• The Korean Journal of Health Service Management
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• v.13 no.4
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• pp.179-190
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• 2019

Objectives: This study aimed to investigate the mediating effects of health promotion behaviors on the correlation between self-perceived health and medical care utilization among older adults. Methods: This study used data from a. Data were analyzed with frequency analysis, descriptive statistics, Pearson's correlation coefficient, and hierarchical multiple regression. Mediation analysis was performed according to the Sobel test. Results: The self-perceived health and some health promotion behaviors in older adults had a statistically significant effect on medical care utilization. Only the nutritional management of health promotion behaviors had a mediating effect on the relation between the self-perceived health and medical care utilization of older adults. Conclusions: The nutritional management of older adults was confirmed as an important factor to health promotion and prevention. This study was meaningful in that it identified the political directions for establishing health care policy for the older adults.

• Journal of Korean Public Health Nursing
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• v.27 no.3
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• pp.619-632
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• 2013

Purpose: The purpose of this study was to develop an obesity management program for obese children and examine its effects on body composition, self-efficacy, and health promotion. The obesity management program was based on a KAP & HBM mixed model and consisted of health education and group playing exercises. Method: This study was implemented at one elementary school in K city for a total of 12 weeks. The study subjects were a single group, and their body composition, self-efficacy, and health promotion were assessed at both pre-treatment and post-treatment. Data were analyzed by Wilcoxon Signed Rank Test using SPSS WIN 20.0. Result: After the program, the average height of subjects increased by 0.9cm (p=.001), whereas BMI decreased by $0.64kg/m^2$ (p=.003), obesity index decreased by 3.79% (p=.003), and body fat decreased by 1.34% (p=.002). There were significant effects on diet self-efficacy (p=.027), exercise self-efficacy (p<.001), and health promotion (p=.001). Conclusion: This obesity management program reduced the degree of obesity and improved self-efficacy and health promotion. Therefore, the obesity management program is an effective intervention method for elementary-aged obese children.

• Journal of Korean Academy of Nursing
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• v.47 no.5
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• pp.663-675
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• 2017

Purpose: The purpose of this study was to construct and test a structural equation model of self-management of liver transplant recipients based on self-determination theory. Methods: Participants were 275 outpatients who received liver transplantation. A structured self-report questionnaire was used to assess health care providers' autonomy support, transplant-related characteristics, illness consequence perception, autonomy, competence, family relatedness, depression and self-management. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0 program. Results: The modified model showed a good fitness with the data: GFI=.96, RMSEA=.06, CFI=.96, NFI=.93, TLI=.93, PGFI=.43, PNFI=.49. The health care providers' autonomy support, competence, family relatedness and depression were factors with a direct influence on the self-management of liver transplant recipients. The health care providers' autonomy support and illness consequence perception had an indirect influence through competence, family relatedness and depression. However, the transplant-related characteristics and autonomy did not have a significant effect on self-management. This model explained 59.4% of the variance in self-management. Conclusion: The result suggests that continuous education must be done to promote the competence of liver transplant recipients and to encourage the patient to positively perceive their current health condition with a view that enhances one's self-management. Additionally, the liver transplant recipients should be screened for depression, which would affect self-management. Most of all, health care providers, who have the most influence on self-management, should improve therapeutic communication and try to form a therapeutic relationship with the liver transplant recipients.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1321-1325
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• 2015

Self-care to prevent cancer and self-management to cope with the disease are two discrete effective mechanisms for improving of control and management of neoplasia. Both them have certain strategies and practices. Often the two are used interchangeably despite their different approaches. Strategies of self-care usually refer to prevention at different levels include primary, secondary and tertiary. In contrast, strategies of self-management are related to management and alleviation of unpleasant cancer-related symptoms and treatment-related side effects for improving the quality of life of cancer survivors. Successful promoting of self-care and self-management strategies need people and survivor empowerment. Within this context, innovative approaches open a new window. In this paper after a brief review of related strategies and practices, we provide an explanation of how cancer portals may play an important role in the empowerment process and what are key potentials for implementing of self-care and self-management strategies for cancer.

