• 성인간호학회지
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• 제14권1호
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• pp.83-92
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• 2002

Purpose: This study was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of exercise behavior using Transtheoretical Model in patients with type 2 diabetes mellitus. Method: The study method was a survey in 100 type 2 DM patients at out-patients clinic of Y medical center from March 19, 2000 to October 30, 2000. Result: The results were as follows: The subjects were divided into five stages of exercise behavior ; 15.0% in pre-contemplation stage, 33.0% in contemplation stage, 17.0% in preparation stage, 16.0% in action stage and 19.0% in maintenance stage. The subjects in pre-contemplation stage used all processes of change in the least. "Dramatic relief(DR)", "Environmental reevaluation(ER)" and "Self reevaluation(SR)" were identified as main processes of change in contemplation stage. "Consciousness raising(CR)", "DR" were used higher than average in preparation stage. Helping relationships(HR)", "CR", "ER", "SR", "Social liberation(SL)", "Counter conditioning (CC)", "Reinforcement management(RM)", "Self iberation(SEL)" and "Stimulus control(SC)" were used higher than average in action stage. The subjects in maintenance stage used all process of change the highest except "DR"and "HR". "Cons" score of decisional balance was the highest in pre-contemplation stage, "Pros" score was the highest in action stage and "Self-efficacy" score was the highest in maintenance stage. Conclusion: This study can provide the basis of staged matching exercise program using TTM for more effective and useful intervention.

• Child Health Nursing Research
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• 제29권1호
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• pp.7-23
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• 2023

Purpose: The purpose of this study was to investigate the effect of family-centered interventions on improving health outcomes in children and adolescents with type 1 diabetes mellitus (T1DM). Methods: A literature search was conducted according to the PRISMA guidelines, using six electronic databases: EMBASE, CINAHL, Medline, CENTRAL, Scopus, and Web of Science. The inclusion criteria encompassed studies with populations of children and adolescents (age <18 years) and at least one parent/caregiver, or only parents/caregivers if the children were very young, and studies that investigated the health outcomes of children and parents/caregivers diagnosed with T1DM. Results: From 2,746 published studies, only nine studies met the inclusion criteria. The key interventions were non-technology-based interventions (n=4), technology-based interventions (n=2), and combined technology- and non-technology-based interventions (n=3). The interventions had effects on glycated hemoglobin, adherence to diabetes management, diabetes self-management behaviors, and parent-child teamwork in diabetes management. Other essential effects were children's quality of life, children's problem-solving skills, parents' quality of life, and parents' coping and depression. Conclusion: Family-centered interventions can effectively improve health outcomes in children and adolescents with T1DM. In the future, family-centered interventions integrated with other approaches, theories, and models should be developed to achieve the best possible outcomes.

• Journal of Korean Biological Nursing Science
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• 제22권1호
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• pp.1-10
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• 2020

Purpose: Diabetes Mellitus (DM) is a leading cause of death with a prevalence rate of 12.4% in South Korea. Self-management is crucial for patients with DM, because many studies have reported that self-management intervention based on the Health Belief Model (HBM) is effective. The purpose of this study was to investigate the current state of HBM based intervention studies and the components and effects of the theories used in the study for diabetes patients. Methods: A systematic review was conducted using the Pubmed, Cochrane Library and Embase databases from January 2009 to May 2019. We reviewed characteristics of intervention based on the HBM in randomized controlled clinical trials (RCTs), quasi-experimental study intervention. Results: Eight studies published in English between 2009 and 2019 were included in this review. The key components of the health behavior promotion program applied to the DM patients were perceived susceptibility, perceived severity, perceived benefits, perceived barriers and self-efficacy. The intervention based on these components has reported to significantly increase the health behavior change, likelihood of taking health action and improve physiological indicators (HbA1c, and fasting blood sugar etc.). Conclusion: This study highlighted the importance of intervention programs based on the HBM for DM patients.

• 한국산학기술학회논문지
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• 제15권7호
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• pp.4301-4309
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• 2014

본 연구는 2형 당뇨병 환자의 당뇨교육요구도와 그와 관련된 영향요인을 파악하고자 시도된 서술적 상관관계연구이다. 연구 자료는 2021년 1월 2일부터 동년 2월 29일까지 수집되었으며, 총 336명의 대상자가 구조화된 설문지(일반적 특성, 당뇨지식 및 당뇨교육요구도)에 응답하였다. 자료 분석은 ANOVA, t-test, Scheffe test, Pearson correlation, 및 단계적 다중 회귀 분석으로 이루어졌다. 연구결과 당뇨교육요구도는 평균 3.03(범위: 1.09-4.00)으로 나타났고 연령이 적을수록 교육요구도가 높고(${\beta}$=-.25, p<.001), 가족이 당뇨병 교육에 참여 한 경우 교육요구도가 높은 것으로 나타났고(${\beta}$=.21, p=.003), 질병관련 특성에서는 자가혈당검사를 하지 않는 경우 교육요구도가 높은 것으로 나타났다(${\beta}$=-.13, p=.045). 이들 3개 변수가 당뇨교육 요구도의 총 11%의 설명력을 보였다. 본 연구결과 당뇨지식의 많고 적음에 따른 교육요구도에는 차이가 없는 것으로 나타나 당뇨교육은 당뇨진단은 받은 모든 환자를 대상으로 가족의 참여를 독려하여 이루어질 때 효율적이라고 생각된다.

