• 보건교육건강증진학회지
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• 제19권1호
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• pp.149-170
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• 2002

The use of health behavior theory in health counseling may improve its effectiveness. This article provides an overview of health behavior theory and guidelines on how to incorporate various theories into effective health counseling. Models that focus on behavior change at the individual level are described, including the health belief model, which focuses on individual health beliefs; social learning theory, which emphasizes interactions between individual, behavior and its environment; theory of reasoned action and theory of planned behavior, which examines factors influencing behavioral intention;. the stages of change model, which focuses on one's stage of readiness for change. Research review provides explanatory and predictive utility of four health behavior theories. Suggestions for effective health counselling are as follows: 1. Unified theoretical framework incorporating key concepts from different health behavior theories is needed. 2. Need assessment should be included in counselling process. 3. Behavior-change counselling should target changes in one or more key variables previously identified. 4. Focusing on promotional efforts into a high profile behavior(gateway behavior) can be an an adjunctive way of initiating other health promotion behaviors. 5. Counselling should be staged based, and different strategies and processes of changes should be applied at different stages.

• 보건교육건강증진학회지
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• 제22권2호
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• pp.97-110
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• 2005

Objectives: Recent studies have shown that tailored messages for cancer screening to the beliefs and stage of cancer screening behavior of individual women increases the take-up probability. Many studies on cancer screening have used the Transtheoretical Model (TTM) to identify variables associated with cancer screening behavior. This study was carried out to identify the cognitive-behavioral factors associated with stomach cancer screening among women aged 40 years and over, and to develop and evaluate a tailored educational program for stomach cancer screening by stages of change. Methods: Building on the TTM constructs, we conducted a quasi-experimental study(N=283) to test the effectiveness of a tailored educational program for endoscopic stomach cancer screening. We carried out pre and post tests in the experimental group(N=162) and the control group(N=121), and the experimental group was subdivided into an on-line group(N=81) and an off-line group(N=81) by educational methodology using e-mail and the postal service. We used the chi-square test, trend test, and paired t-test to test the effectiveness of the program for stomach cancer using a tailored stage-matched messages. Results: To examine the effectiveness of the program for stomach cancer screening by the tailored stage-matched messages, the stage-matched materials were offered to the experimental group(N=162) four times for 4 weeks. The stage-matched materials consisted of the four types for stomach cancer. The tailored message was effective in changing the cognitive-behavioral factors, such as experience process, behavior process, con opinion for stomach cancer, self-efficacy, and the behavioral stages for stomach cancer screening. The stomach cancer screening adherence was higher for the stage-matched materials using postal mail than for those using e-mail. Conclusion: To improve the stomach cancer screening rate, the use of tailored messages for stomach cancer screening will be generated using an expert system. Therefore the implementation of tailored educational program will be supported a partnership between public and private health organizations and increasing awareness of the necessity of community-based interventions.

• 지역사회간호학회지
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• 제18권4호
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• pp.611-623
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• 2007

Purpose: To evaluate a reducing alcohol intervention program for workers. Method: The intervention program employed one-group pretest-post-test design with repeated measuring by quasi-experimental study. The program was developed from literature review based on the Transtheoretical Model, and evaluated from April 6 to June 22, 2006. Sixteen white collar male workers participated. At the beginning, the subjects were at the pre-contemplation stage (50%) and contemplation stage (50%). The intervention was applied personally or in group twice a week for 9 weeks. Results: The scores of each stage of change in the post-test increased significantly compared with those in the pretest. The scores of process (cognitive and behavioral) of change in the post-test increased significantly compared with those in the pretest. The score of self-efficacy of change in the post-test increased significantly compared with that in the pretest. The score of pros-cons for drinking in the post-test decreased significantly compared with that in the pretest. The consumption of alcohol a week and a day in the post-test decreased significantly compared with that in the pretest. The levels in ALT, AST, GGT, total cholesterol, triglyceride, B.P. and BMI in the post-test did not decrease significantly compared with those in the pretest, but the level of FBS decreased significantly compared with that in the pretest. Conclusion: The above result informs us that a stage-based reducing alcohol intervention program for workers has the effect of increasing the stages of change, the process of change (cognitive and behavioral) and self-efficacy, and decreasing pros-cons for drinking alcohol consumption and FBS, and it also has a value as an effective means of nursing for workers.

