated in respective conflict scenarios, and considers its impact on the Korean Peninsula and proposes the directions ROK should steer in response. First of all, since the 1980s the PRC navy has undergone transitions as the focus of its military strategic outlook shifted from ground warfare to maritime warfare, and within 30 years of its effort to construct naval power while greatly reducing the size of its ground forces, the PRC has succeeded in building its naval power next to the U.S.'s in the world in terms of number, with acquisition of an aircraft carrier, Chinese-version of the Aegis, submarines and so on. The PRC also enjoys great potentials to qualitatively develop its forces such as indigenous aircraft carriers, next-generation strategic submarines, next-generation destroyers and so forth, which is possible because the PRC has accumulated its independent production capabilities in the process of its 30-year-long efforts. Secondly, one could argue that ROK still has its chances of coping with the PRC in naval power since, despite its continuous efforts, many estimate that the PRC naval force is roughly ten or more years behind that of superpowers such as the U.S., on areas including radar detection capability, EW capability, C4I and data-link systems, doctrines on force employment as well as tactics, and such gap cannot be easily overcome. The most probable scenarios involving the PRC in sea areas surrounding the Korean Peninsula are: first, upon the outbreak of war in the peninsula, the PRC may pursue military intervention through sea, thereby undermining efforts of the ROK-U.S. combined operations; second, ROK-PRC or PRC-Japan conflicts over maritime jurisdiction or ownership over the Senkaku/Diaoyu islands could inflict damage to ROK territorial sovereignty or economic gains. The PRC would likely attempt to resolve the conflict employing blitzkrieg tactics before U.S. forces arrive on the scene, while at the same time delaying and denying access of the incoming U.S. forces. If this proves unattainable, the PRC could take a course of action adopting "long-term attrition warfare," thus weakening its enemy's sustainability. All in all, thiss paper makes three proposals on how the ROK should respond. First, modern warfare as well as the emergent future warfare demonstrates that the center stage of battle is no longer the domestic territory, but rather further away into the sea and space. In this respect, the ROKN should take advantage of the distinct feature of battle space on the peninsula, which is surrounded by the seas, and obtain capabilities to intercept more than 50 percent of the enemy's ballistic missiles, including those of North Korea. In tandem with this capacity, employment of a large scale of UAV/F Carrier for Kill Chain operations should enhance effectiveness. This is because conditions are more favorable to defend from sea, on matters concerning accuracy rates against enemy targets, minimized threat of friendly damage, and cost effectiveness. Second, to maintain readiness for a North Korean crisis where timely deployment of US forces is not possible, the ROKN ought to obtain capabilities to hold the enemy attack at bay while deterring PRC naval intervention. It is also argued that ROKN should strengthen its power so as to protect national interests in the seas surrounding the peninsula without support from the USN, should ROK-PRC or ROK-Japan conflict arise concerning maritime jurisprudence. Third, the ROK should fortify infrastructures for independent construction of naval power and expand its R&D efforts, and for this purpose, the ROK should make the most of the advantages stemming from the ROK-U.S. alliance inducing active support from the United States. The rationale behind this argument is that while it is strategically effective to rely on alliance or jump on the bandwagon, the ultimate goal is always to acquire an independent response capability as much as possible.

Landscape Composition Based on Placement and Harmony in the Namgea Suhwon (치(置)와 화(和)의 개념으로 분석한 남계서원의 경관짜임)

