• Title/Summary/Keyword: Chronic disease self management program

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A Study on the Factors Affecting Self-Regulation Program for Hypertensives (본태성 고혈압환자를 위한 자기조절 프로그램 관련요인 연구)

  • Park, Young-Im
    • Research in Community and Public Health Nursing
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    • v.6 no.2
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    • pp.234-249
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    • 1995
  • Essential hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Thus the comprehensive self-regulation program was conducted as a nursing intervention on the promotion self-care 'performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi -experimental research with pre and post test design was used. And the whole program was carried out from October, 1993 to February, 1994. Self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The data was analyzed by experimental stages: the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t -test and F-test, and multiple correlation to determine the variables affecting the effect of program. The results were as follows : 1) Subjects in J company were significantly lower diastolic blood pressure than K company after the program (t=2.39, p=.024). Level of cholesterol was significant difference according to position(t=2.23, p=.034), family history (t=-2.66, p=.013), diagnosis duration, and career(t=2.88, p=.055). Perceived self-efficacy was more significantly increased among the group with family history(t=-3.00, p=.013). 2) Before the program, there were significant positive correlation among the variables: internal-LOC and self-efficacy(r=.3952, p=.015), external-LOC and barriers (r=.6515, p=.000), chance-LOC and Barriers(r=.4133, p=.012). However there were significant negative correlation between internal-LOC and barriers (r=-.3236, p=.041, external-LOC and self -efficacy(r=-.3517, p=.028), self-efficacy and barriers(r=-.6654, p=.000). 3) There were significant relationships between changes in self - care performance and self-efficacy at 5th week (r=.5313, p=.001) and changes in self-efficacy at 9th week(r=.4586, p=.005). 4) After the program, internal health locus of control and perceived benefits showed significant correlation(r=.5673, p=.001, but perceived barriers was negative correlation with perceived self-efficacy (t=-4242, p=.01). From the above results, it can be concluded that the self-regulation program is an effective nursing strategy through the change of variables to promote self-care performance of hypertensives and to increase the self-efficacy. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings.

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Structural Equation Modeling of Self-Management of Liver Transplant Recipients (간이식 수혜자의 자기관리 구조모형)

  • Jeon, Mi-Kyeong;Park, Yeon-Hwan
    • Journal of Korean Academy of Nursing
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    • v.47 no.5
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    • pp.663-675
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    • 2017
  • Purpose: The purpose of this study was to construct and test a structural equation model of self-management of liver transplant recipients based on self-determination theory. Methods: Participants were 275 outpatients who received liver transplantation. A structured self-report questionnaire was used to assess health care providers' autonomy support, transplant-related characteristics, illness consequence perception, autonomy, competence, family relatedness, depression and self-management. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0 program. Results: The modified model showed a good fitness with the data: GFI=.96, RMSEA=.06, CFI=.96, NFI=.93, TLI=.93, PGFI=.43, PNFI=.49. The health care providers' autonomy support, competence, family relatedness and depression were factors with a direct influence on the self-management of liver transplant recipients. The health care providers' autonomy support and illness consequence perception had an indirect influence through competence, family relatedness and depression. However, the transplant-related characteristics and autonomy did not have a significant effect on self-management. This model explained 59.4% of the variance in self-management. Conclusion: The result suggests that continuous education must be done to promote the competence of liver transplant recipients and to encourage the patient to positively perceive their current health condition with a view that enhances one's self-management. Additionally, the liver transplant recipients should be screened for depression, which would affect self-management. Most of all, health care providers, who have the most influence on self-management, should improve therapeutic communication and try to form a therapeutic relationship with the liver transplant recipients.