• 한국직업건강간호학회지
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• 제19권1호
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• pp.78-87
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• 2010

Purpose: The purpose of this study was to identify the effects of occupational health service(OHS) for the aged workers in small workplace. Method: A single group of pretest-posttest design was used. 608 aged workers of 253 small workplace who had one out of 4 risk factors were randomly selected. The OHS consisted of education, medical checkup, and counseling. Also information was provided by a visiting nurse 4-5 times every 4-5 weeks from March to November, 2009. The data were collected by interview, self report, and monitored by a nurse. Results: The OHS led to significant reduction of the mean systolic and diastolic blood pressures of 6.46mmHg and 5.22mmHg, each respectively. The mean total cholesterol, glucose, and BMI were also reduced significantly by 6.35mg/dL, 5.91mg/dL, and 0.31kg/$m^2$. And stages of health behavioral change were moved from 1,2,3 stages to 4,5 stages significantly. Conclusion: The OHS showed an effective intervention to improve the aged workers' health in the small workplaces. Therefore, The OHS by visiting a nurse can be a good strategy to extend to small & medium-sized companies having no in-site health manager.

• Biomolecules & Therapeutics
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• 제4권2호
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• pp.167-173
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• 1996

This study was undertaken to evaluate a behavior-electroencephalogram (EEG) pattern relationship in pilocarpine- and kainic acid-induced convulsions of rats. Also we intended to examine the effect of a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, MK-801, and diazepam on the pilocarpine-induced behavioral and electrical seizures in rats. The electrical activities at frontal and hippocampal areas and behavior activities were measured in freely moving rats. At the beginning of the experiments, the rats displayed an exploratory behavior. This awake and moving phase with a low amplitude, irregular, 4-10 Hz wave was followed by a still phase. Pilocarpine (400 mg/kg, i.p.) and kainic acid (0.5 mg/kg, i.c.v.) induced tonic and clonic seizures. The pilocarpine-induced change in electrical activities exhibited a weak correlation with behavioral convulsion at all stages. The amplitude and duration of the electrical response were not linear with the degree of behavioral score. An application of MK-801 (dizocilpine, 7.5 mg/kg) did not affect the amplitudes of the convulsant-induced electrical activities, though the same dose of this drug caused the deformation of the electrical pattern. There was no effect of MK-801 on the behavioral and electrical activities as expected. Diazepam (1 mg/kg) did not affect the amplitude of the electrical activities induced by pilocarpine but changed the pattern of these activities. Our study shows that there is no linear relationship between degree of behavior and amplitude of electrical activities of convulsants. This may indicate that the NMDA receptor stimulation can be processed by the neocortical or hippocampal network in a different way between behavioral and electrical activities.

• 보건교육건강증진학회지
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• 제24권5호
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• pp.23-37
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• 2007

연구 배경: 자궁경부암은 조기검진을 통해 사망률과 의료비 부담을 감소시킬 수 있는 질환으로, 아직까지 우리나라에서는 자궁경부암이 여성암 중 높은 발생률을 보이고 있으나, Pap test를 통해 자궁경부암을 조기에 발견하고, 치료할 수 있는 것으로 알려져 있다. 연구 목적: 이 연구는 자궁경부암 조기검진 수검행동에 영향을 미치는 인지-행동적 요인을 고려하여 행동변화단계별 교육 프로그램을 개발하였고, 이를 40세 이상의 여성 주민에게 적용해봄으로써 행동변화단계별 맞춤형 교육 프로그램의 효과를 평가하고자 하였다. 연구 방법: 이 연구는 서울시 서초구에 거주하는 40세$\sim$59세 사이의 여성 주민을 대상으로 2003년 9월 1일부터 11월 14일까지 자료를 수집하였으며, 서초구의 5개 지역(동)에서 교육 중재군(162명)과 대조군(121명)을 선정하였다. 또한 행동변화단계별 교육 프로그램은 범이론적모형(TTM)을 활용하여 개발되었고, 교육 중재군의 교육내용 전달방법으로 인터넷 서비스와 우편 서비스가 활용되었다. 연구 결과: 조사대상자중 88.9%가 일생 중 1번 이상, 65.4%가 최근 2년 동안 1번 이상 자궁경부암 조기검진을 수검한 것으로 나타났다. 행동변화단계별 교육 프로그램의 효과를 살펴보면, 교육 후 인지 행동적 요인 중 태도와 변화의 과정이 통계적으로 유의하게 높아졌고, 행동변화단계 중 유지단계가 가장 많이 증가하였다. 교육내용 전달 방법은 인쇄된 교육자료를 활용한 우편 서비스가 인터넷 서비스보다 효과적인 것으로 나타났고, 행동변화단계별 전환 양상에서도 우편 서비스 중재군이 인터넷 서비스 중재 군보다 긍정적인 변화를 나타내었다. 한편 행동변화단계별 교육 프로그램에 관한 만족도 평가에서는 전달방법에 따른 유의한 차이가 없는 것으로 나타났다. 결론: 이 연구는 지역사회 여성 주민의 자궁경부암 조기검진에 관한 수검 행동을 증진시키기 위해 행동변화단계에 따른 맞춤형 교육 프로그램을 개발하여 적용하였고, 그 결과, 행동변화단계별 교육 프로그램이 자궁경부암 조기검진의 수검 행동을 증진시키는데 효과적인 것으로 나타났다.

