• 근관절건강학회지
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• 제14권1호
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• pp.26-32
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• 2007

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.

• 대한간호학회지
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• 제36권3호
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• pp.571-580
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• 2006

Purpose: This study was to compare the effects among Tai-Chi exercise, aquatic Exercise, and a self-help program for knee osteoarthritis patients on symptoms of arthritis, muscle strength, balance, and difficulty of performing activities. Method: There were 50 final subjects50. A non-equivalent pretest-posttest design was used. The collected data was analyzed using SPSS for Window. One-way ANOVA and Scheffe's multiple comparison test were used 8weeks after each program. Result: There were significant differences in joint pain(p=.000), stillness (p=.001), knee extensor peak torque(p=.006), knee flexor(p=.002), and difficult of performing activity (p=.000), but there was no significant difference in balance(p=.648). The Tai-Chi group was significantly different from the self-help group for knee extensor peak torque, knee flexor and stiffness on Scheffe's multiple comparison tests. In addition, the Tai Chi group or aquatic group were significantly different from the self-help group for difficulty of performing activities(p<0.05). Conclusion: There are significant differences in the effects of the nursing intervention among the three groups. The Tai Chi group and aquatic group were significantly different from the self-help group. However, it seems that Tai-chi exercise may be more suitable than aquatic exercise in osteoarthritis exercise programs. Further studies with a longitudinal study are necessary to confirm the longer exercise period.

• 근관절건강학회지
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• 제14권2호
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• pp.169-180
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• 2007

Purpose: This study was done to determine the effect of Tai-Chi Self-help program to progress of reduction of symptom, difficulty on activity by application Tai-Chi Self-help program for Fibromyalgia patients. Method: The study was used the method of one group pretest-posttest design. The subjects were 65 outpatients who were diagnosed as Fibromyalgia by ACR(1990) standard at K University Hospital, medical center. Tai-Chi self-help program was done for 8 weeks(three a week for 2 hours)through group meeting of 65 patients. Collected data were analyzed by SPSS for window12.0 program package. Results: The result of this study suggests that could increase in reduction of symptom and lower disturbance in ADL and life Satisfaction compared with the before Tai-Chi Self-help program education. Conclusion: Accoradingly Tai-Chi Self-help program could be used as a proper nursing strategy for Fibromyalgia patients.

• 근관절건강학회지
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• 제18권2호
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• pp.270-281
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• 2011

Purpose: This study was done to determine if osteoarthritis (OA) patients living in rural Korea would have a benefit from a structured group program focused on self-help strategies. Methods: A hundred and twenty-six patients with OA were recruited from nine Primary Health Care Posts. The experimental group received a 6-week self-help education program while the control group received usual care. T-tests and c2-tests were used to determine the homogeneity between the experimental and control groups. Independent sample t-tests were performed to determine the effect of the treatment program. To guard against such likelihood, the level of significance of t-test was determined by Bonferroni correction within the study constructs. When significant group differences were found in study variables at baseline, analysis of covariances (ANCOVAs) were used for group comparisons of outcome variables. Results: The experimental group reported more significant improvement in fatigue, difficulty with physical activity, depression, quality of life, self-efficacy, and health behaviors than did the control group. The experimental group also showed improvements in range of motion and muscle strength as compared to the control group. Conclusion: A self-help group education program was an effective and powerful strategy to promote physical and psychosocial health in OA patients

• 사회복지연구
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• 제41권1호
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• pp.5-37
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• 2010

