• Nutrition Research and Practice
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• 제13권5호
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• pp.415-424
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• 2019

BACKGROUND/OBJECTIVES: Existing evidence on lifestyle modification programs for weight loss is limited by the high attrition rate of such programs. Identifying predictors of adherence to a lifestyle modification program could result in program improvement. However, little is known about behavior-specific adherence and its psychological predictors. This study aimed to examine the psychological predictors of adherence after one-month participation in a community-based lifestyle modification program among Chinese overweight and obese adults in Hong Kong. SUBJECTS/METHODS: A total of 205 Chinese overweight and obese adults aged $38.9{\pm}10.5years$ completed the study. Data were collected at baseline and after one month using self-reported questionnaires, which assessed knowledge (self-developed scale), motivation (Treatment Self-Regulation Questionnaire), stage of change (Stage of Exercise Scale) and self-efficacy (Self-Rated Abilities for Health Practices Scale). At one month, a 4-day dietary recall and the International Physical Activity Questionnaire-Short Form were used to assess dietary and physical activity (PA) adherence. Food and PA diaries were examined to indicate self-monitoring. Program attendance was tracked between baseline and one-month follow-up. RESULTS: After one month, participants reported high dietary adherence, attendance, and adherence to self-monitoring but low PA adherence. Multiple regression analyses suggested that diet self-efficacy (baseline) and nutrition knowledge (one-month change) were independent predictors of dietary adherence score at one month, whereas autonomous PA motivation (baseline) and PA self-efficacy (both baseline and one-month change) were independent predictors of PA adherence score at one month. No significant psychological predictor was identified for attendance or self-monitoring. CONCLUSIONS: The results suggest that the effect of psychological factors on adherence differs between diet and PA adherence outcomes. To promote adherence, practitioners should assess self-efficacy, knowledge, and motivation at the beginning of a weight-loss program and explore behavior-specific strategies to improve knowledge and self-efficacy. The results of this study have direct implications for program improvements.

• 기본간호학회지
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• 제2권2호
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• pp.155-168
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• 1995

Many arthritis patients experience physical and psychological impairment. The influence psychological factors on physical functioning beyond disease & demographic factors has been investigated. Unlike others studied the relationship between just two variables (i. e., depression & helplessness or self-efficacy & depression), the relationships among several variables such as depression, helplessness and self-efficacy were examined altogether. Foully-two patients were examined to identify the relationship between the variables. It was found that ADL is significantly negatively related to depression and helplessness, and positively related to self-efficacy. And ADL was more strongly correlated with self-efficacy and helplessness than depression. Contrary to ADL, pain was significantly negatively related to self-efficacy, and positively related to depression and helplessness. Then stepwise regression analysis was performed to identify the variables to predict ADL. It revealed that helplessness was the only significant predictor of ADL. Finally, it is suggested that the inclusion of the method to increase self-efficacy & to decrease helplessness in any nursing intervention is very important.

• 대한간호학회지
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• 제50권1호
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• pp.52-65
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• 2020

Purpose: To examine the effects of a smartphone application-based exercise program on self-efficacy expectations (SEE) and outcome expectations regarding exercise (OEE), physical fitness, activity level, physiological indices, and health-related quality of life in a sample of hemodialysis patients. Methods: A quasi-experimental control group pre-test post-test design was used. Subjects were recruited from two university hospitals in G city. The subjects were assigned randomly by coin toss: 33 participants to the experimental group and 30 to the control group. A literature review and the self-efficacy theory were used to develop the smartphone program. Experts designed and verified the program to be userfriendly and in consideration of user interaction. Data were collected through a self-report pre-test post-test questionnaire and online medical records. Results: In the experimental group, the levels of physical fitness and physical activity were significantly improved post-test, but the scores on health-related quality of life and the physical indices did not improve. In the experimental group, the SEE and OEE post-test scores were also significantly higher than the pre-test scores, but the control group's scores did not change. Conclusion: The smartphone application-based exercise program based on self-efficacy theory significantly improved the level of physical fitness and activity, SEE, and OEE for hemodialysis patients. The use of this application-based exercise program for hemodialysis patients might be an effective nursing intervention tool for improving SEE, OEE, level of physical fitness, and physical activity.

• 지역사회간호학회지
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• 제19권4호
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• pp.704-714
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• 2008

Purpose: This study explored the feasibility of a 12 week self-efficacy based exercise intervention for overweight and obese college students. Method: A repeated measure, 4-group randomized controlled design was used. Students were recruited from two universities. in Seoul. Korea using: (1) flyers either on the campus bulletin boards or in campus restrooms: (2) advertisement on campus e-board: and (3) self-referral. Inclusion criteria were: (1) Korean college students aged 18 to 29: (2) BMI >23: (3) viscerally obese: and (4) accessible to a phone and a computer. Participants completed three self-reported questionnaires: socio-demographic questionnaire (at the baseline), Exercise Self-Efficacy Scale (at the baseline and $12^{th}$ week), and Physical Fitness sub-subscale (at the baseline and $12^{th}$ week). Additionally. physiological data (height, weight, blood pressure) were collected at the baseline and $12^{th}$ week. Descriptive statistics and a two-way mixed ANOVA were performed using SPSS12.0. Results: No significant group difference was observed. However. students with increased exercise self-efficacy during the program showed better physical fitness in the $12^{th}$ week. When students' physical fitness was enhanced. the physiological factors were improved. Conclusions: Self-efficacy based exercise intervention may be applicable and acceptable to the college students. It is necessary to conduct a replicated study with a larger sample and an elongated intervention period.

