• 성인간호학회지
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• 제14권2호
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• pp.184-193
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• 2002

Purpose: The purpose of this study was to assess the characteristics of the user of complementary alternative therapies(CAT) and to identify the important predictive factors associated with them. Method: This study included 142 patients attending outpatient rheumatology clinics of D Hospital in Busan between July and August in 2001. The multiple logistic regression model was developed to estimate the likelihood of user or nonuser of CAT. Result: The duration of illness and chance score of health locus of control were found to be significant factors through the estimated coefficients of using CAT. Duration of illness is longer and chance score of health locus of control is higher in patients who have used CAT in past than that of nonuser. When the model performance was evaluated by comparing the observed outcome with predicted outcome, the model correctly identified 95% of user of CAT and 31% of nonuser. Conclusion: In this survey, duration of illness and chance score of health locus of control are found to be significant factors in predicting utilization of CAT. Nurses who care for rheumatoid arthritis patients should take consideration into health locus of control in planning health education programs.

• 근관절건강학회지
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• 제8권1호
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• pp.5-26
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• 2001

Many studies have reported that regular aquatic exercise can lead to improvement of health for patients suffering from arthritis. In spite of these benefits, the adherence rate has shown as few as 26% of patients with arthritis who had completed the aquatic exercise education program. Moreover, when patients with arthritis begin an aquatic exercise, 47% withdraw within the first 6 month. No study has been found that constructs model to explain aquatic exercise adherence of patients with arthritis. The purpose of this study were to identify the factors influencing exercise adherence and to construct and test a structural model to explain aquatic exercise adherence of patients with arthritis. Hypothesized model was constructed on the basis of Bandura's social cognitive theory and literature review. Exogenous latent variables included in this model are group cohesion and barrier, endogenous latent variables are self-efficacy, outcome expectancy and self-evaluation. Empirical data used was collected through individual interviews with the structural questionnaire on 249 patients with arthritis who had completed the 6-week aquatic exercise education program of Korean Rheumatology Health Professionals Academy. The interviews were performed from September 6, 1999 through October 8, 1999. A model tested by the covariance structural analysis with LISREL 8.12a program and by descriptive statistics and correlation with SAS 6.12 program. The results are summarized as follows: First, hypothesized model showed a good fit to the empirical data. In the modified model added one new path showed a much better fit. Second, group cohesion had a direct, indirect positive effects, self-efficacy and self evaluation had a direct positive effects on exercise adherence. Barrier had a direct, indirect negative effects on exercise adherence. Outcome expectancy had a direct negative effect, indirect positive effects through self-evaluation on exercise adherence, but total effects was not significant. Total effect size of the variables were group cohesion, self-efficacy, barrier and self evaluation in order. All variables accounted for 54% of the total variance of exercise adherence in the model. In conclusion, this model confirmed to be proper in explaining of aquatic exercise adherence. Group cohesion, self-efficacy, outcome expectancy, self-evaluation, barrier contributed to the aquatic exercise adherence of patients with arthritis. The results of this study suggested that improvement of group cohesion, self-efficacy and self-evaluation, motivation of outcome expectancy through self-evaluation, and reduction of the barrier should be included in the strategy of nursing intervention for the aquatic exercise adherence of patients with arthritis.

• Journal of Nutrition and Health
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• 제38권7호
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• pp.578-585
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• 2005

Maternal zinc deficiency is relatively common worldwide, but its consequences for pregnancy outcome are not established. The purpose of this study was to examine the effect of zinc status in the second trimester on pregnancy outcome. Subjects were 248 pregnant Korean women (25-28 wk gestation). Cord blood was collected from subgroup of 69 women and pregnancy outcome data were obtained from 185 babies. Anthropometry measurement, dietary intake, and biochemical characteristics of pregnancy and cord serum substances were measured. The subjects were divided into quartiles on the basis of maternal serum Zn concentration; $ZnQ_1$ (< 25 percentile), $ZnQ_2$ ($26\~50$ percentile), $ZnQ_3$ ($51\~75$ percentile), and $ZnQ_4$ ($76\~100$ percentile). Zn groups were compared in terms of various maternal factors, concentrations of cord serum substances, and pregnancy outcome. Maternal serum Zn concentration was $118.4\;{\pm}\;35.5\;{\mu}g/dl$ as mean. Intake of Zn was lower than Korean RDA. The rate of Zn deficiency among all subjects was $8.5\%$. Maternal serum Zn levels belonged to normal range. Cord serum Zn level was about $154.7\%$ of maternal serum level. Intakes of energy, calcium, iron, folic acid, and riboflavin did not meet the Korean RDA for pregnant women by gestational age. The mean birth weight of neonates is 3083 $\pm$ 697 g, of whom $9.1\%$ were of low birth weight (< 2,500 g). Maternal serum Zn level was positively correlated with pre-pregnancy weight, pre-pregnancy body mass index, and vitamin C intake (p < 0.05). $ZnQ_1$ group had significantly lower maternal serum iron concentration and higher cord serum cholesterol than those in other groups. Maternal serum Zn level, cord serum Zn level, and dietary Zn intake were no related to the pregnancy outcome. The birth weight had a correlation with the maternal hemoglobin and albumin concentration. In conclusion, at this study, we could not find the association with maternal Zn status in 2nd trimester and pregnancy outcome.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2947-2951
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• 2016

