One of the major causes of morbidity and mortality in breast cancer patients is delay in seeking help. Leventhal's self-regulation model provides an appropriate framework to assess delay in seeking help. The aim of this study was to investigate the relationship between "illness perception" and "help seeking delay" in breast cancer patients based on Leventhal's self-regulation model. In this correlational descriptive study with convenience sampling conducted in 2013, participants were 120 women with breast cancer who were diagnosed in the last year and referred to chemotherapy and radiotherapy centers in Rasht, Iran. Data collection scales included demographic data, Revised Illness Perception Questionnaire (IPQ-R)and a researcher made questionnaire to measure the delay in seeking help. Pre-hospital delay (help seeking delay) was evaluated in 3 phases (assessment, disease, behavior). The data were analyzed using SPSS-19. The mean (SD) age calculated for the patients was $47.3{\pm}10.2$. Some 43% of the patients had a high school or higher education level and 82% were married. The "pre-hospital delay" was reported ${\geq}3months$. Logistic regression analysis showed that none of the illness perception components were correlated with appraisal and behavioral delay phases. In the illness delay phase, "time line" (p-value =0.04) and "risk factors"(p-value=0.03) had significant effects on reducing and "psychological attributions" had significant effects on increasing the delay (p-value =0.01). "Illness coherence" was correlated with decreased pre-hospital patient delay (p-value<0.01). Women's perceptions of breast cancer influences delay in seeking help. In addition to verifying the validity of Leventhal's self-regulation model in explaining delay in seeking help, the results signify the importance of the "illness delay phase" (decision to seek help) and educational interventions-counseling for women in the community.
This quasi-experimental study was intended to test the effect of self-help group program, which is one of the way to enhance adaptation and quality of life to mastectomy patients. Data was collected from July 14, 1998 to Oct. 31, 1998 at two Medical Center in Seoul. The subjects for this study were the patients who had undergone mastectomy and were follow-up ; 14 in experimental group and 14 in control group matched with age and treatment. The instruments for this study were adaptation in Lee(1994)'s physical symptom questionnaire, Zung's Self-rating Depression Scale(SDS, 1965), and Self-rating Anxiety Scale(SAS, 1970), quality of life in Spranger(1996)'s and No(1988)'s Quality of Life Questionnaire. The self-help group program for mastectomy patients was developed based on literature review and pilot study by the investigator. The subjects of experimental group were participated in 6 weeks self-help group program and were received arm and shoulder exercise, informational support, and interpersonal support by group members. The control group were received no intervention, Both group answered questionnaires prior to intervention and 6 weeks later. The data analyzed by frequency, $X^2$-test, Mann-Whitney U test. Wilcoxon Signed Rank test, Pearson's Correlation Coefficient and Stepwise Multiple Regression using SPSS WIN. The results are as follows ; Hypothesis 1. "The experimental group with the self-help group program will have a higher score on adaptation state than control group." was not supported. But the post test score of anxiety and depression in experimental group were declined and the depression score was reduced relatively. Hypothesis 2. "The experimental group with the self-help group program will have a higher score on quality of life than control group." was not supported. But the posttest score of quality of life in experimental group was reduced relatively. Hypothesis 3. "The higher adaptation state of mastectomy patients, the higher quality, of life." was supported(r=,80, p<.001). Additionally, the lower physical symptom, depression and anxiety, the higher quality of life And depression, which was the main predictor of quality of life, accounted for 59.5%, depression and anxiety accounted for 65.5% of the variance in quality of life. In conclusion, when the self-help group program was intervened to mastectomy patients, it was tended to increase quality of life and to reduce depression and anxiety. So self-help group program can be considered useful nursing inter vention effect on adaptation and quality of life of mastectomy patients. With discussion, I suggest repeated further re search on self-help group with appropriate sample size and longitudinal study. Also during adjuvant therapy, it is needed to develop convenient method to be supported from peer group and family, such as computer mediated support group.
