• Journal of Korean Academy of Nursing
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• v.46 no.3
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• pp.443-453
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• 2016

Purpose: The purpose of this study was to define the concept for psychological insulin resistance in the Korean population with diabetes. Methods: The Hybrid model was used to perform the concept analysis of psychological insulin resistance. Results from both the theoretical review with 26 studies and a field study including 19 participants with diabetes were included in final process. Results: The preceding factors of psychological insulin resistance were uncontrolled blood glucose and change in daily life. The concept of psychological insulin resistance was found to have three categories with 8 attributes such as emotional factors (negative feeling), cognitive factors (low awareness and knowledge, low confidence for self-injection) and supportive factors (economic burden, dependency life, embarrassing, feeling about supporters, feeling of trust in, vs mistrust of health care providers). The 8 attributes included 30 indicators. Conclusion: The psychological insulin resistance of population with diabetes in Korea was defined as a complex phenomenon associated with insulin therapy that can be affected by emotional factors, cognitive factors, and supportive relational factors. Based on the results, a tool for measuring psychological insulin resistance of Koreans with diabetes and effective programs for enhancing insulin adherence should be developed in future studies.

• Journal of Korean Biological Nursing Science
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• v.24 no.1
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• pp.58-66
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• 2022

Purpose: The purpose of this study was to identify the level of psychological insulin resistance and self-care activities and to evaluate the factors affecting self-care activities in patients with type 2 diabetes mellitus undergoing insulin therapy to provide basic data for the development of educational programs. Methods: Data were collected through the interviews using a structured questionnaire from August 29 to October 20, 2017, from the patients with type 2 diabetes mellitus visiting the Diabetes Mellitus Center at H-General Hospital in J-city. The subjects were 168 patients who had been being treated via self-injection for at least three months after the start of insulin therapy. Data analyses were conducted using t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression using the SAS WIN 9.2 program. Results: The mean score of psychological insulin resistance was 61.25 (range 19-95) and the mean score of self-care activities was 53.19 (range 18-90). Self-care activities were significantly different by gender (t = -2.94, p= .004), perceived health status (F= 7.00, p< .001), and hypoglycemia during the last three months (t= -2.47, p= .015). Negative correlation was observed between psychological insulin resistance and self-care activities (r= -.33, p< .001). Self-care activities were significantly predicted by psychological insulin resistance, perceived health status, gender, and hypoglycemia during the last three months, and 19.0% of the variance in self-care activities was explained (F= 9.01, p< .001). Conclusion: Psychological insulin resistance in patients undergoing insulin therapy and its effects on self-care activities identified in this study will be useful in starting and maintaining insulin therapy in the future.

• Journal of Korean Academy of Nursing
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• v.46 no.6
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• pp.813-823
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• 2016

Purpose: This study was done to develop and validate a measure to evaluate the Korean version of psychological insulin resistance (K-PIR) in patients with diabetes in Korea. Methods: Items were initially generated from literature reviews and interviews with 19 patients with diabetes. The content validity of the items was evaluated by experts. Participants were 424 patients with diabetes recruited through convenience sampling. A cross-sectional survey was designed for item-analysis, exploratory factor analysis with principal axis factoring, and confirmatory factor analysis. Cronbach's alpha was calculated to measure the internal consistency. Results: For the 24 items of the Korean version of psychological insulin resistance, six items were eliminated because of low correlation with the other items. Exploratory factor analysis with 18-item showed that two factors (psycho-cognitive factor and supportive factor) explained 41.8% of the variance, and the factor structure of K-PIR model had a good fit. Internal consistency of K-PIR with 18 items revealed good reliability. Conclusion: The findings show that the K-PIR is reliable for measuring the psychological resistance to insulin therapy for Korean patients with diabetes. However, further study is needed to evaluate the validation because the proportion of variation of K-PIR was low in this study.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.86-93
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• 2018

Objectives : The purpose of this study was to investigate the association between the insulin resistance and depressive mood, suicidal ideation, psychological stress, and quality of life in general Korean population. Methods : We selected 3,613 subjects from the third year's data of 6th Korean National Health and Nutritional Examination Survey. Insulin resistance was evaluated with Homeostatic Model Assessment of Insulin Resistance. Questionnaires on depressive mood, suicidal ideation and psychological stress were conducted. The quality of life was assessed with the EuroQol-5 dimension index. We used correlation and regression analysis for analysis. Results : The risk of depressive mood and suicidal ideation was significantly higher in the insulin resistance group than in the control group. The risk of psychological stress was significantly higher in the male group with insulin resistance. The EuroQol-5 dimension index showed a negative correlation with insulin resistance. After adjusting for age, sex and body mass index, increased risk of suicidal ideation was identified only. Conclusions : We confirmed that insulin resistance is associated to mental health problems related with depression in Korean adults.