Influence of Uncertainty and Uncertainty Appraisal on Self-management in Hemodialysis Patients (혈액투석 환자의 불확실성과 불확실성 평가가 자기관리에 미치는 영향)

  • Jang, Hyung Suk;Lee, Chang Suk;Yang, Young Hee
    • Journal of Korean Academy of Nursing
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    • v.45 no.2
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    • pp.271-279
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    • 2015
  • Purpose: This study was done to examine the relation of uncertainty, uncertainty appraisal, and self-management in patients undergoing hemodialysis, and to identify factors influencing self-management. Methods: A convenience sample of 92 patients receiving hemodialysis was selected. Data were collected using a structured questionnaire and medical records. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlations and multiple regression analysis with the SPSS/WIN 20.0 program. Results: The participants showed a moderate level of uncertainty with the highest score being for ambiguity among the four uncertainty subdomains. Scores for uncertainty danger or opportunity appraisals were under the mid points. The participants were found to perform a high level of self-management such as diet control, management of arteriovenous fistula, exercise, medication, physical management, measurements of body weight and blood pressure, and social activity. The self-management of participants undergoing hemodialysis showed a significant relationship with uncertainty and uncertainty appraisal. The significant factors influencing self-management were uncertainty, uncertainty opportunity appraisal, hemodialysis duration, and having a spouse. These variables explained 32.8% of the variance in self-management. Conclusion: The results suggest that intervention programs to reduce the level of uncertainty and to increase the level of uncertainty opportunity appraisal among patients would improve the self-management of hemodialysis patients.

Perceptions of the Self-regulation in Patients with Diabetes Mellitus

  • Han, Hye-Sook;Bae, Sun-Hee;Park, Young-Sun
    • Journal of the Korea Society of Computer and Information
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    • v.26 no.4
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    • pp.169-179
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    • 2021
  • The purpose of this study is to examine types and characteristics of self-regulation which explain how individual diabetic patients determine their behavior in terms of diabetes management. Based on the results, we proposed the management method of the diabetic patients. As a method of analyzing the subjectivity of each item, a Q method study was used. There were 38 subjects who were treated with oral drugs or insulin injections, but not currently hospitalized. And 40 statements in Q samples were classified in the form of a normal distribution using a 9-point scale. Research results regarding self-regulation in diabetic patients, type 1 is evidence-based compliance, type 2 is crisis responding denial reaction, type 3 is information-based orientation to relationship, type 4 is independent practice, and type 5 is willingness deficit impulse reaction. Therefore, for effective management of diabetic patients, it is necessary to understand the characteristics of each type of self-regulation and develop a program that reflects motivation for diabetes management, improvement of confidence, and countermeasures for negative emotions related to disease.

A Study of Job Educational Satisfaction for Activating of Tailor Made Visiting Home Health Care (맞춤형 방문건강관리사업 활성화를 위한 직무교육 만족도)

  • Lim, Ji-Young;Kim, Ji-Yoon
    • Journal of Home Health Care Nursing
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    • v.14 no.1
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    • pp.23-30
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    • 2007
  • Purpose: The aim of this study was to establish basic data for developing education program of tailor made visiting home health care. Method: For this study, the subject was recruited in one directorial area among 14 nation-wide areas. The data collection was done using self-report questionnaire developed by Korea Health Industry Development Institute. Ninety one questionnaires were analyzed and response rare was 88.3%. Result: The major results were as follows. Aspect of education operations, the satisfaction of education space was revealed high. However, the satisfaction of education time, hour, and schedule were low. The overall satisfaction of education contents were revealed high. The most useful curriculums were found Chronic disease management, Infant & toddler health management, and Case management of tailor made visiting home health care. However the most unuseful curriculums were Nutritional management according to subject's health problem, Health promotion for poor family, and Understanding of visiting service in community health center. Conclusion: With these results, it was identified that the most needed contents of tailor made visiting home health care education program. So these results will be used to develop the more effective education program to activate tailor made visiting home health care service in community health center.