A quasi-experimental study was conducted to develop a health education modification program based on self-efficacy and motivation regarding liver flukes and cholangiocarcinoma development in Keang Sanam Nang district, Nakhon Ratchasima province, Thailand. A total of 36 individuals were invited to participate in the program and were screened for population at risk of liver fluke infection and cholangiocarcinoma using SUT-OV-001 and SUT-CCA-001. Development of health education modification program regarding liver fluke and cholangiocarcinoma prevention included 3 steps: (1) preparation, (2) health education program, and (3) follow-up and evaluation. The study was implemented for 10 weeks. Pre-and-post-test knowledge was measured with questionnaires, Kuder-Richardson-20: KR-20 = 0.718,and Cronbach's Alpha Coefficient = 0.724 and 0.716 for percection and outcome expectation questionnaires. Paired and independent t-tests were applied for data analysis. The majority of the participants were female (55.6%), aged between ${\leq}50$ and 60 years old (36.1%), married (86.1%), education level of primary school (63.9%), agricultural occupation (80.6%), and income <4,000 Baht (44.4%). The results revealed that after the health education program, the experimental group had a mean score of knowledge, perception, and outcome expectation regarding liver fluke and cholangiocarcinoma prevention significantly higher than before participation and in the control group. In conclusion, this successful health education modification program for liver fluke and cholangiocarcinoma, therefore may useful for further work behavior modification in other epidemic areas.

• 한국의료질향상학회지
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• 제7권2호
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• pp.218-228
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• 2000

Background : Among 'structure', 'process' and 'outcome' approaches, outcome evaluation is considered as the most direct and best approach to assess the quality of health care providers. Risk-adjustment is an essential method to compare outcome across providers. This study has aims to judge performance of hospitals by severity adjusted mortality rates of coronary artery bypass graft (CABG) surgery. Methods : Medical records of 584 patients who got the CABG surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups was used to quantify severity of patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex. For evaluation of hospital performance, we calculated ratio of observed number to expected number of deaths and z score [(observed number of deaths - expected number of deaths)/square root of the variance in the number of deaths], and compared observed mortality rate with confidence interval of adjusted mortality rate for each hospital. Results : The overall in-hospital mortality was 7.0%, ranged from 2.7% to 15.7% by hospital. After severity adjustment the mortality by hospital was from 2.7% to 10.7%. One hospital with poor performance was distinctly divided from others with good performance. Conclusion : In conclusion, severity-adjusted mortality rate of CABG surgery might be applied as an indicator for hospital performance evaluation in Korea. But more pilot studies and improvement of methodologies has to be done to use it as quality indicator.

• 보건행정학회지
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• 제18권1호
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• pp.85-107
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• 2008

This study aims to describe levels and distribution of the continuity of primary care among children and adolescent patients who are 2-19 years old, and analyze the effects of it on the risk of hospitalization. Study population was 2-19 year old child and adolescent patients as of 2002, who had more than three ambulatory care visits in the years of 2002-3 and whose most frequent provider was the primary care practices (189,660 persons). Association of levels of primary care with the risk of hospitalization was evaluated using multiple event survival analysis. Outcome variables were whether the patient had hospitalized or not, and whether the patient had hospitalized due to ambulatory care-sensitive conditions or not. Multiple event survival analysis revealed statistically significant association of the levels of primary care with the risk of hospitalization. Hazard ratio was 1.34 [1.27-1.41] at the medium level of continuity and 1.47 [1.39-1.55] at the lower level where outcome variable was whether the patient had been hospitalized or not. Hazard ratios were 1.35 [1.21-1.50] at the medium level of continuity and 1.60 [1.44-1.78] at the lower level, where outcome variable was whether the patient been had hospitalized due to ambulatory care-sensitive conditions or not. This study produced some evidences on the benefits of continuity of care, which will in turn support the introduction of personal doctor registration program in the future.