• 치위생과학회지
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• 제13권4호
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• pp.449-460
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• 2013

본 연구는 23명 대학생을 대상으로 1차 강의식 교육과 2차 소그룹별 실습 교육의 구강보건교육을 실시한 후 올바른 칫솔질, 치실질 실천 및 식습관 중 영양성분표 확인 등의 구강건강행동별로 변화단계와 동기요소의 변화 양상을 파악하고, 면접조사를 통해 동기요소에 영향을 미친 요인을 심층적으로 확인하여 구강건강행동의 변화 과정을 분석하여 다음과 같은 결과를 얻었다. 1) 1, 2차 교육 후 1개월 내 행동을 시작하려는 준비단계의 응답비율이 소폭 증가하였다. 구강건강행동별 동기요소는 1차 교육에 비해 2차 교육 후 올바른 칫솔질에 대해 귀찮다고 느끼는 장애 인식에서 '귀찮음'에서 '귀찮지 않음'으로 긍정적으로 변화한 비율이 39.1%로 가장 높았고, 치실질 실천과 영양성분표 확인에서는 자기 효능감 인식에서 '자신 없음'에서 '할 수 있음'으로 긍정적으로 변화한 비율이 각각 50.0%, 30.4%로 높게 나타났다. 2) 올바른 칫솔질 실천에 대한 필요성 또는 유익성을 인식하였을 때 칫솔질 실천에 대해 귀찮아하는 장애 인식이 낮았다. 치실질 실천의 경우, 평소에 치아 사이를 관리하는 것에 대한 필요성을 느꼈거나, 지인으로부터 치실 사용을 권고받은 경험이 있거나 지인의 직접 사용하는 것을 보았을 때 치실질을 할 수 있겠다고 인식하는 자기효능감이 높았고, 식습관 중 영양성분표 확인에 대해 귀찮아하는 장애 인식이 낮고, 필요성과 유익성을 명확히 인식할 때 간식 구매 시 영양성분표를 확인하겠다고 하는 자기효능감 인식이 높았다. 3) 교육 대상자의 구강건강인식 및 행동변화에 영향을 미친 교육의 특성으로는 실험, 실습을 통해 결과를 직접, 바로 확인할 수 있는 참여위주의 교육이었고, 이해하기 쉬운 그림, 사진자료를 활용하였기 때문인 것으로 나타났다. 이에 따라 실습, 참여위주의 교육을 통해 구강건강행동을 실천할 수 있다는 자기효능감은 높이고 행동에 대한 어려움 인식은 낮추며, 자신의 상태를 관찰해 봄으로써 구강질환에 대한 취약성을 인식하고, 그림과 사진 자료를 이용하여 쉽게 이해함에 따라 구강건강행동의 유익성을 명확히 인식함으로써 긍정적인 행동변화를 유도하는 효과적인 교육이 이루어질 수 있겠다. 추후 변화단계별 다양한 동기요소를 이끌어낼 수 있는 구체적인 전략이 개발되어 실제적인 행동변화를 유도할 수 있는 구강보건교육이 이루어져하며, 다양한 건강행동모형에 근거하여 구강건강행동 변화를 유도하는 경로와 관련 요인을 검증하고, 관련 요인에 개입할 수 있는 전략을 개발하는 연구가 이루어져야 할 필요가 있겠다.

