• Korean Journal of Psychosomatic Medicine
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• v.17 no.2
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• pp.68-74
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• 2009

Objectives : Illness behavior is defined as the persistence of an adaptive/maladaptive mode of perceiving, evaluating and responding to health status and symptoms according to the status. In a cognitive aspect, somatizing symptoms are regarded as being originated from distortions, including magnification and/or amplification, of perceiving, evaluating and responding to symptoms such as bodily sensations. That is somatization may be explained by maladaptive illness behavior. In this study, we tried to investigate differences of illness behavior in depressive patient according to the presence of somatization. Methods : We divided 45 patients who were diagnosed as depression with ICD-10 diagnostic criteria into two groups(somatizing and non-somatizing group) according to the somatization subscale of Korean Depression Scale and compared two groups in the differences of illness behavior using the Illness Behavior Questionnaire. Results : Somatizing group showed significantly higher scores than non-somatizing group on the disease affirmation subscale($6.79{\pm}2.08$ vs. 4.76, p=0.003) and the denial subscale($3.25{\pm}1.22$ vs. $2.10{\pm}1.41$, p=0.006). There were no significant differences between two groups on the general hypochondriasis subscale and the affective unstability subscale. In a logistic regression analysis, somatizing group also showed higher odds ratio (OR) scores on the disease affirmation subscale(OR=1.418, p=0.089) and the denial subscale(OR=1.880, p=0.083). Conclusion : The disease affirmation and denial may be a discriminative mechanism of somatization in depressive patients. These subscales of Illness Behavior Questionnare could be useful markers, and psychiatric illnesses with somatizing and depressive symptoms may be differentially diagnosed and be predicted through these subscales.

• Korean Journal of Health Education and Promotion
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• v.18 no.3
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• pp.11-36
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• 2001

The purpose of this study is to analyze health behavior by comparing the difference between self-perceived health status and health examination results. The study subjects consist of 7,702 people aged over 20, surveyed by Health Interview survey, Health Examination survey, Dietary Life survey, Health Consciousness and Behavior survey. Data used in the study are drawn from raw data from a 1998 National Health and Nutrition survey. General characteristics variables are sex, age, education level, residential area, marital status, occupation, and living standard while dichotomous variables, ‘not healthy’ and ‘healthy’ are used to measure self-perceived health status. Variables for health examination results are high blood pressure, high cholesterol, diabetes, liver diseases, liver inflammation, kidney diseases, normal weight, regular diet, optimum sleeping time(7-8 hours), regular health examination and health behavior practice group. Major findings of the study are as follows: 1) Analysis of self-perceived health status and health behavior by disease: Variables significantly correlated with high self-perceived health status have strong associations with high health behavior practice, which supports the hypothesis that as one has high self-perceived health status, one is more likely to practice health promoting behavior. The results of analysis of health behavior differences by dividing subjects into two categories, ‘cases of illness’ and ‘cases of no illness’ indicate that drinking, sleeping time, health examination are significant variables (p〈0.001, 0.05) whereas smoking, weight control, regular exercise, regular diet are not significant. 2) Analysis of disparity patterns between self-perceived health status and health examination: The hypothesis that health behaviors would be different according to the disparity pattern between self-perceived health status and health examination is supported as a result of χ2 test. Among Type I : Self-perceived health status is high and actual health status is good (no disease) Type II: Self-perceived health status is high and actual health status is poor(have disease) Type III: Self-perceived health status is low and actual health status is good(no disease) Type IN: Self-perceived health status is low and actual health status is poor(have disease) Type I and Type IV show no disparity, Type I shows the highest health promoting behavior whereas Type IV shows the lowest health promoting behavior. Type II, and III, compared to Type I, practise lower health promoting behavior. Multi-logistics regression analysis was conducted to find out the degree of impact on health behavior. Independent variables are general characteristics, self-perceived health status and health examination result and presence of illness, while the dependent variable is health promoting behavior. The analysis of the impact of self-perceived health status on the health promoting behavior shows that smoking, drinking, weight control, regular exercise, health examination practice, and/or regular diet are significantly correlated to self-perceived health status. High self-perceived health status is inversely related to high health promoting behavior. This finding supports the hypothesis that the higher one perceives one's health, the more likely one is to practice health promoting behavior. On the contrary, the presence of illness has little impact on health promoting behavior. 3) Multiple logistics analysis on how disparity patterns between self-perceived health status and health examination affect health behavior: The results of multiple logistics analysis made on health behavior variables compared to the standard variable are as follows: When analyzed on the standard of Type I, smoking is a significant risk factor for the Type IV. In case of drinking, all the patterns show a high probability of relative risk ratio. With regard to weight control, it is a risk factor for Type II while all the patterns show high probability of not practising when analyzed on the standard of type IV. Type III and IV show high probability of not doing regular exercise while Type IV, shows a high probability of not taking appropriate sleeping time. When analyzed on the standard of type IV, all the patterns show a high probability of not taking health examinations. Type III and IV show a high probability of not having regular meals. As for overall health promoting behavior, Type III and IV show a high relative risk ratio. These two groups have low self-perceived health status. It implies that self-perceived health status has significant impact on health promoting behavior. This is also supported by the fact that Type I with high self-perceived health status and no illness shows a high practice rate of health promoting behavior. Types II and III the groups with high disparity between self-perceived health status and health examination results, show a low practice rate of health promoting behavior when compared to Type I. Type IV, that is the group with low self-perceived health status and actual illness, shows the lowest practice of health promoting behavior. It is highly probable that this type proves to be the poorest health group.