Purpose: The purpose of the study was to compare the effects of Tai Chi self-help program and Tai Chi exercise in patients with osteoarthritis. Methods: quasi experimental design was utilized for the study to compare the effects after implementing tai chi self-help program and Tai Chi exercise for 6 weeks. The subjects of the study was osteoarthritis patients who visited to two Public Health Centers in Gyunggi-do from August to December, 2005. Total of 25 OA patients agreed to participate in the study, and 10 tai chi self-help program group and 9 Tai Chi exercise group were included for the final analysis after 6 weeks. Tai Chi self-help program was provided twice a week, 2 hours per session (one hour for tai chi exercise, one hour for self help program) for 6 weeks, and Tai Chi exercise group was provided once a week, 2 hours per session for 6 weeks. Outcome measures include flexibility, 6 m walking, and balance. Mann-Whitney U test of SPSS WIN 11.0 was utilized to compare the group differences. Results: The subjects of both program participants were not improved in their arm flexibility, and the difference was not significant. Tai chi self-help group improved more in their 6 m walking ability than Tai Chi exercise group, but the difference was not significant (F=.000, p>.05). Tai chi self-help group improved more in their balance than Tai Chi exercise group, but the difference was not significant (Rt: U=.24, p>.05; Lt: F=2.60, p>.05). Conclusion: The provision of both Tai Chi self-help program and Tai Chi exercise can lead improvement of 6 m walking, and balance, but the group difference was not significant. A rigorous research design should be further utilized to identify the potential benefits for this population.
Purpose: The purpose of this study was to determine the effects of 5 weeks self-help management program developed by Kim et al. (2000-b) and reinforced with music therapy for post stroke patients. Method: This was pre-experimental study and the subjects were 14 post stroke hemiplegic patients at home who were registered at the Gunsan Health Center. The program was applied for five weeks and two hours for each session composed of the preparation step, the main step and the finishing step. The contents of the program were ROM exercise, daily activity training, risk factors and aftereffects, nutrition management and stress management. To collect data, all subjects were questioned before and after the application of the program. Collected data were analyzed through frequencies, percentages, Wilcoxen signed rank test and Cronbach's alpha using SPSS-WIN program. Result: After the application of the self-help management program, a statistically significant increase was observed in the subjects' ability to perform activities of daily living (p=.039), ability to perform instrumental activities of daily living (p=.005), self-efficacy (p=.001), self-care behavior (p=.001) and quality of life (p=.001), and a statistically significant decrease was observed in depression (p=.012). Conclusion: The present self-help management program was found to be helpful in improving the subjects' physical and psychological functions after they were attacked by stroke, so to be an effective nursing intervention strategy for post stoke patients. Future researches need to reinforce and materialize music therapy and to develop and apply a self-help management program that includes not only post stroke patients but also their families. In addition, it is necessary to expand the scope of subjects and apply follow-up management in order to continue self-help meetings.
Purpose: The purpose of this study was to determine if osteoarthritis patients would benefit in terms of pain, fatigue, difficulty with physical activity, joint stiffness, and flexibility of the joints from a structured self-help program. Method: This self-help program was carried out 2-3 hours once a week for 6 weeks in 2005-2006, and evaluated in one group pretest-posttest pre-experimental design. The subjects of this study who were diagnosed osteoarthritis were recruited at two different Community Health Centers in Kangwon. The subjects who agreed with the purpose of this study and participated both pretest and post-test were 55 patients. Mean age is 63.48 (9.48) years, mean duration of disease is 7.95 (7.66) years. The self-help program was consisted of weekly health contract, exercise, health education, group discussion, group counseling, and recreation. At every meeting, researcher and trained public health nurse evaluated the program, and prepared the next program. The measurement tools were pain rating scale (0-10), fatigue rating scale (0-10), Korean WOMAC (Western Ontario and McMaster University Osteoarthritis) Index, ruler, and goniometer. Results: At the completion of 6 weeks of self-help program, the subjects reported significantly less pain and difficulty with physical activity and more flexibility in both shoulder and knee joints compared to pretest. Conclusion: The self-help program would be helpful on pain, physical activity, and joint flexibility for arthritis patients.
This study examined factors affecting the intention to formal and in formal help in adults with recent suicidal thoughts. 215 adults who were recruited through online community participated in the self-report online survey. The results showed that social support had a significant effect on the formal help seeking. Social support, suicide stigma, and self-Concealment had a significant effect on the informal help seeking. In conclusion, social support had a major influence on the intention of asking for help. These results highlight the need for interventions to increase social support and reduce self-concealment in order to increase the request for help for suicide in the high-risk group.