• 근관절건강학회지
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• 제5권1호
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• pp.39-56
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• 1998

This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

• 근관절건강학회지
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• 제4권2호
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• pp.262-276
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• 1997

The purposes of this study are 1) to modify a self-help program for patients having fibromyalgia, 2) to revise instruments to measure the self-efficacy and impact of fibromyalgia; and 3) to test the effects of the program in terms of self-efficacy, physical activities, and clinical symptoms. The subjects of this study were persons diagnosed as fibromyalgia at a university hospital. For the first two purposes, six patients were selected. Twenty three subjects for the third purpose were selected and assigned to experimental and control group on the base of their residence. Thirteen were assigned to the experimental group, while 10 to the control group. Instruments selected for revision were self-efficacy scale and fibromyalgia impact profile. On the basis of the text developed by Arthritis Foundation, a program for patients with fibromyalgia was tentatively developed. Instruments for measurement of self-efficacy and impact of fibromyalgia were revised to show high reliabilities. Results obtained by utilization of the program were as follows : 1) There were no increase of self-efficacy and physical activities. 2) There were no improvement of the number of tender points and pain. 3) There were improvement of depression, fatigue and sleep impairment. These findings indicate the needs for modification of the program with emphasis of exercise for relaxation of tender points, increases of enactive action and vicarious learning.

• 근관절건강학회지
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• 제8권1호
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• pp.122-140
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• 2001

The aims of this study were to understand and to predict the determinent factors affecting the exercise behaviors and physical fitness by testing the Pender's revised health promotion model, and to help the patients with rheumatoid arthritis and osteoarthritis perform the continous exercise program, and to help them maximize the physical effect such as muscle strength, endurance, and functional status and mental effects including self efficacy and quality of life, and improve the physical and mental well being, and to provide a basis for the nursing intervention strategies. Of the selected variables in this study, the endogenous variables included the physical fitness, exercise score, exercise participation, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue) and the exogenous variables included personal sociocultural factor(education level), personal biologic factor(body mass index), personal psychologic factor(perceived health status) and prior related behavior factors(previous participation in exercise, life-style). We analyzed the clinical records of 208 patients with rheumatoid arthritis and degenerative arthritis who visited the outpatient clinics at H university hospital in Seoul. Data were composed of self reported qustionnaire and good of fitness score which were obtained by padalling the ergometer of bicycle for 9 minutes. SPSS Win 8.0 and Window LISREL 8.12a were used for statistical analysis. Of 75 hypothetical paths that influence on physical fitness, exercise participation, exercise score, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue), 40 were supported. The physical fitness was directly influenced by life-style, perceived health status, education level, family support, fatigue, which explained 12% of physical fitness. The exercise participation were directly influenced by life-style, education level, past exercise behavior, perceived benefits of action, perceived barriers of action, depression and duration of arthritis, which explained 47% of exercise participation. Exercise score were directly affected by perceived self efficacy. BMI, life-style, past exercise behavior, perceived benefits of action, family support, perceived health status. perceived barriers of action, and fatigue, which explained 70%. Perceived benefits of action was directly influenced by BMI, life-style, which explained 39%. Perceived barriers of action were directly influeced by past exercise behavior, perceived health status, which explained 7%. Perceived self efficacy were directly influeced by level of education, perceived health status, life-style, which explained 57%. Depression were directly influeced by past exercise behavior, BMI, life-style, which explained 27%. Family support were directly influeced by life-style, perceived health status, which explained 29%. Fatigue were directly influeced by BMI, life-style, perceived health status. which explained 41%. Duration of arthritis were directly influeced by life-style, past exercise behavior, BMI, which explained 6%. In conclusion, important variables for physical fitness were life-style, and variable affecting exercise participation were life-style. Perceived self-efficacy of exercise was a significant predictor of exercise score. BMI, Life-style, perceived benefits of action, family support, past exercise behavior showed direct effects on perceived self-efficacy. Therefore, disease related factor should be minimized for physical performance and well being in nursing intervention for patients with rheumatoid arthritis, and plans to promote and continue exercise should be seeked to reduce disability. In addition, Exercise program should be planned and performed by the exact evaluation of exercise according to the ability of the patients and the contents to improve the importance of exercise and self efficacy in self control program, dedicated educational program should be involved. This study suggest that the methods to reduce the disease related factors, the importance of daily life-style, recognition of benefit of exercise, and educational program to promote self efficacy should be considered in the exercise behavior promotion and nursing intervention for continous performance. The significance of this study is also thought to provide patients with chronic arthritis the specific data for maximal physical and mental well being through exercise, chronic therapeutic procedure, daily adaptation and confrontation in nursing intervention.

