• 대한간호학회지
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• 제46권3호
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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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• 제24권1호
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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.

• 대한간호학회지
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• 제46권6호
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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.

• 정신신체의학
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• 제26권2호
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• pp.86-93
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• 2018

연구목적 본 연구는 한국 성인의 인슐린 저항성 정도와 우울감, 자살 생각, 스트레스 및 삶의 질 사이의 연관성을 탐색하고자 하였다. 방 법 제6기 3차년도 국민건강영양조사 자료를 이용하여 3,613명의 대상자를 선정하였다. 인슐린 저항성은 Homeostatic Model Assessment of Insulin Resistance를 통해 계산하였다. 우울감, 자살 생각, 스트레스에 대한 설문이 이루어졌으며, 삶의 질은 EuroQol-5 dimension의 삶의 질 지수를 통해 평가되었다. 분석 방법으로는 상관 분석과 회귀 분석이 사용되었다. 결 과 인슐린 저항성 집단에서 대조 집단에 비해 우울감과 자살 생각의 위험성이 유의하게 높았다. 스트레스는 남성에서만 인슐린 저항성 집단에서 위험성이 유의하게 증가하였다. 삶의 질 지수는 인슐린 저항성과 음의 상관관계를 보였다. 나이, 성별, 체질량 지수를 보정하였을 경우에는 자살 생각에서만 위험성 증가가 확인되었다 결 론 한국 성인에서 인슐린 저항성이 우울증과 관련된 정신건강 문제들과 연관성을 갖는 것을 확인하였다.

• 임상간호연구
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• 제28권3호
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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.

• 한국융합학회논문지
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• 제9권12호
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• pp.485-493
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• 2018

본 연구는 심리적 인슐린 저항성이 있는 제2형 당뇨병 환자들의 인슐린 치료 시작과 관련하여 겪게 되는 어려움과 동기의 변화과정을 파악하고자 제2형 당뇨병 환자의 동기강화상담 내용을 분석하였다. 동기강화상담 과정에 기초하여 지속적 비교분석 방법(consistent comparative analysis)을 활용하였다. 연구결과는 관계 형성하기, 초점 맞추기(당뇨병 자가관리에 대한 문제점을 스스로 탐색하기, 당뇨병 관리에 대한 한계점 인식, 합병증에 대한 걱정, 미래의 모습 상상하기), 유발하기(인슐린 투여 시 예상되는 장단점 그려 보기, 인슐린 강점 새롭게 알아가기, 인슐린 치료 시작에 대한 생각의 변화), 계획하기(변화에 대한 구체적 호기심 들어내기, 변화 계획하기), 변화행동 유지하기(변화 자신감 유지), 평가(내담자 상담자가 평가같이 내려 보기)로 도출되었다. 연구결과를 바탕으로 심리적 인슐린저항성이 있는 제2형 당뇨병 환자를 이해하는 데 기여할 것이다. 또한 이러한 대상자를 돕는 전문가들에게 시사점을 제공할 수 있을 것이다.

• 한방비만학회지
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• 제8권1호
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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.

• 한국응용과학기술학회지
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• 제35권3호
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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.

• 한국산학기술학회논문지
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• 제20권5호
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• pp.394-405
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• 2019

본 연구의 목적은 허약노인에 대한 개념의 명확한 속성 규명과 이론적 근거를 마련하는 것이다. 연구방법은 Walker와 Avant(2005)의 개념분석을 위한 기본 원리에 근거하여 절차에 따라 진행하였다. 허약노인에 대한 개념 사용의 연구결과는 허약노인은 건강과 질병의 중간상태에 있다. 허약노인은 신체적으로 근감소증, 염증, 인슐린 저항성에서 신체적으로 취약하고, 진행된 질병의 결과로 입원, 낙상, 장애, 사망에 이를 수 있다. 생리적, 심리적, 사회적 생활습관, 경제적 요인과 관련된 다면적 속성을 가지며, 일상생활에 제한으로 다른 사람의 도움을 필요로 하여 의존적이며, 회복시간과 회복의 정도가 저하되는 것과 소진(exhaustion)의 속성을 가지고 있는 것으로 확인되었다. 즉, 역동적 과정(dynamic process), 다면적 요소(multidimensional factors), 의존성(dependency), 취약성(vulnerability)이다. 허약노인은 건강과 질병의 중간 상태로 변화 가능성을 내포한 역동적 과정이며, 신체적, 정신적, 인지적, 사회 환경적 요소를 포함한다. 또한 일상생활에 어려움이 있는 노인으로, 신체적 취약성과 함께 적응에 어려움을 가지고 있는 노인을 의미하였다. 결론적으로 본 연구는 허약노인의 개념분석과 이해를 통해 노인의 허약 수준을 파악하고, 체계적으로 관리함으로써 장기요양상태에 이르지 않도록 지역사회 방문간호를 포함한 보건의료체계 마련을 위한 기초자료 제공에 기여할 것이다.