Objective: This study examined the use of mental health helping systems among college students in Korea. A behavioral model of health service utilization was applied to examine factors influencing different types of helping systems. Methods: A total of 454 college students from four universities participated in the survey. A self-administered questionnaire measuring help-seeking behaviors including formal health and mental health services, informal helping system, peer group, and family support was used. Results: Respondents frequently turn to family members and peer group when in need, and age, sex, mental Health status, and attitude and knowledge on mental illness were significant factors affecting help-seeking behaviors of Korean students. While older students and those with more severe symptoms were more likely to seek help from formal resources, students with more severe symptoms were less likely to seek help from informal resources. Male students and those with negative attitude toward mental illness were less likely to ask peer groups for help. Conclusions: Study results indicate that informal resources and peer groups can be significant sources of social support for individuals in their late adolescence and young adulthood, however, their role as gateways to professional help is limited. Student counseling centers should take on a more active role in reaching out; implications for developing peer leaders as counselors and self-help groups are discussed.
The purpose of this study was to explore the social workers' reflections developed during the participatory action research seeking practice methods in the community welfare center single parent self-help groups. Nine social workers and researchers sharing difficulties in the community welfare center single parent self-help group practice were involved in the participatory action research. We performed a circulatory research repeating 'plan-action-reflection-replan' cycles through ten sessions of research meetings including peer supervision in parallel with 4 self-help group practices. Multiple practice methods were derived as the result among which change in the social workers' perception was the key. We focused on the result that the social workers' perception was changed by reflections from participatory action research and the contents of the reflections were qualitatively analyzed using materials acquired during the study. As a result the following 5 themes were derived; 'recognition and worry on the lack of appropriate practice for the self-help group', 'specification of the social workers' role based on the changed perspective on the member-social worker relation', 'confirmation of the possibility of the concerned person initiated practice', 'detailed understanding of the single parent self-help group in the community welfare center', and 'renewed recognition of the development of the single parent self-help group in the community welfare center'. Based on these results, empowerment and reflection/reflective practice for single parent self-help group in the community welfare center were discussed.
The purpose of this study was to understand the ways to enhance academic help-seeking by analyzing the structural relations among individual(achievement goal orientation) and contextural (teacher behaviors and classroom climate) factors known to affect help-seeking, one of the effective self-regulated learning strategies, for upper elementary students. More specifically, it explored the mediational roles of general classroom climate and student achievement goal orientation in the relation between supportive teacher behaviors and student academic help-seeking. A survey was administered to 315 fifth- or sixth-grade students in three elementary schools and the data from the survey was analyzed. Main results are as follows. First, supportive and learning-oriented teacher behaviors with high expectation related to more cohesive and positive classroom climate and more adaptive achievement goal such as mastery goal. Positive classroom climate played an important role in improving student mastery goal, and only mastery goal among different types of achievement goal orientation had a positive prediction of student help-seeking. Second, teacher behaviors significantly predicted student help-seeking through a double mediation of classroom climate and student mastery goal, which showed that classroom contextual factors and student individual factors interacted for help-seeking. These results suggest that the role of teachers as well as the mastery goal of students are important for enhancing students' help-seeking behavior as an adaptive learning strategy.
Purpose: The purpose of this study was to identify the effects of Self-help program for Young adults with hemophilia. Method: A quasi-experimental design was used. The subjects were 40 young adults with hemophilia, 21 in the experimental group and 19 in the control group. The subjects of the experimental group participated in a self-help group program for five sessions for 5 weeks. The program consisted of health education abouthemophilia, exercise, and therapeutic recreation. Its outcomes were evaluated on self-efficacy, ADL, depression, and quality of life. The obtained data was analyzedusing the Mann- Whitney U test of SPSS. Result: 1) The scores of self-efficacy, ADL and quality of life increased significantly in the experimental group as compared to the control group. 2) The score of depression decreased significantly in the experimental group as compared to the control group. Conclusion: Considering these research results, the program is effective in improving self-management ability and quality of life. Therefore this program could be implemented as a self-help group program for hemophilia clients.
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