• 성인간호학회지
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• 제18권3호
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• pp.345-356
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• 2006

Purpose: This study was conducted to compare the process of change, decisional balance, and self-efficacy according to the stages of change of exercise on the basis of the Transtheoretical Model in order to investigate factors associated with the change of exercise in adult diabetic patients. Method: Data were collected from January to April 2005. The subjects were 160 patients in the G university hospital and public health center in J city. Results: The entire process of change showed the significant difference depending on the stage of change(F=20.007, p=.000). For each process of change, the Consciousness Raising(F=14.602, p=.000), Dramatic Relief(F=7.751, p=.000), Environmental Re-evaluation(F=11.843, p=.000), Self Re-evaluation(F=16.035, p=.000), Social Liberation(F=10.968, p=.000), Counter-conditioning (F=24.090, p=.000), Helping Relationships(F= 7.625, p=.000), Reinforcement Management(F= 16.693, p=.000), Self Liberation(F=11.990, p= .000) and Stimulus Control(F=4.020, p=.002) demonstrated significant differences depending on the stages of change of exercise. For the decisional balance, the Pros showed the significant difference depending on the stage of change(F=14.121, p=.000). For the self efficacy showed significant difference depending on the stage of change(F=17.137, p=.000). Conclusion: In order to proceed the stage of change of exercise in patients with Diabetes Mellitus, intensive use of a specific process of change, a stage of change matching is needed.

• Journal of Community Nutrition
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• 제4권2호
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• pp.118-129
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• 2002

Nutrition is important in the management of diabetes mellitus, however, there are few little education materials specifically designed for older adults. The objective of this study was to develop nutrition education materials for prevention and management of diabetes moll for older adults. Materials developed were a booklet and four leaflets. The contents of materials were based on lesson plans. After several revisions of the draft of materials, illustrations and icons appropriate to the contents were designed using illustrator 9.0 and Photoshop 6.0. The booklet was composed of five chapters and 40 pages. The first chapter began with an introduction about diabetes and diabetes management by diet, exercise and medication. The second chapter dealt with ideal body weight, calculation of adequate caloric intake and food exchange list. The third chapter provided information for meal planning and sample menus. The fourth chapter focused on practical tips on nutritional care of diabetes, by providing tips on reducing sugars, fat and salt, and suggestions on eating for special occasions. The fifth chapter dealt with information in case of low blood sugars, exercise and foot care. The topics of the four leaflets were “Diabetes, what is it and care”, “Food exchange list and meal planning”, “Healthy eating for diabetes”, “Special care for diabetes low blood sugars, exercise and foot care” Each leaflet was composed of six sections and was printed in large paper (B4 size) for older adults. The draft of educational materials were re-viewed by four nutrition professionals and finally pilot-tested with ten adults aged 50 and older. The characteristics of the developed materials are as follows, i) messages are delivered using simple, specific information, ⅱ) messages focused on practical applicable tips, ⅲ) various pictures, illustrations and artwork were created and inserted to enhance understanding and interest, ⅳ) sections including risk factor assessment, calculation of ideal body weight and meal planning were designed to induce the user's participation, ⅴ) sample menus and food pictures were inserted in the booklet, vi) characteristics of older adults and transformed characteristics are diversely used to help the user feel familiarity. These materials are self-explanatory and can be used by older adults. These materials also can be used widely in nutrition education at public health centers or senior centers.

• 한국컴퓨터정보학회논문지
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• 제19권11호
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• pp.149-157
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• 2014

당뇨병은 급성합병증을 예방하고 장기간의 합병증의 위험도를 감소하기 위하여 지속적인 치료와 환자 자가 관리 교육이 필요한 만성질환이다. 또한 전 세계적으로 당뇨병에 대한 유병률과 사망률이 대부분의 인구집단에서 역학적 비율에 도달하였다. 많은 연구에서 당뇨병에 대한 조기진단은 적절한 치료와 생활습관을 지키는 관리를 통하여 발병을 예방하는데 도움을 줄 수 있으며, 이를 통하여 당뇨병의 합병증을 감소시키고 생존률을 향상시킬 수 있다고 보고하고 있다. 본 연구는 PIMA Indians 당뇨 데이터에 대하여 mixture of expert 모형을 적용하여 당뇨유병환자의 여부를 분류하고, 이를 로지스틱 회귀분석, 신경망분석의 성능과 비교함으로서 그 유용성을 주장하고자 하였다. 연구결과 정확도 및 ROC 곡선, c-통계량에서 ME 모형이 다른 분류도구들에 비해서 높게 나타남을 확인할 수 있었다.

