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자기효능 이론이 적용된 건강행위 관련 연구의 분석 (A Review of Research on Self Efficacy Theory Applied to Health Related Behavior)

  • 구미옥;유재순;권인각;김혜원;이은옥
    • 대한간호학회지
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    • 제24권2호
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    • pp.278-302
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    • 1994
  • This article reviewed and analyzed 39 studies on self efficacy theory applied to health related behavior. The following analysis was done : 1) study subjects 2) measurement tools 3) analysis according to the type of research design(intervention re-search, explanatory research). Some findings are summarized as follows : The study subjects were both healthy people in various developmental stages and patients with various illnesses. The health related behaviors examined in the studies were also various including exercise, smoking cessation, self care behaviors, etc. The measurement of self efficacy was done with specific tools in most studies. In the tools, activities that measured the health behavior domain were listed according to increasing difficulty or contexual arrangement or in combination of both of them The analysis of 17 intervention research studies showed that generally the intervention program increased the self efficacy level of subjects and then the increased strongly self efficacy influenced behavioral changes. Most studies used more than one intervention method for increasing the self efficacy level. these were derived from sources of self efficacy suggested by Bandura. The analysis of 21 explanatory research studies showed that self efficacy strongly influenced behavior change and persistence. The major independent variable to affect the self efficacy was performance accomplishment in the past. Self efficacy explained more of the variance in health related behavior when it was applied with the variables in the health belief model, health promotion model, and reasoned action theory. On the basis of the above findings, the following suggestions are made : 1. For a desirable research design, self efficacy should be the intervening variable. That is, desirable designs would include intervention-self efficacy-behavior in intervention research studies and antecedent-self efficacy-behavior in explanatory research studies. 2. More prospective, longitudinal studies are needed to test the effect of self efficacy on persistence in health related behavior. 3. Studies comparing the effects of intervention methods are needed for each health related behavior, subject group, and context. 4. It is necessary to develop a reliable, valid measurement tool for self efficacy for each health related behavior. 5. Studies to differenciate the effect of self efficacy from that of outcome expectation on the health related behavior are necessary. 6. The antecedents of self efficacy should be investigated further.

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금강유역 보건진료소 지역주민의 간흡충 감염 실태와 지식 및 행태변화 의도 (Prevalence of Clonorchiasis, Knowledge and Intention to Change Behavior of Village People living in the Catchment Area of Community Health Posts along the Geum River)

  • 박지연;전경자;박도순;조경녀;조정숙;김순찬;석은숙;신동숙;이은경;김옥님
    • 한국농촌간호학회지
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    • 제4권1호
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    • pp.5-12
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    • 2009
  • Purpose: The purpose of this study was to describe the prevalence of clonorchiais and analyze the knowledge level and intention of the participants to change their behavior related to clonorchiais. Method: The participants were 514 people from 7 community health posts along the Geum River. The formalin-esther sedimentation technique was used to detect the Clonorchis Sinensis (CS) eggs and a questionnaire for data on related factors. The study was carried on from December 2008 to January 2009. Results: The prevalence of CS averaged 9.3%, with a range from 0% to 24.6%. The significant factors were sex, habit of eating raw fish, and habit related to smoking and alcohol consumption. The level of knowledge was not high and not significantly different between the CS positive group and CS negative group. Intention to change their habits of eating raw fish showed various stages of change and attitudes to raw fish eating habit of others were not positive. Conclusions: These results suggest that a CS control program needs to be developed by community health services in the Geum River area to decrease the prevalence of clonorchiais.