• Journal of Korean Clinical Nursing Research
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• v.28 no.3
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• pp.277-288
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• 2022

Purpose: This study was conducted to evaluate the effects of the insulin therapy adherence program (INSTA GRAM) for patients with type 2 diabetes mellitus. Methods: This study examined a total of 63 patients with type 2 diabetes for whom the initiation of insulin therapy is being considered or within 6 months of undergoing insulin therapy. INSTAGRAM is a stage-specific intervention consisting of strategies for motivating patients to initiate and maintain insulin therapy using the transtheoretical model on the stages of change, the process of change, and self-efficacy. The participants were randomly assigned to either the INSTAGRAM group (experimental group, n=32) or the standard diabetes education group (control group, n=31). The INSTAGRAM group received 6 sessions over 8 weeks(face-to-face education was conducted in the first and last sessions, and telephone coaching was conducted from the second to fifth sessions). The outcomes were measured by psychological insulin resistance, self-efficacy, and glycosylated hemoglobin (HbA1c). Results: Psychological insulin resistance (p<.001), self-efficacy (p<.001), and HbA1c (p=.024) of the participants in the INSTAGRAM group significantly improved compared to those in the control group. Conclusion: INSTAGRAM is effective in overcoming psychological insulin resistance and improving self-efficacy and HbA1c. Therefore, the INSTAGRAM can be recommended as a nursing intervention for type 2 diabetic patients who delay the initiation of insulin therapy.

• Journal of the Korea Convergence Society
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• v.9 no.12
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• pp.485-493
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• 2018

This study analyzed the motivational interviewing of type 2 diabetes patients in order to understand the difficulties and motivations associated with starting insulin treatment in psychosomatic insulin-resistant patients. The method used the consistent comparative analysis. The results of study were as follows: building relationships, focusing (Self-explore of problems with diabetes self-management, Recognizing the limitations of diabetes management, Concerns about complications, Imagine the future), inducing (Imagine the expected benefits and disadvantages of insulin administration, Discovering the benefits of insulin, Changes in thinking about starting insulin therapy), planning (Show specific curiosity about change, Planning change), maintaining change behavior (Keeping change confident), and evaluating. This study will contribute to understanding patients with type 2 diabetes with psychological insulin resistance. It may also provide implications for professionals helping these subjects.

• Journal of Korean Medicine for Obesity Research
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• v.8 no.1
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• pp.23-32
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• 2008

Objectives We aimed at reviewing the clinical trials of the acupuncture application for obesity treatment, recently. Methods We searched the clinical trials papers with keywords of obesity, weight loss, overweight, obese and acupuncture and limited method to clinical trial since 2006 in the search site, Scopus. Results & Conclusion We reveiwed 13 articles searched. Recently, acupuncture application for obesity treatment were 3 types ; traditional acupuncture, auricular acupuncture and electroacupuncture. In the 13 articles, 6 articles were uncontrolled trials and 7 were controlled trials. Acupuncture application were effective method to decrease weight and to improve complication such as Polycystic ovarian syndrome, insulin resistance and psychological symptoms.

• Journal of the Korean Applied Science and Technology
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• v.35 no.3
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• pp.956-962
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• 2018

Childhood obesity causes a higher risk of obesity, premature death and disability in adulthood. In addition, obese children experience an increased risk of respiratory problems, hypertension, cardiovascular disease, insulin resistance and psychological effects. This study aimed to investigate how an exercise intervention affects health-related physical fitness and inflammatory-related blood factors in obese children after. We hypothesized that there would be positive effects on serum levels of insulin-like growth factor-1 (IGF-1), connecting peptide(C-peptide) and resistin, as well as in muscle and cardiovascular-related physical capacities, after an exercise intervention in obese children. Thirty-seven obese children haveperformed health-related fitness tests and provided blood samples for the analysis of changes in circulating biomarkers, both before and after an 8-week exercise intervention, which includes stretching, aerobic exercise, resistance exercise and sports games. The results indicate that exercise training beneficially affects body compositions, especially percentage body fat and muscle mass, without influencing to body weight and height. The results of the physical fitness tests show that muscle and cardiovascular capacity were increased in obese children in response to exercise training. Simultaneously, the exercise training decreased circulating levels of C-peptide, which equated to a "large" effect size. Although there were no significant effects on the levels of IGF-1 and resistin, they show a "small" effect size. Therefore, our findings suggest that the exercise intervention have beneficial effects on body composition and physical fitness levels in obese children, whichmight be associated with the decline in circulating C-peptide.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.5
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• pp.394-405
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• 2019

The purpose of this study is to clarify the concept of the frail elderly and to obtain theoretical evidence. The research method was conducted using the basic principles for conceptual analysis of Walker and Avant(2005). As a Result of a review of the literature about how to utilize the concept of a frail elderly, frail elderly might be in the intermediate state of health and disease. They can be defined as physically vulnerable in the sarcopenia, inflammation, insulin resistance, and preceding advanced disease, lead to hospitalization, falls, disability, and death. The attributes were physiological, psychological, and socio-environmental and economic factors, so they had multidimensional factors. They were required the assist daily living of another person. Also, their attributes had decreased the amount of recovery time and degree, and exhaustion. The attributes of frail elderly consisted of these facts: dynamic process, multidimensional factors, dependency, vulnerability. The frail elderly was a dynamic process that involves the possibility of change to health and disease, and include physical, mental, cognitive, and social environmental factors. In addition, the frail elderly was difficulty in daily life, physical vulnerability and difficulty in adaption. In conclusion, frail elderly as defined by the results of this study will contribute to the foundation of health care systems, including community visiting nursing to understand the level of frail elderly and systemic management to do not go into long term care.