• 한국산학기술학회논문지
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• 제18권7호
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• pp.184-192
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• 2017

본 연구는 노인 당뇨환자를 위한 교육용 기능성 게임 콘텐츠(롤리폴리 160)를 개발하고 적용가능성을 평가하기 위한 예비연구이다. 롤리폴리 160은 문헌고찰, 요구도 조사 및 자문의뢰, 게임을 활용한 기능성 콘텐츠 추출, 롤리폴리 160 개발, 사용자 사전 만족도 조사, 보건교육자 대상 워크샵, 롤리폴리 160 수정, 롤리폴리 160 사용자 만족도 조사와 같은 8단계 연구절차를 걸쳐서 개발되었다. 롤리폴리 160은 노인 당뇨환자가 자가관리를 할 수 있는 3가지 모듈(식사자가관리, 카드게임, 퀴즈게임)로 직관적으로 구성되었으며, 6가지 원칙에 입각하여 설계되었다. 첫째, 사용자의 연령을 고려한 직관적인 인터페이스를 구축하였다. 둘째, 음식은 한국인이 주로 섭취하는 음식위주로 배열하고 음식선택시 칼로리 학습이 동시에 이루어지도록 하였다. 셋째, 사용자 선택한 음식의 칼로리와 영양소(탄수화물, 지방, 단백질, 칼슘, 나트륨)가 분석되고, 문진표에 기록한 모든 검사자료는 년, 월, 주 별로 그래프로 도식화하여 변화추이가 한눈에 파악되도록 설계하였다. 넷째, 필요한 자료는 저장하여 출력하여 교육 자료로 활용 가능하도록 하였다. 다섯째, 사용자의 자료는 호환 및 합산이 가능하며 1억 명까지 회원가입이 가능하도록 하였다. 여섯째, 필요 시 모바일 App으로 개발이 가능하도록 설계하였다. 롤리폴리 160을 활용하여 119명의 노인 당뇨환자에게 당뇨교육을 실시한 후 만족도 점수는 5점 만점 중 4.26점으로 나타났다. 이는 롤리폴리 160이 당뇨환자 자가간호 도구로 적절하며, 향후 보건소나 병 의원에서 당뇨환자를 교육하는 프로그램으로 활용가능성이 있음을 시사해준다.

• 한국융합학회논문지
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• 제10권11호
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• pp.501-510
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• 2019

본 논문은 당뇨병의 관리전략 수립을 위해 일상생활에서 조절가능한 혈당조절 요인을 파악하고자 하였다. 개인이 조절하기 어려운 성별, 당뇨병 유병기간, 당뇨병 치료방법, 교육수준, 가구소득 등을 매칭한 코호트내 환자-대조군 디자인으로 분석을 하였다. 7기 국민건강영양조사(2016-2017) 원시자료를 이용하여, 983명의 당뇨병 환자를 분석한 결과, 289명(30%)만이 당화혈색소가 6.5% 미만으로 혈당이 조절되었다. 일상생활에서 조절이 가능한 당화혈색소 조절 요인 파악하기 위해 조건부 다변량 로짓스틱 회귀분석 시행한 결과, 매칭전 코호트에서는 당뇨병 유병기간, 당뇨병 치료 여부, 매칭 코호트에서는 체질량지수, 흡연, 안저검사가 당화혈색소 달성에 유의한 영향을 미치는 것으로 파악되었다. 본 결과는 집중 관리가 필요한 대상선정(장기 유병기간, 약물치료 대상자) 및 생활습관(체질량지수, 흡연, 안저검사 등) 관리전략을 마련하는데 근거자료로 활용되고, 지역사회내 국민건강 증진에 기여할 것으로 사료된다.

• Clinical and Experimental Pediatrics
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• 제61권10호
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• pp.307-314
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• 2018

The incidence of type 1 diabetes mellitus (T1DM) in children and adolescents is increasing worldwide. Combined effects of genetic and environmental factors cause T1DM, which make it difficult to predict whether an individual will inherit the disease. Due to the level of self-care necessary in T1DM maintenance, it is crucial for pediatric settings to support achieving optimal glucose control, especially when adolescents are beginning to take more responsibility for their own health. Innovative insulin delivery systems, such as continuous subcutaneous insulin infusion (CSII), and noninvasive glucose monitoring systems, such as continuous glucose monitoring (CGM), allow patients with T1DM to achieve a normal and flexible lifestyle. However, there are still challenges in achieving optimal glucose control despite advanced technology in T1DM administration. In this article, disease prediction and current management of T1DM are reviewed with special emphasis on biomarkers of pancreatic ${\beta}-cell$ stress, CSII, glucose monitoring, and several other adjunctive therapies.