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Implementation of PDA-based Personal Asthma Management System (PDA 기반 개인용 천식관리 시스템 구현)

  • Park, Jong-Cheon;Hwang, Dong-Guk;Lee, Woo-Ram;Jun, Byung-Min
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2007.06a
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    • pp.634-637
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    • 2007
  • Self management of chronic asthma is of great importance, since the disease could lead the patient into an emergent situation. In the present study, we describe implementation of a personal digital assistant(PDA) based asthma management system for personal application including symptom and medication to prevent from the potential exacerbation of the disease. The software program was written by the Visual C++ tool in the mobile computing environment and Object Store was applied for data management. User friendly GUI environment was provided for the patient to input his/her daily condition and self treatment such as medication for successful management. The input screen design substituted for keyboard input to a mouse in order to easy to select an item and minimize the keyboard input. The implementation results of this system., Real-time data collection and process were possible and be able to have been carried effectively out a continuous symptom, a medication of asthma patients, risk management.

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Work related diseases in Korean fire fighters (소방공무원의 직무관련질환과 건강실태 조사)

  • Roh, Sang-Gyun;Kim, Jee-Hee
    • Journal of Digital Convergence
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    • v.11 no.10
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    • pp.571-576
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    • 2013
  • The purpose of this study is to investigate work related diseases in Korean firefighters and to prepare the preventive measure for health management for the firefighters. Structured self-reported questionnaire was distributed to the firefighters. The result revealed that 37.7% of fire fighters had chronic diseases and 12.3% had chronic low back pains. The affected parts included lumbar region(41.5%), shoulder(33.0%), and neck(23.6%). The affected parts caused physical pain and work discomfort for more than a month. A total of 54.1% firefighters visited to the hospital within a year. This results suggest that it is necessary to develop the health promotion program for the prevention of musculoskeletal disease and regular health checkup for the acute disorders caused by workload.

Health Management Experience of Residents through Participation in the Community Based Hypertension and Diabetes Registry Program (지역사회 고혈압·당뇨병등록관리사업 참여를 통한 주민의 건강관리경험)

  • Park, Mi Kyoung;Park, Hyeung Keun;Kim, Hyun Ju;Kim, Ok Jin;Gong, Moon Yeon
    • Research in Community and Public Health Nursing
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    • v.32 no.4
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    • pp.518-528
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    • 2021
  • Purpose: This study was conducted to explore the healthcare experience of residents participating in the Community-Based Hypertension and Diabetes Registry Program. Methods: This study used qualitative content analysis. Data were collected from in depth interviews of fifteen participants, who either participated in the program hosted by the Training Center for Hypertension and Diabetes for more than two years or participated in an intensive one-on-one education program. Results: The results showed that the core theme in healthcare of participants was 'Proactive healthcare with attention and systematic guidance of experts'. The positive reinforcement of staffs and the improvement of self-efficacy through effective close management were found to be positive influencing factors of participation. The theme consisted of the following categories: 'Participation in the program with positive expectations on healthcare', 'Interest in body and health', 'Vitality in life', 'Confidence in dealing with disease', 'Thankfulness for close care and attention', and 'Desire for continuous care'. Conclusion: When establishing policies on managing chronic diseases, a strategy that reflects the results of the study is required. It is necessary to build up emotional relationship among stakeholders, and expand opportunities for close healthcare such as one-on-one customized training, and mutual cooperation with various organizations in the local community.

A Study on Self-care Behavior Types of Hypertensives : Q-methodological Approach (고혈압환자의 자가간호행위 유형에 관한 연구 : Q 방법론 적용)

  • Park Young-Im
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.1
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    • pp.39-57
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    • 1999
  • Essential hypertension is a typical chronic disease requiring adequate and continuous management. And many studies supported that self-care was the essential factor to promote the wellbeing. The purpose of this study is to identify and understand the behavior patterns of self-care in hypertensives. As a research method, 35 Q-statements were collected through Individual interviews and review of the related literatures. 21 subjects were interviewed and the data were analyzed by the PC QUANL program with principal component analysis. There were 6 different self-care types classified as follows 1) Type 1 was the self-oriented control type, monitoring the blood pressure and taking the low salt diet. But they didn't take the anti -hypertensive drug and visit the health agency regularly. 2) Type 2 was the stress-control type. Their main activities were meditation to relieve the stress and communication with family. 3) Type 3 was called daily-life control type. This type tried to make their mind comfort and think positively. They also preferred walking and exercise regularly. 4) Type 4 was the medical-oriented control type, taking the anti-hypertensive drug, visiting the medical personnel and following the medical regimens. 5) Type 5 was the medication-oriented type. They only took the anti -hypertensive drug regularly and didn't any other self-care like as monitoring the blood pressure, taking the low salt diet and exercise. 6) Type 6 was called non-medication control type. This type had no medication, but tried to visit the health agency and health personnel. From the above results, it can be concluded that the self-care types were very various and self-care education have to provide individually according to the characteristics of self-care type. Another repeated study can be recommended to improve the nursing intervention the self-care behavior in chronic patient like as diabetics or rheumatoid arthritis.