Metastasis Risk Reduction Related with Beta-Blocker Treatment in Mexican Women with Breast Cancer

  • Parada-Huerta, E;Alvarez-Dominguez, TP;Uribe-Escamilla, R;Rodriguez-Joya, JF;Ponce-Medrano, JA Diaz;Padron-Lucio, S;Alfaro-Rodriguez, A;Bandala, C
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권6호
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    • pp.2953-2957
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    • 2016
  • Background: Breast Cancer (BCa) is the most common malignant tumour in Mexican women. In BCa, several studies have linked ${\beta}2-adrenergic$ receptor activation with increased tumour growth and progression as related with Epinephrine-NorEpinephrine (E-NE) stimulation. The aim of this study was to describe Beta-Blocker (BB) treatment related with reduction of the risk of metastasis in Mexican patients with BCa. Materials and Methods: We collected data of 120 patients seen at the High-Specialty Naval General Hospital in Mexico City (HOSGENAES), all of these with a histopathological diagnosis of BCa. Four groups of patients were divided as follows: without Systemic Arterial Hypertension (SAH); with SAH treatment with non-selective BB; with SAH treatment with selective BB, and with SAH treatment with other antihypertensive drugs. Chi-square, Mantel-Haenszel, Student t, and ANOVA tests were performed for data analysis. Results: On average, patients were $54.8{\pm}11.8$ years of age. Risk factors such as smoking and consuming alcohol exhibited a frequency of 33 and 36.5% respectively. Clinical stages III- IV were found in 50% of patients, while, 30% of patients had arterial hypertension (n=29 and N=96, respectively) and 17.5% used BB. One hundred percent of patients with arterial hypertension treated with BB for ${\beta}1$ - and ${\beta}2$ -adrenergic-receptors did not present metastasis globally, but patients treated with ${\beta}1$ BB presented 30% of metastasis while patients treated with no BB or without SAH had around 70% of metastasis. Conclusions: In Mexican patients with BCa and SAH treated with non-selective (${\beta}1$- and ${\beta}2-adrenergic$ receptors) BB, a decrease in the risk for metastasis was observed at the time of diagnosis.

Overall and disease-specific survival outcomes following primary surgery for oral squamous cell carcinoma: analysis of consecutive 67 patients

  • Sim, Yookyeong Carolyn;Hwang, Jong-Hyun;Ahn, Kang-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제45권2호
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    • pp.83-90
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    • 2019
  • Objectives: This study evaluated the predictive factors for survival of patients with oral squamous cell carcinoma (OSCC) and investigated the overall and disease-specific survival (DSS) outcomes. Materials and Methods: A total of 67 consecutive patients who underwent surgery for OSCC from January 2006 to November 2014 were included in this study. Patients were classified according to age, sex, pTNM stages, primary sites, smoking and alcohol drinking habits, depth of invasion, perineural and lymphovascular invasion, cell differentiation and postoperative radiotherapy. Kaplan-Meier methods were used to estimate the survival categorized by patient groups. Cox regression methods were used to investigate the main independent predictors of survival. Results: Nineteen patients died of OSCC during follow-up periods. Another five patients died of other diseases including lung adenocarcinoma (n=1), cerebral infarction (n=1), general weakness (n=2), and pneumonia (n=1). The tongue (n=16) was the most common site for primary origin, followed by buccal mucosa (n=15), mandibular gingiva (n=15), maxillary gingiva (n=9), floor of mouth (n=9), retromolar trigone (n=2), and palate (n=1). Eleven patients had pTNM stage I disease, followed by stage II (n=22) and stage IV (n=34). No patients had pTNM stage III disease in this study. The overall survival of all patients was 64.2% and the DSS was 71.6%. DSS of patients with stage I and II disease was 100%. Stepwise Cox regression showed the two predictors for DSS were pTNM stage (P<0.0001, odds ratio=19.633) and presence of metastatic lymph nodes (P=0.0004, odds ratio=0.1039). Conclusion: OSCC has been associated with poor prognosis; however, there were improved survival outcomes compared with past studies. Advanced-stage disease and presence of metastatic lymph nodes were associated with poorer survival compared with early-stage OSCC and absence of neck node metastasis. Stage I and II OSCC were associated with excellent survival results in this study.