• 지역사회간호학회지
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• 제22권3호
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• pp.342-354
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• 2011

Purpose: This study was to estimate the effectiveness of an intervention program using the trans-theoretical model on the stages of change, the process of change, decisional balance, self-efficacy, the levels of medication adherence, and blood pressure difference. Methods: A similar experiment was conducted using a nonequivalent control group pre- and post-test design. The study subjects were 108 hypertensive patients. The program was administered to the experimental group while educational materials were given to the control group. Descriptive analysis, 2-test, t-test, and repeated measures ANOVA were used with SPSS 17.0 to analyze collected data. Results: After treatment with this program, the experimental group showed stage of change ($x^2=52.917$, p<.001), cognitive (F=13,528, p<.001), behavioral process of change (F=10.808, p<.001), benefits (F=5.569, p=.012), loss of medication adherence (F=15.661, p<.001), self-efficacy (F=5.407, p=.011), levels of medication adherence (F=51.442, p<.001). Conclusion: There was a significant improvement in the experimental group who participated in the TTM medication adherence intervention program. Given that this intervention program motivated and stimulated hypertensive patients to adhere to the prescribed medications, the TTM medication adherence intervention program is expected to be an effective and practical intervention method for health improvement.

• 보건교육건강증진학회지
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• 제23권1호
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• pp.63-75
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• 2006

Objective: This study was performed to identify the related factors of change affecting the stage of change, on the assumption that there are various stages of change in the exercise behavior of workers. Method: The subjects of the study consisted of 138 workers of 10 workplaces located in Daejeon City, and data collected by using questionnaires were analyzed with SPSS/WIN 11.5 program. Results: The subjects were distributed in the stage of exercise behavior change as follows: precontemplation stage(10.9%), contemplation stage(22.5%), preparation stage(41.3%), action stage(8.7%), and maintenance stage(16.7%). Of the process of change depending on the stage of exercise behavior change, the consciousness raising(F=11.50, p=.00), dramatic relief(F=2.82, p=.02) showed significant difference in the cognitive process, and the counter conditioning(F=4.56, p=.00), reinforcement management(F=4.64, p=.00), self-liberation(F=9.46, p=.00), and stimulus control(F=13.28, p=.00) showed significant difference in the behavioral process. For decision-making depending on the stage of exercise behavior change, both the pros of decision-making(F=9.23, p=.00) and the cons of decision-making(F=2.45, p=.04) showed significant difference. Self-efficacy depending on the stage of exercise behavior change showed significant difference as F=11.50, p=.00. The related factors of change affecting the stage of exercise behavior change were the pros of decision-making, the cons of decision-making, and self-efficacy including 34.1% R-square. Conclusion: In order to change the exercise behavior of workers positively, they need to be stimulated to use the cognitive and behavioral process in the process of change properly, and to be induced to make a decision positively. And also exercise programs suitable to various characteristics of each worker as well as those of workplaces to enhance self-efficacy need to be applied after being devised. Through the further longitudinal research, it is necessary to analyze the various aspects, such as groups to select, to maintain, to stop or give up the exercise, and to avoid the change, and to study how the related factors of change affect diversity like the above.

• 대한가정학회지
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• 제35권5호
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• pp.61-72
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• 1997

The purpose of this study was to examine the developmental changes about self-perception from childhood to adult period. The subjects were 365 of 5th graders in elementary school, the 2nd graders in junior and senior high school, sophomore in college, and adults. The instruments used for this study were Harter's Self-Perception Profile for the children, adolescences, college students, and adults. The results were as follows. 1. From elementary school to junior high school, the score of scholastic, athletic, physical appearance, behavioral conduct, and global self-worth were decreased. At the developmental perspective, the junior high school students were highly anxious for self-perception. 2. Physical appearance were the best predictor of the global self-worth for all developmental stages. 3. Physical appearance, behavioral conduct predicted more about the global self-worth than any other factors for elementary and junior high school students. And for junior high school students, social acceptance and friendship also predicted about the global self-worth. Scholastic competence showed higher correlation with global self-worth for the senior high school and college students than elementary and junior high school students. 4. For college students, males had higer scores than females on ability-oriented but also relationship-oriented subscales. But the adults showed no differences in nurturance, household management, job competence depending on sex.