• Journal of Korean Academy of Nursing
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• v.40 no.5
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• pp.662-675
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• 2010

Purpose: This ethnography was done to explore the meaning of illness in Korean Americans with chronic hepatitis B. Methods: The participants were 6 patients with chronic hepatitis B and 6 general informants who could provide relevant data. Data were collected from iterative fieldwork with ethnographic interviews within Korean communities in two cities in the United States. Data were analyzed using causal chain analysis developed by Wolcott. Results: The analyses revealed three meanings for the illness: hidden disease, intentionally hidden disease, and inevitably hidden disease. The contexts of meaning of illness included characteristics of the illness, social stigma, structure of health care system and communication patterns and discourse between health care providers and clients. Conclusion: The meaning of illness was based on folk illness concepts and constructed in the sociocultural context. Folk etiology, pathology and interpretation of one's symptoms were factors influencing illness behavior. These findings could be a cornerstone for culture specific care for Korean Americans with chronic hepatitis B.

• Child Health Nursing Research
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• v.6 no.3
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• pp.291-304
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• 2000

The purpose of this study was to explore the health and illness concepts of hospitalized preschoolers. The subjects were 52 hospitalized preschoolers from 3 to 6 grade in one general hospital. Data were collected through semistructured interviews by author. this study was conducted from Mar 2, 2000 to Jun. 30, 2000. Data were coded and categorized by content analysis. The results were as follows : 1. Hospitalized preschoolers's answers about health concepts were coded and then classificated to 7 categories(physical well-being, food, powerfulness, exercise, obedience to authority, cleanliness, sleep.) 2. Hospitalized preschoolers's answers about health behavior to maintenance health were coded and then classificated to 8 categories (food, obedience to authority, treatment, exercise, cleanliness, powerfulness, sleep, psychological stability). 3. Hospitalized preschoolers's answers about prevention of illness were coded and then classificated to 9 categories(food, treatment, obedience to authority, powerfulness, emotional stability, psychological stability, exercise, physical well-being, ability of social adaption). 4. Hospitalized preschoolers's answers about cause of illness were coded and then classificated to 3 categories(illness, trauma, food). 5. Hospitalized preschoolers's answers about treatments of illness were coded and then classificated to 9 categories(treatment, rest, emotional stability, sleep, psychological stability, food, obedience, exercise, powerfulness). 6. The levels of health and illness concepts in this sample were higher than those of the physical causality.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.185-194
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• 1997