Metabolic Syndrome Prediction Using Machine Learning Models with Genetic and Clinical Information from a Nonobese Healthy Population

  • Choe, Eun Kyung;Rhee, Hwanseok;Lee, Seungjae;Shin, Eunsoon;Oh, Seung-Won;Lee, Jong-Eun;Choi, Seung Ho
    • Genomics & Informatics
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    • 제16권4호
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    • pp.31.1-31.7
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    • 2018
  • The prevalence of metabolic syndrome (MS) in the nonobese population is not low. However, the identification and risk mitigation of MS are not easy in this population. We aimed to develop an MS prediction model using genetic and clinical factors of nonobese Koreans through machine learning methods. A prediction model for MS was designed for a nonobese population using clinical and genetic polymorphism information with five machine learning algorithms, including naïve Bayes classification (NB). The analysis was performed in two stages (training and test sets). Model A was designed with only clinical information (age, sex, body mass index, smoking status, alcohol consumption status, and exercise status), and for model B, genetic information (for 10 polymorphisms) was added to model A. Of the 7,502 nonobese participants, 647 (8.6%) had MS. In the test set analysis, for the maximum sensitivity criterion, NB showed the highest sensitivity: 0.38 for model A and 0.42 for model B. The specificity of NB was 0.79 for model A and 0.80 for model B. In a comparison of the performances of models A and B by NB, model B (area under the receiver operating characteristic curve [AUC] = 0.69, clinical and genetic information input) showed better performance than model A (AUC = 0.65, clinical information only input). We designed a prediction model for MS in a nonobese population using clinical and genetic information. With this model, we might convince nonobese MS individuals to undergo health checks and adopt behaviors associated with a preventive lifestyle.

고혈압 환자의 라이프케어 증진을 위한 약물 순응도 영향요인 분석 (Analysis of Factors Affecting Medication Adherence to Improve Life Care in Patients with Hypertension)

  • 길은하
    • 한국엔터테인먼트산업학회논문지
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    • 제14권2호
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    • pp.213-224
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    • 2020
  • 본 연구는 고혈압 환자의 라이프케어 증진을 위한 약물 순응도 영향요인을 파악하기 위하여 패널 데이터를 활용한 서술적, 2차 분석 조사연구이다. 연구대상자는 한국의료패널 2015년 데이터(β-version 1.0)를 활용하여 고혈압 진단 후 약물을 복용하고 있는 2,484명을 대상으로 하였다. 자료분석은 SPSS/win 22.0을 이용하여 Chi-Square, Scheffe's test, logistic regression으로 하였다. 연구결과 고혈압 환자의 약물 순응도 수준은 94.2%로 나타났으며 약물 순응도 영향요인은 인구학적 요인의 Model I에서는 성별, 나이로 나타났고 신체-사회적 요인을 추가한 Model II에서는 장애유무, 흡연, 음주여부로 나타났으며 약물복용 요인을 추가한 Model III에서는 음주여부, 약물복용 기간, 부작용 발생, 약물 만족도, 약제비 지불 부담으로 확인되었다. 본 연구결과를 바탕으로, 고혈압 환자가 라이프케어를 증진시켜 합병증이 발생하지 않도록 고혈압 진단 초기부터 개개인의 특성에 맞춰 약물복용의 중요성 및 부작용, 복용 방법 등에 대한 교육과 중재가 필요하겠다.

비소세포 폐암에서 FHIT 유전자의 발현소실의 임상적의의 및 세포고사 및 세포분열주기에 미치는 영향 (Loss of FHIT Expression in Non-Small Cell Lung Cancer; The Clinical Significance and Effects on Apoptosis and Cell Proliferation Cycle)