  • Rho, Jae-Hyun;Shin, Sang-Sup
    • Journal of the Korean Institute of Landscape Architecture
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    • v.37 no.4
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    • pp.72-85
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    • 2009
  • This study attempts to examine the principles of landscape composition for a 'Suhwon(書院)' and the meaning and value of its traditional landscape architecture, in order to apply the results to the design of modern landscape architecture. A 'Suhwon' is a vital space containing the form and meaning of human activity. This study analyzes the characteristics of landscape composition in the construction of the Namgea Suhwon, located in Hamyang, by examining the form and meaning of its area and composition. The Namgea Suhwon was constructed with a suitable configuration and harmony in a good location, neither field nor mountain, and which encompasses transcendence and a return after passage through a period of birth and abundance. Its appearance means 'life existence and hidden death(生居死幽)'. Its spatial system is a reflection of the idea of Samshinoje(三神五帝: The three abilities of Providence and its five subjects) connected with Ilsangje -Samshin -Ohje. It was built based on the idea of Biryebudong(非禮不動) meaning that one should follow only good decorum and avoid discourtesy, complying with "the frame of decorum" developed by the family rites of Chu Hsi. The environmental design of the Namgea Suhwon was interrupted by the material confrontation between mountains and water and a binary code system, such as front to rear, length to breadth, and movement to stillness. The design did not adhere to stiff axes, but pursued the harmonic principles of asymmetric balance in the building and the yard, which are very naturalistic. The name 'Namgea Suhwon' is closely related with the view of placement(置) and harmony(和), which are unified with the function and meaning formed by connecting Sung Confucianism with the Pungsu-Sasinsa structure in the layout of the grounds. When examining the D/H ratio of the building and yard, it can be seen that the spaces of Ganghak, Yusang and Jehyang were built appropriately, according to the natural characteristics of each space, such as a sense of openness, enclosure, tension, relief, enhancement, and hierarchical order. The spaces also reflect human scale concepts that take advantage of auditory features. The transition process after the construction of 'Namgea Suhwon' reveals the intentions of the builder to create an ecological landscape composition based on Placement and Harmony. Placement embodies' a purposeful space in which nature and the building are connected naturally, 'incomplete open space pursuing completion', and 'potential beauty in which tension and relaxation are repeated'. Harmony embodies 'order and continuity having a sense of unity with the natural environment' and the 'sharing of daily life and memory'. 'Namgea Suhwon' contains many ideas for landscape planning, land use and the design of a campus environment.

Kinematical Analysis of Heel-Brake Stop in Inline Skate (인라인 스케이트(Inline Skate) 힐 브레이크(Heel-Brake) 정지에 관한 운동학적 분석)

  • Han, Jae-Hee;Lim, Yong-Kyu
    • Korean Journal of Applied Biomechanics
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    • v.15 no.2
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    • pp.11-20
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    • 2005
  • This study has a purpose on contributing to apprehend safe and right way to stop to the inline skate beginners and to the instructors who teaches line skating on the basis for the result of the kinematical analysis on Heel brake stop movement of the inline skate, focusing on the displacement on COG, angle displacement of ankle joint, angle displacement of knee joint, angle displacement of hip joint, using a 3D image method by DLT. To achieve this goal, we analysed the kinematical factor of the 3 well-trained inline skating instructors and obtained the following results. 1. During the movement of heel-brake stop, when strong power was given to a stable and balanced stop and the lower limbs, if the physical centroid is lowered the stability increases, and if it is placed high from the base surface, as the stability decreases compared to the case of low physical centroid, we should make a stop by placing a physical centroid in the base surface and lowering the hight of physical centroid. 2. To make a stable and balanced stop and to provide a strong power to the lower limbs, it is advisable to make a stop by decreasing an angle displacement of ankle joint during a "down" movement. In case of the left ankle joint, in all events and phases the dorsiflexion angle showed a decrease. Nevertheless, in the case of the right ankle joint, the dorsiflexion angle shows an increase after a slight decrease. The dorsiflexion angle displacement of ankle joint can be diminished because of the brake pad of the rear axis frame of the right side inline skate by raising a toe, but cannot be more decreased if certain degree of an angle is made by a brake pad touching a ground surface. To provide a power to a brake pad, it is recommended to place a power by lowering a posture making the dorsiflexion angle of the left ankle joint relatively smaller than that of the right ankle. 3. To make a stable and balanced stop and to add a power to a brake pad, the power must be given to the lower limbs in lowering the hight of physical centroid. For this, it is recommended to make a down movement by decreasing the flexion angle of a knee joint and it is necessary to make a down movement by a regular decrease of the angle displacement of knee joint rather than a swift down movement in every event and phase. 4. The right angle displacement of hip joint is made by lowering vertically the hight of physical centroid as leaning slightly forward. If too narrow angle displacement of hip joint is made by leaning forward too much, the balance is lost during the stop by placing the center in front. To make a stable and balance stop and to place a strong power to the lower limbs, it is recommendable to make a narrow angle by lower the hip joint angle. However, excessive leaning of the upper body to make the angle too narrow, can cause an instable stop and loss of physical centroid. After this study, it is considered to assist the kinematical understanding during the heel brake stop movement of the inline skate, and, to present basic data in learning a method of stable and balanced stop for the inline skating beginners or for the inline skate instructors in the present situation of the complete absence of the study in inline skating.