• 디지털융복합연구
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• 제19권3호
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• pp.415-423
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• 2021

본 연구는 생존수영교육 참여를 통한 초등학생의 수중불안, 신체적 자기효능감 및 수상안전 의식의 변화와 변인 간 영향관계를 살펴보고자 하였다. 이를 위해 편의표본추출법을 이용하여 부산광역시 소재 초등학생 중 생존수영교육에 참여한 초등학생 312명 중 300명을 유효표본으로 사용하였다. 수집된 자료는 SPSS 25.0 통계 프로그램을 이용하여 탐색적 요인분석, 신뢰도 분석, 대응표본 t-검정, 다중회귀분석을 통해 분석하였으며, 이에 따른 결과는 다음과 같다. 첫째, 생존수영교육 참여한 초등학생은 사전·사후효과를 비교하였을 때 사후 수중불안은 감소하고, 신체적 자기효능감과 수상안전 의식은 증가하였다. 둘째, 생존수영교육 참여 초등학생의 수중불안은 신체적 자기효능감과 수상안전 의식에 부분적으로 부정적인 영향을 미치며, 신체적 자기효능감은 수상안전 의식에 부분적으로 긍정적인 영향을 미치는 것으로 나타났다. 이러한 결과를 바탕으로 생존수영교육의 효과성을 확인할 수 있었으며, 프로그램의 질적 확대 방향성에 대해 재고해 볼 수 있을 것이다.

• 한국산학기술학회논문지
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• 제18권3호
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• pp.408-417
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• 2017

본 연구는 여가스포츠에 참여중인 만 60세 이상 노인들을 대상으로 신체적 자기효능감, 우울감, 자아통합감의 구조적 관계를 규명하는데 그 목적이 있다. 또한 최근 자아통합감에 영향을 미치는 변인은 다차원적으로 제시되고 있으므로 변인들의 인과관계를 통합적 관점에서 살펴보는 것이 매우 중요하다. 이상의 목적을 달성하기 위하여 노인기관에서 여가스포츠 프로그램에 참여중인 노인 427명을 연구대상으로 설정하였으며, 구조방정식 모형분석을 실시하였다. 이를 위해 각 변인을 대상으로 확인적 요인분석과 신뢰도 분석을 실시하였으며, 직접효과, 간접효과, 총효과 등을 추정하였다. 모형 적합도는 TLI, CFI, RMSEA를 참고하였으며, 측정모형의 적합도와 연구모형의 적합도 모두 그 기준을 만족하였다. 연구가설 검증결과 첫째, 설문지에 관한 타당도와 신뢰도 검증 결과 신체적 자기효능감, 우울감, 자아통합감 변인 모두 적합한 것으로 나타났다. 둘째, 인지된 신체능력은 우울감, 현재생활만족, 지혜로운 삶, 생에 대한 태도에 긍정적인 영향을 미치는 것으로 나타났으며 신체적 자기표현 자신감은 현재생활만족, 생에 대한 태도에는 긍정적인, 지나온 삶 수용에는 부정적인 영향을 미치는 것으로 나타났다. 마지막으로 우울감은 현재생활만족에 부정적인 영향을 미치는 것으로 나타났다. 이상에서 나타난 결과는 노인들의 신체적 자기효능감, 우울감, 자아통합감의 통합적 관계를 규명하였다는 것에 의미가 있다.

• 근관절건강학회지
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• 제10권1호
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• pp.19-31
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• 2003

Purpose : The purpose of this study was to examine the effect of the self- efficacy, group cohesion and family support on adherence of aquatic exercise in arthritis patients. Method : The Subjects were 30 patients with arthritis who had participated in the 6-week aquatic exercise programs of Korean Rheumatology Health Professionals Society. All subjects were interviewed from November to December, 2001(1st) and Feburary, 2002(2nd) using a structured questionnaire which was composed of 42 items. SPSS Win 10.0 was used for data analysis. Results : Ten out of thirty were adherer who were keeping aquatic exercise for three months since they completed 6-week aquatic exercise program. The major reasons of adherence were affectional reasons and general condition improvement on the first month. The reasons of 3-month adherence were improvement of arthritis symptoms, affectional improvement, expectations, general condition improvement and group activity. The major reasons of drop out were environment factors and physical factors. The environmental reason were time shortage, economic problem and long distance. And the physical factor were cold, pain and other health problem. The scores of self-efficacy were decreased from 528.00 to 476.00 within 3 months after compeleting aquatic exercise program and that was statistically significant(p=.029). But there were no statistically differences in group cohesion and family support. There was a significant positive correlation between exercise adherence and self-efficacy. Factors influencing the exercise adherence was self-efficacy which accounted for 23% of the variance in the exercise adherence. Conclusion : In conclusion, self-efficacy is a significant variable in the exercise adherence and changes within 3 month after completing aquatic exercise program. The results of this study suggested that the strategy for maintaining self-efficacy should be developed.