  • 김학렬;양세훈;정은택
    • Tuberculosis and Respiratory Diseases
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    • 제54권6호
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    • pp.610-620
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    • 2003
  • 연구배경 : 폐암에서 가장 흔한 염색체 결손부위인 3p14.2 결손에 따른 FHIT 자체 기능 즉 암억제 기능의 소실이 폐암의 형성과정에 중요한 기능이 있으리라 생각된다. 흡연 여부, 병리조직학적, TNM 병기 진행에 따른 FHIT 소실여부를 확인하고, 또 흡연및 생존률과의 관계, FHIT의 기능 특히 암 세포의 세포고사, 세포분열에 미치는 영향을 확인하였다. 방 법 : 원발성 비소세포 폐암으로 근치적 절제술을 시행 받은 83례의 paraffin 보관 병리 조직을 절편하여 면역조직화학염색법으로 FHIT의 소실 여부를 확인한 후, 여러 임상적 인자들과의 관계를 파악하고, 유식세포 분석법에 의해, sub-G1 peak로서 세포고사의 정도를, S-phase fraction과 G1-phase fraction으로서 세포분열주기에 미치는 영향을 확인하였다. 결 과 : 전체 83례 중 36례(43%)에서 FHIT가 소실되었고, FHIT 소실율이 편평상피암 52%, 선암 22%; TNM I병기 30%, II병기 48%, III 병기 69%; 흡연경험자 54%, 비흡연자 22%로서, 선암보다는 편평상피암에서, TNM 병기가 진행할수록, 흡연의 경험이 있을수록 FHIT 소실율이 높았다. FHIT 소실군과 발현군의 중간 생존기간은 24개월, 25개월, 2년 생존율은 44%, 51%로서 FHIT 소실여부에 따른 생존율의 차이는 없었다. 세포고사율은 FHIT 소실군과 발현군에서 각각 50.72(${\pm}13.93$)%, 59.38(${\pm}14.33$)%로서 유의한 차이가 있었으며, FHIT 소실군과 발현군에서의 S-phase fraction은 각각 13.93(${\pm}7.35$)%, 15.65(${\pm}6.59$)% G1-phase fraction은 각각 51.50(${\pm}23.15$)%, 54.16(${\pm}20.25$)%로서 각 군간의 유의한 차이는 없었다. 결 론 : FHIT는 인체의 비소세포 폐암의 43%에서 소실되었고, 흡연의 경험이 있을수록, 선암보다는 편평상피암일수록, TNM 병기가 진행할수록 유의하게 FHIT 소실이 높았고, FHIT 소실여부에 따른 생존율의 차이는 없었다. FHIT 소실군에서 발현군보다 세포고사율이 유의하게 낮았으며, S 및 $G_1$ phase fraction의 차이는 없었다.

일부 여대생의 운동행위단계별 우울과 생활스트레스 차이 (Differences between Depression and Life Stress in Exercise behavior change stage of Some Female College Students)

  • 고대식;류소연;정대인;김미정;김용남;박종
    • 디지털융복합연구
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    • 제11권5호
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    • pp.395-404
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    • 2013
  • 본 연구는 일부 여대생을 대상으로 운동행위변화단계별 우울 및 생활스트레스의 차이를 알아보고자 하였다. 일개 대학에서 여대생 250명을 편의추출하여 자기기입식 설문조사를 실시한 후 미응답자와 응답이 불충분한 58부를 제외한 192부를 최종 분석대상자로 선정하였다. 연구결과 우울은 학년, 경제수준, 음주상태, 흡연, 운동행위변화단계에 따라 유의한 차이가 있었으며, 생활스트레스는 학년, 동거형태, 건강인식, 운동행위변화단계에 따라 유의한 차이가 있었다. 본 연구결과로부터 여대생의 우울과 생활스트레스를 감소시키기 위하여 건강관련행위를 증진시키고, 특히 규칙적이고 지속적인 운동을 제공하기 위하여 운동행위변화단계별로 동일한 프로그램이 아닌 단계별로 차별화되고, 개별적인 운동 및 교육프로그램의 개발 및 적용이 필요하다고 사료된다.