A comparison was made regarding illness behavior among patients with somatoform disorders, depressive disorders and psychosomatic disorders. The subjects consisted of out-patients with somatoform disorders(N=52), depressive disorders(N=52) and psychosomatic disorders(N=51). illness behavior was assessed by illness Behavior Assessment Schedule and the questionnaire about help-seeking behavior. The patients with somatoform disorders and psychosomatic disorders more often affirmed the presence of somatic disease, were more likely to have phobia of disease, had more preoccupation with ideas of disease and more frequently shopped around oriental clinics than the patients with depressive disorders. The patients with somatoform disorders more often attributed its cause to physical factors, less often attributed the origin of affective disturbance to psychological causes, showed Less depression and irritability, and were less likely to accept psychiatric treatment recommended by other physicians than depressive patients. The patients with somatoform disorders were more likely to report having been told that they suffered from a mild illness than those with psychosomatic disorders. The patients with somatoform disorders with psychological problems tended to inhibit expression of their emotion. Female patients with somatoform disorders more often affirmed the presence of psychological disorder and attributed its cause to psychological factors than male ones. These results suggest that in illness behavior, patients with somatoform disorders are different from depressive patients, whereas the former patients are similar to psychosomatic patients except the discrepancy between therapists and patients regarding evaluation of their symptoms. Thus, it is emphasized that first, therapists need to approach patients with somatoform disorders somatically with understanding of their underlying need to deny psychological problems, followed by either psychological or biopsychosocial approach.

• Journal of Korean Academy of Nursing
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• v.31 no.2
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• pp.340-350
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• 2001

The purpose of this study was to investigate the factors influencing social adaptation of chronic mental illness. The subjects of this study were 190 patients, over the age of 20 with chronic mental illness diagnosed by a physician, and living in Seoul, Korea during May, 2000 to December 2000. The instruments for this study were the social adaptation scale by Wallace (1979), the self-esteem scale by Rogenberg (1965), social support scale by ParkJiWon (1985), coping behavior scale by Shirley Zeitlin (1978), self efficacy scale by Sherer et. al (1982), and Rand mental health inventory(1979). The data were analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. The results of this study are as follows: 1. The level of social adaptation showed moderate (M=3.43). 2. The social adaptation showed significant positive correlation with self-esteem (r=0.39, p=0.00), self-efficacy (r=0.31, p=0.00), social support (r=0.47, p=0.00), self-productive coping (r=0.14, p=0.05), self-flexible coping (r=0.22, p=0.00), environment-active coping (r=0.21, p=0.00), and environment-flexible coping (r=0.14, p=0.04). The social adaptation showed significant negative correlation with anxiety (r=-0.16, p=0.02), and emotional problems (r=-0.18, p=-0.00). 3. The stepwise multiple regression analysis revealed that the most powerful predictor of social adaptation was social support (21%). A combination of social support, depression, behavioral controllability, self-efficacy, and environmental coping behavior accounted for 39% of the variance in social adaptation in chronic mental illness. From the results of this study, it is suggested to develop and apply a social adaptation training program for chronic mental illness.

• Journal of Korean Academy of Nursing
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• v.54 no.2
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• pp.162-177
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• 2024

Purpose: This study aimed to investigate the influence of uncertainty-related factors on the health behavior of individuals with coronary artery disease (CAD) based on Mishel's uncertainty in illness theory (UIT). Methods: We conducted a cross-sectional study and path analysis to investigate uncertainty and factors related to health behavior. The study participants were 228 CAD patients who visited the outpatient cardiology department between September 2020 and June 2021. We used SPSS 25.0 and AMOS 25.0 software to analyze the data. Results: The final model demonstrated a good fit with the data. Eleven of the twelve paths were significant. Uncertainty positively affected danger and negatively affected self-efficacy and opportunity. Danger had a positive effect on perceived risk. Opportunity positively affected social support, self-efficacy, perceived benefit and intention, whereas it negatively affected perceived risk. Social support, self-efficacy, perceived benefit and intention had a positive effect on health behavior. We found that perceived benefit and intention had the most significant direct effects, whereas self-efficacy indirectly affected the relationship between uncertainty and health behavior. Conclusion: The path model is suitable for predicting the health behavior of CAD patients who experience uncertainty. When patients experience uncertainty, interventions to increase their self-efficacy are required first. Additionally, we need to develop programs that quickly shift to appraisal uncertainty as an opportunity, increase perceived benefits of health behavior, and improve intentions.