본 연구는 장기간의 활동을 통해 다양한 변화 과정을 경험해온 빈곤 한부모여성 자조집단을 대상으로, 정체기 이후 자조집단 참여자들이 변화를 주도하게 된 동기와 과정 및 전략을 살펴보고 그 변화가 참여자들과 소속집단, 기관에 주는 시사점을 분석함으로써 자조집단이 지향해야 할 실천방향을 모색하는데 목적이 있다. 이를 위해 참여자와 실천가가 협력적으로 대안을 모색하는 참여실행 연구방법(PAR)을 적용하여, 문제도출, 지역조사 및 계획, 실행, 평가 및 검토의 4단계에 걸친 연구과정을 통해 변화의 과정과 내용을 분석하고 그에 따른 사회복지실천의 함의를 고찰하였다. 연구결과, 첫째, 자조집단 참여자들의 변화 동기는 주체적으로 활동방향을 결정해야 한다는 문제인식에서 비롯되었으며, 그 결과 자신들의 역량을 고려한 활동모색을 변화의 필요성으로 도출하였다. 둘째, 변화를 모색하는 과정에서 참여자들은 변화의 범위와 내용을 주도적으로 결정했으며, 그 결과 정서적 지지를 넘어서 '목적성 있는 활동'을 지향하고자 하였다. 셋째, 변화를 위한 구체적인 전략으로 '의미있는 활동'이 제시되었으며 이는 지역자원봉사활동과 한부모 참여자 강사활동으로 계획·실행되었다. 결론적으로 자조집단이 지향해야 할 변화는, 참여자들의 주체적 인식의 변화를 기반으로 실천가 중심에서 참여자 중심의 실천으로 실천주체가 변화해야 할 것으로 나타났으며, 이를 통해 자신의 삶을 조성하는 사회적 조건에 대한 통제력을 갖도록 사회적 차원의 임파워먼트를 강화하는 것으로 나타났다. 나아가 자조집단의 한계를 극복하기 위해 공동체적 접근으로의 변화를 고려해보아야 할 필요성이 있는 것으로 제시되었다. 이러한 분석결과를 바탕으로 본 연구가 사회복지실천에 주는 함의를 제시하였다.

• 대한간호학회지
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• 제45권2호
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• pp.192-201
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• 2015

Purpose: The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness. Methods: A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function. Results: Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups. Conclusion: The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.

• 근관절건강학회지
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• 제1권1호
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• pp.1-30
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• 1994

Rheumatoid arthritis is a chronic systematic disease with unpredictable course of exacerbation and remission, characterized by pain, joint deformity and reduced activity by joint limitation. The growing public awareness of the need for health management of chronic illnesses, provides impetus for nursing to demonstrate social effectiveness by active nursing intervention in this vast area in general, and with rheumatoid condition in particular. However, nursing interventions to date have not demonstrated its active participation in the management of chronic conditions. Nursing intervention for the patients having rheumatoid arthritis is one such area that needs to be studied intensively and to demonstrate their effectiveness empirically. The purposes of this study were two fold : first, to develop a comprehensive program that was intensified with therapeutic joint exercises in water, self-help group activities and utilization of self-efficacy promoting strategies : and secondly, to determine the effect of aquatic exercise program on pain, physiological changes and quality of life in the rheumatoid arthritis patients. Thirty five female subjects participating in this study were selected from outpatients in the Rheumatism Center, Hanyang University hospital. The period of data collection was from December, 1992 to March, 1993 in seoul and Taejeon. Subjects in Taejeon were assigned to the experimental group. The comprehensive aquatic exercise program for the experimental group was carried out three times a week for 6 weeks in regular swimming pool. Subjects in Seoul did not participated in the program, and treated as the control group. Data were analyzed with repeated measure MANCOVA, t-test, ANCOVA, percentage of change, Kruskal-Wallis 1-Way ANOVA using SPSS $PC^+$ program. Results were obtained as follows : 1) Scores on Korean pain scale, Numeric pain score, and RAI score of the experimental group were significantly lower than those of the control group (t=2.11, p=0.022 ; F=4.40, p=0.044 : t=3.10, p=0.002). 2) There was significant improvement in the physiological parameters (higher joint movement parameters, F=15.64, p=0.024 ; higher lean body mass, percentage of change=+12.2, lower body weight, t=1.01, p=0.026 : lower ESR, t=1.69, p=0.001) in the experimental group compaired with subjects In the control group. 3) There was significant improvement in the specific self-efficacy score through the comprehensive aquatic exercise program(t=2.73, p=0.011), but not in the general self- efficacy score(t=0.62, p=0.113). 4) The quality of life failed to show significant improvement in the experimental group as compaired with the control group (F=3.69, p=0.064). 5) In the experimental group, findings from additional analysis showed no significant difference in the specific self-efficacy between those who continued to aquatic exercise after completing 6 week program and those who stopped (X2=0.086, p=0.690). Therefore, adherence to aquatic exercise program for 6 weeks seem to be affected mainly by self-help group activities. An indepth study to delve into articulation of mechanisms affecting the effect of aquatic exercise program be recommended. A further study is necessary to determine the difference in the effect of group and individual aquatic exercise program, to assess factors affecting adherence to exercise for an extended length of time.