Risk Factors for Stage IV Breast Cancer at the Time of Presentation in Turkey

  • Uyeturk, Ummugul;Tatli, Ali Murat;Gucuk, Sebahat;Oksuzoglu, Berna;Ulas, Arife;Avci, Nilufer;Ozbay, Mehmet Fatih;Gunduz, Seyda;Akinci, Muhammed Bulent;Salim, Derya Kivrak;Sonmez, Ozlem Uysal;Akdag, Fatma;Ergenc, Hasan
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7445-7449
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    • 2013
  • Background: Breast cancer (BC) is the one of the most common cancers in women. It is also a leading cause of death. Unfortunately, some patients initially present with distant metastases and are diagnosed with stage IV disease that is nearly always, by then, incurable. This retrospective analysis investigated the risk factors for stage IV BC that may underlie such late presentation. Materials and Methods: In all, 916 patients with BC who visited the medical oncology polyclinic of eight different centres in Turkeybetween December 2011 and January 2013 were analysed. Results: A total of 115 patients (12.6%) presented with stage IV disease. In univariate analysis; to comparing these with patients at other stages, no statistical difference was found for median diagnosis age or age at menarche (p=0.611 and p=0.820), whereas age at menopause and age at first live birth were significant (p=0.018 and p=0.003). No difference was detected in terms of accompanying diseases, use of oral contraceptives and hormone replacement therapy, smoking, alcohol consumption and the rate of family history of BC between the patients (p=0.655, p=0.389, p=0.762, p=0.813, p=0.229, p=0.737). However, screening methods were employed less often, the rate of illiteracy was higher, and the rate of other cancers was higher in patients with stage IV BC (p=0.022, p=0.022, p=0.018). No statistical difference was observed between the patients in terms of tumour histopathology, and status of oestrogen receptor, progesterone receptor, or human epidermal growth factor-2 receptor (p=0.389, p=0.326, p=0.949, p=0.326). Grade 3 tumours were more frequent in patients with stage IV disease (p<0.001). On multivariate analysis, risk factors for stage IV breast cancer at the time of presentation were found to be age at first live birth and educational level (p=0.003 and p=0.047). Conclusions: Efforts should be made to perform mammography scans, in particular, at regular intervals through national training programs for all women, particularly those with family histories of breast and other types of cancer, and to establish early diagnosis of BC long before it proceeds to stage IV. Additionally, women's education had better be upgraded. In order to make women aware of BC, national education-programmes must be organised.

Clinical, Laboratory Biomarkers and Imaging Findings of Pancreatic Adenocarcinoma in Iran

  • Hadizadeh, Mohammad;Padashi, Maryam;Alizadeh, Amir Houshang Mohammad;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권10호
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    • pp.4349-4352
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    • 2014
  • Background: Pancreatic cancer has a high mortality rate because it is usually diagnosed late. Since little is known about this cancer in Iran, with the aim of improving this knowledge deficiency, we evaluated clinical, laboratory biomarkers, imaging findings and treatment modalities in Iranian patients with pancreatic adenocarcinoma. Materials and Methods: 131 cases of pancreatic adenocarcinoma in 2010-2013 were obtained from the Taleghani Hospital Record Department. Cases confirmed by histopathology from CT-guided biopsy, EUS-FNA and surgery examination were included. We excluded those with incomplete medical records. Results: The study included 131 subjects between 24 and 97 years of age and a mean age of $63{\pm}13.4$ years. Eighty (61.1%) were male and 51 (38.9%) female. Previous history included diabetes mellitus in 36 (27.5%), alcohol drinking in 5 (3.9%), smoker in 28 (21.4%) and opium addiction in 13 (10%). The common presenting history included weight loss in 79 (60.3%), abdominal pain in 77 (58.8%), fever in 11 (8.4%), nausea in 30 (22.9%), jaundice in 72 (55%), pruritus in 52 (39.7) and anemia in 33 (25.2%). CA19-9 levels with cut offs of 50, 100 and 200 U/ml were increased in 81%, 72% and 66% of patients, respectively. Tumor staging was: stage I, 3 (2.3%); stage II, 10 (7.6%); stage III, 58 (44.3%); and stage IV, 60 (45.8%). From 45 patients, 17 received ERCP inserted metallic stents and 22 plastic stents, the remaining 6 failed that PTC was done. Whipple surgery and chemotherapy were conducted for 10 and 29 patients, respectively. Conclusions: This disease affected older people and there was a male preponderance. The commonest risk factors were diabetes mellitus, smoking and cholelithiasis. The majority of patients presented with loss of appetite, loss of weight, jaundice, abdominal pain and discomfort. Almost all presented at late stages of the disease so that curative surgery was impossible. Also chemotherapy was only performed in a few patients as a neoadjuant treatment.