Effects of Motion Correction for Dynamic $[^{11}C]Raclopride$ Brain PET Data on the Evaluation of Endogenous Dopamine Release in Striatum (동적 $[^{11}C]Raclopride$ 뇌 PET의 움직임 보정이 선조체 내인성 도파민 유리 정량화에 미치는 영향)

  • Lee, Jae-Sung;Kim, Yu-Kyeong;Cho, Sang-Soo;Choe, Yearn-Seong;Kang, Eun-Joo;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul;Kim, Sang-Eun
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.413-420
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    • 2005
  • Purpose: Neuroreceptor PET studies require 60-120 minutes to complete and head motion of the subject during the PET scan increases the uncertainty in measured activity. In this study, we investigated the effects of the data-driven head mutton correction on the evaluation of endogenous dopamine release (DAR) in the striatum during the motor task which might have caused significant head motion artifact. Materials and Methods: $[^{11}C]raclopride$ PET scans on 4 normal volunteers acquired with bolus plus constant infusion protocol were retrospectively analyzed. Following the 50 min resting period, the participants played a video game with a monetary reward for 40 min. Dynamic frames acquired during the equilibrium condition (pre-task: 30-50 min, task: 70-90 min, post-task: 110-120 min) were realigned to the first frame in pre-task condition. Intra-condition registrations between the frames were performed, and average image for each condition was created and registered to the pre-task image (inter-condition registration). Pre-task PET image was then co-registered to own MRI of each participant and transformation parameters were reapplied to the others. Volumes of interest (VOI) for dorsal putamen (PU) and caudate (CA), ventral striatum (VS), and cerebellum were defined on the MRI. Binding potential (BP) was measured and DAR was calculated as the percent change of BP during and after the task. SPM analyses on the BP parametric images were also performed to explore the regional difference in the effects of head motion on BP and DAR estimation. Results: Changes in position and orientation of the striatum during the PET scans were observed before the head motion correction. BP values at pre-task condition were not changed significantly after the intra-condition registration. However, the BP values during and after the task and DAR were significantly changed after the correction. SPM analysis also showed that the extent and significance of the BP differences were significantly changed by the head motion correction and such changes were prominent in periphery of the striatum. Conclusion: The results suggest that misalignment of MRI-based VOI and the striatum in PET images and incorrect DAR estimation due to the head motion during the PET activation study were significant, but could be remedied by the data-driven head motion correction.

A Model for Health Promoting Behaviors in Late-middle Aged Woman (중년후기 여성의 건강증진행위 모형구축)