• Health Policy and Management
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• v.31 no.1
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• pp.74-90
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• 2021

Background: It is getting important to improve the oral health status of the elderly because oral health status may affect their health status of the whole body. In this respect, we aimed to explore the association of oral health status and behavior factors with self-rated health status by sex. Methods: Using the data from the 7th Korea National Health and Nutrition Examination Survey for health surveys and oral examinations (2016-2018), we analyzed a total of 3,070 people aged 65 or older (men: 1,329; women: 1,741). Our dependent variable, self-rated health status, was divided into two groups: not good (bad and very bad) and good (very good, good, and fair), whereas our independent variables of interest were oral health status and behavior factors. In addition to descriptive analysis and the Rao-Scott chi-square test, reflecting survey characteristics, we conducted hierarchical multivariable logistic regression analyses adjusted for socio-demographics and health status and behavior factors. All analyses were stratified by sex. Results: The proportion of people having 'not good' self-rated health was 36.5% in women but 24.5% in men. In a model adjusted for all covariates, the self-rated health status showed significant association with the self-rated oral health status. For example, in men, the risk of having 'not good' self-rated health was high in people having 'poor' (odds ratio [OR], 5.31; 95% confidence interval [CI], 2.34-12.03) self-rated oral health status and in those having 'fair' (OR, 4.03; 95% CI, 1.68-9.70) in comparison with those having 'good' self-rated oral health status. Dental status regarding speaking difficulty seemed to be very important in influencing self-rated health status. For instance, in women, compared to people having 'no discomfort' speaking difficulty, the risk of having 'not good' self-rated health was high in people having 'not bad' (OR, 1.60; 95% CI, 1.14-2.24) and 'discomfort' (OR, 1.79; 95% CI, 1.30-2.47) speaking difficulty. The covariates significantly associated with the risk of having 'not good' self-rated health were: physical activity, chronic disease, stress, and body mass index in both sexes; health insurance type and drinking only in men; and economic activity only in women. Conclusion: Oral health status and behavioral factors were associated with self-rated health status among the elderly, differently by sex. This suggests that public health policies toward better health in the elderly should take their oral health status and oral health behaviors into account in a sex-specific way.

• Journal of Korean Public Health Nursing
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• v.19 no.2
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• pp.261-273
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• 2005

Purpose: The purpose of this study was to explore the self management and related factors that affect the self management of diabetes between the middle aged and elderly groups. Method: This study was based by the conceptual framework of Cox's interaction model of client health behavior. The subjects were two groups; the middle aged group, 80 and the elderly group, 85 who were diabetes mellitus patients. Result: In the middle aged group, gender, education and social support were significantly correlated with self-management of diabetes mellitus. In the elderly group, gender, education, social support and the duration of diagnosis were significantly correlated with self-management of diabetes mellitus. In too middle aged group, the intrinsic motivation of diabetes mellitus patients and their understanding of diabetes were significantly correlated with self-management of diabetes mellitus. Understanding of diabetes and self perception were significantly correlated with self-management in middle aged group. In the elderly group, intrinsic motivation, understanding of diabetes and the attitude of the patients were significantly correlated with self-management Conclusion: In the middle aged group, maintaining a positive attitude of diabetes, reducing stress and continuous social support were important for improving self-management of diabetes mellitus. In the elderly group, enhancing their knowledge of diabetes, and maintaining continuous social support were important to improve self-management of diabetes mellitus.

• Journal of Korean Academy of Nursing
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• v.49 no.4
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• pp.472-485
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• 2019

Purpose: This study aimed to develop and evaluate the effectiveness of an adapted health literacy self-management intervention for elderly cancer patients undergoing chemotherapy. Methods: The intervention in this study was systematically developed through the six stages of Intervention Mapping Protocol and was based on Fransen et al's causal pathway model. A quasi-experimental trial was conducted on a total of 52 elderly patients (26 in an experimental group and 26 in a control group) undergoing chemotherapy in Korea. The intervention consisted of seven sessions over 5 weeks. The experimental tool for this study was an adapted health literacy self-management intervention, which was designed to promote a reduction in the symptom experience and distress of elderly cancer patients through the promotion of self-management behavior. To develop efficient educational materials, the participants' health literacy was measured. To educate participants, clear communication and the teach-back method were used. In addition, for the improvement of self-efficacy, four sources were utilized. For the promotion of self-management behavior, five self-management skills were strengthened. Data were collected before and after the intervention from June 4 to September 14, 2018. The data were analyzed with SPSS/WIN 21.0. Results: Following the intervention, self-management knowledge and behavior and, self-efficacy significantly improved in experimental group. Symptom experience and distress decreased in the experimental group compared to the control group. Conclusion: The self-management intervention presented in this study was found to be effective in increasing self-management knowledge and behavior and, self-efficacy, and ultimately in reducing symptom experience and distress for elderly patients undergoing chemotherapy.