• Journal of Korean Academy of Nursing
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• v.27 no.3
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• pp.614-626
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• 1997

The main purposes of the study were to develop and test a model which explains the dynamic relationship among factors reported as affecting to the quality of life of individuals with rheumatoid arthritis and to examine the relationship between self-help response and quaility of life. Data for the study were collected from March 1996 to December 1996 from 153 female patients who regularly visited a clinic for people with rheumatism. The patients were introduced to the investigators by nurses who worked at that clinic, and then the investigator interviewed the patients for 30 to 40 minutes to collect the data. Instruments used in the study were modified self-report questionaires from the ones which were already developed in previous studies or from related literature. Data analysis were performed using LISREL(Lineal Structural Relations) 8 program to test whether the proposed hypothesized model fit the collected data. To test the fitablity of the hypothesized model both a general fit measure and a detailed fit measure were used. Based on the test results from the various fit measures, the hypothesized model was found to be well suited to the real data. As characteristics related to illness becomes severe, the feasibility for these characteristics leading to the perception of uncertainty about the illness tend to increase, but, the direct effects from the illness characteristics(such as level of physical symptoms, sense of social-psychologic change, limitations of action) as they are related to the other intrinsic variables (self-efficacy or self-help behavior and quality of life), were found to be not significant. It was found that uncertainty had a direct effect on self-efficacy but did not have a direct effect on self-help behavior or quality of life. Also, it is noted that self-efficacy had a positive effect on self-help behavior and quality of life and there was a bilateral relationship between self-efficacy and self-help behavior. Lastly, the hypothesis proposed from the theoretical model in this study was supported basis of the results that self-help behavior provides both direct and positive effects to quality of life. Particularity, since a bilateral relationship was also found between self-help behavior and quality of life in the modified model, as self-help behavior increased, so did quality of life. And, reversely, as quality of life increased, so did self-help behavior. In conclusion, the results of this study suggest that focusing on both acquirement and reinforcement of adjustment factors or self-help behavior is more efficient than focusing on the characteristics of illness in establishing the stategies for improving quality of life of individuals with rheumatoid arthritis.

• Journal of Korean Academy of Nursing
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• v.39 no.6
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• pp.805-817
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• 2009

Purpose: This ethnograpy was done to explore patterns of health care behavior in patients with chronic health problems. Methods: The participants were 15 patients with chronic hepatitis B and 2 family members. Among the patients 4 had progressed to liver cirrhosis and liver cancer. Data were collected from iterative fieldwork in a department of internal medicine of I hospital. Data were analyzed using text analysis and taxonomic methods. Results: Illness and disease, relationship between health care givers and clients, and communication patterns between health professions and clients were discussed as the context of health care behavior. Health care behavior of the participants was categorized by its focus: every day work centered, body centered, organ centered, and pathology centered. Conclusion: Participants' health care behavior was guided by folk health concept and constructed in the sociocultural context. Folk etiology, pathology, and interpretation of one's symptoms were influencing factors in illness behavior. These findings must be a cornerstone of culture specific care for the chronic diseases.

• Journal of Digital Convergence
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• v.11 no.1
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• pp.381-388
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• 2013

The study was done to identify factors influencing the health risk behavior of the chronic mental illness in the community. A cross-sectional study design was used in this study. The sample was 255 chronic mentally ill persons from D city and C province and who agreed to participate in the study. Data were collected on August-september, 2011 and analyzed using the SPSS/WIN 20. Stress event, insight and depression had significant correlations with health risk behavior. Hierarchial regression analysis showed gender (men), diagnosis (schizophrenia), stress event, insight and depression together explained 24% of variance in health risk behavior. Findings of this study allow a comprehensive understanding of health risk behavior of the chronic mentally ill persons in community. It is necessary to integrated health promotion programs designed for this population should focus on these factors for effective behavioral modification.