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An Effect of Aquatic Exercise Program with Self-help Group Activites and Strategies for Promoting Self-efficacy on Pain, Physiological Parameters and Quality of Life in Patients having Rheumatoid Arthritis. (자조집단 활동과 자기효능성 증진법을 이용한 수중운동 프로그램이 류마티스 관절염 환자의 통증, 생리적 지수 및 삶의 질에 미치는 영향)

  • Kim, Jong-Im
    • Journal of muscle and joint health
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    • v.1 no.1
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    • pp.1-30
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    • 1994
  • Rheumatoid arthritis is a chronic systematic disease with unpredictable course of exacerbation and remission, characterized by pain, joint deformity and reduced activity by joint limitation. The growing public awareness of the need for health management of chronic illnesses, provides impetus for nursing to demonstrate social effectiveness by active nursing intervention in this vast area in general, and with rheumatoid condition in particular. However, nursing interventions to date have not demonstrated its active participation in the management of chronic conditions. Nursing intervention for the patients having rheumatoid arthritis is one such area that needs to be studied intensively and to demonstrate their effectiveness empirically. The purposes of this study were two fold : first, to develop a comprehensive program that was intensified with therapeutic joint exercises in water, self-help group activities and utilization of self-efficacy promoting strategies : and secondly, to determine the effect of aquatic exercise program on pain, physiological changes and quality of life in the rheumatoid arthritis patients. Thirty five female subjects participating in this study were selected from outpatients in the Rheumatism Center, Hanyang University hospital. The period of data collection was from December, 1992 to March, 1993 in seoul and Taejeon. Subjects in Taejeon were assigned to the experimental group. The comprehensive aquatic exercise program for the experimental group was carried out three times a week for 6 weeks in regular swimming pool. Subjects in Seoul did not participated in the program, and treated as the control group. Data were analyzed with repeated measure MANCOVA, t-test, ANCOVA, percentage of change, Kruskal-Wallis 1-Way ANOVA using SPSS $PC^+$ program. Results were obtained as follows : 1) Scores on Korean pain scale, Numeric pain score, and RAI score of the experimental group were significantly lower than those of the control group (t=2.11, p=0.022 ; F=4.40, p=0.044 : t=3.10, p=0.002). 2) There was significant improvement in the physiological parameters (higher joint movement parameters, F=15.64, p=0.024 ; higher lean body mass, percentage of change=+12.2, lower body weight, t=1.01, p=0.026 : lower ESR, t=1.69, p=0.001) in the experimental group compaired with subjects In the control group. 3) There was significant improvement in the specific self-efficacy score through the comprehensive aquatic exercise program(t=2.73, p=0.011), but not in the general self- efficacy score(t=0.62, p=0.113). 4) The quality of life failed to show significant improvement in the experimental group as compaired with the control group (F=3.69, p=0.064). 5) In the experimental group, findings from additional analysis showed no significant difference in the specific self-efficacy between those who continued to aquatic exercise after completing 6 week program and those who stopped (X2=0.086, p=0.690). Therefore, adherence to aquatic exercise program for 6 weeks seem to be affected mainly by self-help group activities. An indepth study to delve into articulation of mechanisms affecting the effect of aquatic exercise program be recommended. A further study is necessary to determine the difference in the effect of group and individual aquatic exercise program, to assess factors affecting adherence to exercise for an extended length of time.

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