  • Park, Chai-Soon
    • Women's Health Nursing
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    • v.2 no.2
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    • pp.298-331
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    • 1996
  • Recent improvements in living standard and development in medical care led to an increased interest in life expectancy and personal health, and also led to a more demand for higher quality of life. Thus, the problem of women's health draw a fresh interest nowadays. Since late-middle aged women experience various physical and socio-psychological changes and tend to have chronic illnesses, these women have to take initiatives for their health control by realizing their own responsibility. The basic elements for a healthy life of these women are understanding of their physical and psychological changes and acceptance of these changes. Health promoting behaviors of an individual or a group are actions toward increasing the level of well-being and self-actualization, and are affected by various variables. In Pender's health promoting model, variables are categorized into cognitive factors(individual perceptions), modifying factors, and variables affecting the likelihood for actions, and the model assumes the health promoting behaviors are affected by cognitive factors which are again affected by demographic factors. Since Pender's model was proposed based on a tool broad conceptual frame, many studies done afterwards have included only a limited number of variables of Pender's model. Furthermore, Pender's model did not precisely explain the possibilities of direct and indirect paths effects. The objectives of this study are to evaluate Pender's model and thus propose a model that explains health promoting behaviors among late-middle aged women in order to facilitate nursing intervention for this group of population. 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 417 women living in Seoul, between July and November 1994. Questionnaires were developed based on instruments of Walker and others' health promotion lifestyle profile, Wallston and others' multidimensional health locus of control, Maoz's menopausal symptom check list and Speake and others' health self-rating scale. IN addition, items measuring self-efficacy were made by the present author based on past studies. In a pretest, the questionnaire items were reliable with Cronbach's alpha ranging from .786 to .934. The models for health promoting behaviors were tested by using structural equation modelling technique with LISREL 7.20. The results were summarized as follows : 1. The overall fit of the hypothetical model to the data was good (chi-square=4.42, df=5, p=.490, GFI=.995, AGFI=.962, RMSR=.024). 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 (chi-square =4.55, df=6, p=.602, GFI=.995, AGFI=.967, RMSR=.024). 3. The results of statistical testing were as follows : 1) Family function internal health locus of control, self-efficacy, and education level exerted significant effects on health promoting behaviors(${\gamma}_{43}$=.272, T=3.714; ${\beta}_[41}$=.211, T=2.797; ${\beta}_{42}$=.199, T=2.717; ${\gamma}_{41}$=.136, T=1.986). The effect of economic status, physical menopausal symptoms, and perceived health status on health promoting behavior were insignificant(${\gamma}_{42}$=.095, T=1.456; ${\gamma}_{44}$=.101, T=1.143; ${\gamma}_{43}$=.082, T=.967). 2) Family function had a significance direct effect on internal health locus of control (${\gamma}_{13}$=.307, T=3.784). The direct effect of education level on internal health locus of control was insignificant(${\gamma}_{11}$=-.006, T=-.081). 3) The directs effects of family functions & internal health locus of control on self-efficacy were significant(${\gamma}_{23}$=.208, T=2.607; ${\beta}_{21}$=.191, T=2.2693). But education level and economic status did not exert a significant effect on self-efficacy(${\gamma}_{21}$=.137, T=1.814; ${\beta}_{22}$=.137, T=1.814; ${\gamma}_{22}$=.112, T=1.499). 4) Education level had a direct and positive effect on perceived health status, but physical menopausal symptoms had a negative effect on perceived health status and these effects were all significant(${\gamma}_{31}$=.171, T=2.496; ${\gamma}_{34}$=.524, T=-7.120). Internal health locus and self-efficacy had an insignificant direct effect on perceived health status(${\beta}_{31}$=.028, T=.363; ${\beta}_{32}$=.041, T=.557). 5) All predictive variables of health promoting behaviors explained 51.8% of the total variance in the model. The above findings show that health promoting behaviors are explained by personal, environmental and perceptual factors : family function, internal health locus of control, self-efficacy, and education level had stronger effects on health promoting behaviors than predictors in the model. A significant effect of family function on health promoting behaviors reflects an important role of the Korean late-middle aged women in family relationships. Therefore, health professionals first need to have a proper evaluation of family function in order to reflect the family function style into nursing interventions and development of strategies. These interventions and strategies will enhance internal health locus of control and self-efficacy for promoting health behaviors. Possible strategies include management of health promoting programs, use of a health information booklets, and individual health counseling, which will enhance internal health locus of control and self-efficacy of the late-middle aged women by making them aware of health responsibilities and value for oneself. In this study, an insignificant effect of physical menopausal symptoms and perceived health status on health promoting behaviors implies that they are not motive factors for health promoting behaviors. Further analytic researches are required to clarify the influence of physical menopausal symptoms and perceived health status on health promoting behaviors with-middle aged women.

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