• 대한간호학회지
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• 제50권2호
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• pp.242-254
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• 2020

Purpose: The purpose of this study was to examine the effects of smart-phone app-based walking exercise programs for taxi drivers on self-efficacy and outcome expectations for exercise, health-related quality of life, walking as an exercise, and physiological indexes. Methods: A nonequivalent control group with a pre-post-test design was used. The subjects were recruited in G metropolitan city. Subjects were assigned to the experimental (n=31) or control groups (n=30). The smart phone app-based walking exercise program consisted of educations via the app, twelve short message services, and one individual telephone counseling session, which was spread over 12 weeks. Results: Self-efficacy, outcome expectations, and health-related quality of life had significantly higher pre-post test differences in scores in the experimental group. Additionally, blood pressure, body mass index, and waist circumference had significantly decreased prepost-test difference levels in the experimental group. Walking as an exercise (which consisted of days walked, number of steps walked, and amount of time walked) had significantly increased in the experimental group after 7~12 weeks in the period following the intervention program rather than 1~6 weeks after the program. Conclusion: The smart phone app-based walking exercise program based on the self-efficacy theory demonstrates a significant effect on improving self-efficacy, outcome expectations physical activities, and health-related quality of life for taxi drivers. Therefore, it is recommended to actively use the program as a tool to promote self-efficacy, physical activities, and health behaviors in taxi drivers.

• Journal of Preventive Medicine and Public Health
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• 제37권4호
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• pp.291-299
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• 2004

As there have been growing concerns about the adverse effects of air pollution on birth outcome, studies for this area has been carried out in different populations and sites. We reviewed the epidemiologic studies that evaluated the effects of air pollution on birth outcome such as low birth weight and preterm births. We identified the air pollution exposure during pregnancy was related with low birth weight and preterm birth, although there are differences among studies for the critical period of vulnerability. The biological mechanisms whereby air pollution might influence health of fetus are not clearly established. The exposure to carbon monoxide(CO) during pregnancy could increase fetal carboxyhemoglobin and result in tissue hypoxia. On the other hand, ambient particles less than $10{\mu}m$ in aerodynamic diameter($PM_{10}$) could lead to inflammation and increase blood viscosity. Controlling for potential confounders and valid assessment of exposure are the methodological issues remained in these epidemiologic studies. In the future, more studies are needed to investigate the effect of air pollution on preterm birth or stillbirths, considering the various exposure period and the biological mechanism.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.101-105
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• 2016

Purpose: The purpose of this study was to determine the effects of group exercise, manual therapy, and a home exercise program on VAS (visual analogue scale), ROM (range of motion) of shoulder, and functional outcome in adhesive capsulitis. Methods: The study was conducted with 45 patients. All subjects were randomly assigned to 3 groups: group exercise (n=15), manual therapy (n=15), home exercise (n=15). The subjects performed an intervention program 3 times a week for 4 weeks a total of 12 times. Outcome measurements were VAS, ROM, and Constant-Murley score outcome measures. Measurements were taken four times, at baseline, 4 weeks later, 8 weeks later, and 12 weeks later. Results: VAS, ROM of the shoulder, and functional outcomes showed improvement in all groups at the final follow-up (p<0.05). VAS and ROM showed greater improvement with group exercise and manual therapy than home exercise, however, there were no significant differences between the two groups (p>0.05). Functional outcomes showed the greatest improvement in group exercise at the final follow-up. This improvement was greater than with manual therapy or home exercise (p<0.05). Conclusion: Group exercise and manual therapy were more effective for improving pain, ROM, and function than home exercise in adhesive capsulitis. In particular, group exercise is more effective in functional recovery than other physiotherapy interventions.

• Child Health Nursing Research
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• 제23권1호
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• pp.10-18
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• 2017

Purpose: The purpose of this study was to identify personal, contextual, and cognitive factors influencing the career preparation behavior of Korean nursing students. In this study, an examination was done of the fitness of a path model for the relationship among these factors based on the social cognitive career theory. Methods: The participants were 413 nursing students in South Korea. Data were collected using self-report questionnaires that included self-esteem, social support, self-efficacy, outcome expectation, career decision level, and career preparation behavior. Data were analyzed using descriptive statistics, Pearson correlation analysis, and path analysis. Results: The factors influencing career preparation behavior were self-efficacy, career decision level, self-esteem, outcome expectation, and social support. The factors influencing career decision level were self-efficacy, outcome expectation, self-esteem, and social support. Conclusion: The findings indicate that self-efficacy is an important factor influencing the career behavior of Korean nursing students. Nurse educators should consider personal, contextual, and cognitive factors of nursing students and develop systemic career guidance programs to help nursing students' career preparation behavior.