• 근관절건강학회지
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• 제10권2호
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• pp.167-187
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• 2003

Ankylosing spondylitis(AS) is one of the most common forms of chronic arthritis causing pain and progressive disability. The purposes of this study were 1) to develop an offline educational program and online educational program for the patients with ankylosing spondylitis; and 2) to test the effectiveness of each program in terms of changes in ankylosing spondylitis self-efficacy, exercise continuity disease activity, physical functioning, and depression. The convenient samples for three groups were selected acceding to the inclusion criteria. Online education group consists of 7 patients, and 14 patients were included for the offline group, while 12 patients were assigned to the control group. Outcomes variables included self efficacy, exercise continuity, disease activity, physical function, and depression and the reliability of each measure was ranged from .88 to .95 in the present study. The offline educational program demonstrated positive effects on self-efficacy, exercise continuity, disease activity, and depression, whereas the online educational program on exercise continuity, disease activity, and depression. The self-efficacy was showed positive effect only in the offline educational program, whereas physical functioning did not improve in both intervention groups. These partial improvements may be due to the small sample size and the methods of online education program. In conclusion, the effectiveness of the offline and online educational programs was partially supported in the present study. For the improvement of these programs, the further study would be necessary to apply this kind of intervention program with larger sample and to test the psychometric of the newly development tools.

• 근관절건강학회지
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• 제21권1호
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• pp.1-10
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• 2014

Purpose: The purpose of the study was to identify the attributes of self-help groups, their antecedents and consequences relating to self-help groups. Methods: We used the Walker and Avant (2010) method using the key word "self-help groups" the Korea Education and Research Information Service (www.riss4u.net), Pubmed, CINAHL and ProQuest for articles on this topic published between January 2000 and March 2013 were searched. Ultimately, 64 domestic and 21 foreign papers were selected for in-depth analysis. Results: The attributes of self-help groups are as follows: 1) members share common experiences and are supportive of each other; 2) members set goals for individual change; 3) groups are self-monitoring; 4) groups learn problem-solving processes through voluntary and active participation; and 5) groups are small and meet regularly. The antecedents of self-help groups are as follows: 1) an intervention by an expert; 2) a diagnosis of their illness; 3) motivation to change individuals' state; and 4) educational desire. The consequences of self-help groups are the relief of symptoms, the improvement of physiological parameters and quality of life, the decrease in depression, stress, and anxiety, the improvement of illness-related knowledge and self-help activity, and a change in beliefs. Conclusion: Self-help groups can be used as an intervention strategy to help people with chronic illness manage their own problems.

• 근관절건강학회지
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• 제18권1호
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• pp.83-92
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• 2011

Purpose: The purpose of this study was to identify the changes of physical function, perceptual and cognitive function, emotional function, and functional independence in the institutionalized aged according to functional group activity program (self help Tai Chi exercise plus functional task). Methods: Study subjects were 20 institutionalized aged from June to October in 2010. The subjects received functional group activity program two times a week for 15 weeks. Physical function (grip strength, coordination, lower extremity strength, balance, gait, trunk flexibility), perceptual and cognitive function, emotional function(depression, social skill), and functional independence were measured before and after the program. Results: The subjects showed significantly increased physical function (coordination, lower extremity strength, gait, trunk flexibility), perceptual and cognitive function, emotional function (depression, social skill), and functional independence. The functional group activity program may be an effective strategy for institutionalized elders to enhance their functions. Conclusion: The functional group activity program may be effective on elderly institutions which have limitation in human, material, environmental resources.