• Research in Community and Public Health Nursing
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• v.32 no.3
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• pp.303-311
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• 2021

Purpose: This study investigated the health literacy level of, the hypertension knowledge of, the self-management behaviors of, and the factors influencing self-management behaviors of the hypertensive elderly population residing in the urban and rural areas. Methods: Data were collected from November to December 2017 by the trained research staff. For two months, a total of 160 subjects in urban and rural areas who had been taking antihypertensive medications consented to participate in the project. 157 participants completed the survey. Results: The health literacy score of the hypertensive elderly subjects was at 48.38±8.13, the hypertension knowledge score at 8.90±2.01 points, and the self-management behaviors score at 52.96±8.08. The factor that influenced the self-management behaviors of the hypertensive elderly subjects the most was the health literacy, followed by the residential area, and the hypertension knowledge. Conclusion: The research findings suggest that a health promotion program for the hypertensive elderly population should be designed in consideration of the health literacy, the area of residence and the hypertension knowledge of the elderly.

• Journal of Nutrition and Health
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• v.55 no.3
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• pp.406-417
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• 2022

Purpose: The incidence of chronic diseases is increasing and the age of onset is decreasing in South Korea. Healthy eating habits to prevent chronic diseases are established in adolescence. This study verified the identified factors and dynamics that affect diet self-assessment for sustainable adolescent health and the prevention of chronic diseases. Methods: Data were collected from 492 middle and high school students in South Korea from June to July 2018, and the participants answered a questionnaire on dietary safety management competency for sustainable health. Results: The healthy dietary self-assessment scores of overweight/obese adolescents and adolescents who perceived their health as normal were significantly lower than those of other groups. Factor analysis verified the validity of the items that comprised each study area before a multiple regression analysis was used to investigate the factors affecting healthy dietary self-assessment. Sweet and salty diets, anxiety, food and nutrition knowledge, weight management knowledge, stress management, exercise, basic eating habits, and healthy eating habits significantly affected healthy dietary assessment among adolescents. A higher perception of one's health indicated a higher healthy dietary self-assessment, dietary safety knowledge, and health management practice scores (p < 0.01). Factors like healthy dietary self-assessment, food and nutrition knowledge, and weight management knowledge appear to have a significant correlation with other identified factors, except overeating. The adolescents' awareness, knowledge, and dietary safety practices influenced healthy dietary self-assessment, which can prevent chronic diseases and achieve sustainable health. Conclusion: This study illustrated how the adolescents' awareness, knowledge, and practices of dietary safety influenced their healthy diet self-assessment. The results indicate that diet-based health management competency education relative to the adolescents' self-perception and weight levels should be implemented.

• The Korean Journal of Health Service Management
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• v.10 no.4
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• pp.239-248
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• 2016

Objectives : The purpose of this study was to examine the mediation effects of self-efficacy on the relationship between life stress and depression in university students to provide a basis for planning nursing interventions to improve the mental health of university students. Methods : Data were collected from September 1 to September 30, 2015 by giving a questionnaire to 272 university students. The instruments for this study were life stress, self-efficacy, and depression. The data were analyzed with descriptive statistics, Pearson's correlation coefficients, and multiple linear regression with the SPSS/WIN 18.0 program. Results : There were significant correlations among life stress, self-efficacy, and depression. Additionally, self-efficacy had a mediating effect on the relationship between life stress and depression. Conclusions : Based on the findings of this study, health management programs focusing on stress management and self-efficacy improvement are highly recommended to promote good mental health in university students.