Factors related to the Identification of Middle-Aged Women Who are Disadvantaged by Cardio-cerebrovascular Disease

PURPOSE: To investigate factors related to cardio-cerebrovascular disease and groups disadvantaged by it in Korean middle-aged women, using the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: The present study was conducted with 1,627 middle-aged women, aged 40 to 64 years, who participated in the 7th (2016) Korea National Health and Nutrition Examination Survey conducted by the Korea Centers for Disease Control and Prevention. RESULTS: Cardio-cerebrovascular disease among middle-aged women was associated with quality of life, menopause, diabetes mellitus, body mass index, and family history of hypertension. The incidence of cardio-cerebrovascular disease in middle-aged women was found to be the most prevalent in women who have entered menopause, have a family history of hypertension, and have a body mass index greater than 30.0 kg/m². CONCLUSION: This study classifies the subjects according to the risk level of each disadvantaged group for cardio-cerebrovascular disease prevention and management in middle-aged women. The results provide evidence to support a tailored cardio- cerebrovascular disease prevention and management program based on the related factors of disadvantaged groups and to establish strategies in educational and practical aspects.

A Comparison of Pain, Pain Interference and Fatigue according to the Level of Physical Activity in the Elderly with Chronic Pain

PURPOSE: This study was conducted to evaluate differences in pain, pain interference, and fatigue, according to the level of physical activity in the elderly with chronic pain. METHODS: Data were collected between January and March 2011 from 116 elders with chronic pain living in community settings. The data were analyzed using the SPSS/WIN 17.0 program for descriptive statistics, 2 test, t-test, ANOVA and ANCOVA. The reliability of the instruments was tested with Cronbach's alpha coefficient, which ranged from .91 to .93. RESULTS: The results were as follows. The mean total physical activity was 2287.4 MET-min/week, and 41.4% of the investigated subjects were classified into the low physical activity group. After adjusting for age and sex, the moderate and high physical activity groups were significantly lower in pain (F=6.33, p=.002), pain interference (F=11.57, p<.001), and fatigue (F=3.16, p=.046) than the low physical activity group. CONCLUSION: Results from this study suggest that the level of physical activity can influence pain, pain interference and fatigue. Therefore, incorporating more physical activities into daily routines, inactive elderly individuals may improve their pain, pain interference and fatigue.

Correlations among Meta Cognition, Critical Thinking and Self-efficacy of Nursing Students Studying through Problem Based Learning(PBL)

PURPOSE: This study was performed to examine the degree of meta cognition, critical thinking and self-efficacy and to identify correlations among the meta cognition, critical thinking, and self-efficacy of nursing students studying through PBL. METHOD: The subjects were 140 nursing students who had studied through PBL over three terms at C College. Data were collected from August to September, 2005 using a structured questionnaire and analyzed using SPSS 10.0. RESULTS: The mean score of meta cognition was 40.14 (SD=6.02), critical thinking was 181.46 (SD=14.49), and self-efficacy was 942.93 (SD=167.05). There was a statistically significant positive correlation between meta cognition and self-efficacy and age. Also, meta cognition had a positive correlation with appropriateness to nursing and interest in nursing knowledge, and critical thinking had a positive correlation with appropriateness to nursing, interest in nursing knowledge, interest in lab on campus and interest in clinical practicum. There were statistically significant positive correlations among meta cognition, critical thinking and self-efficacy. CONCLUSION: Based on above results, further research should be done about many factors influencing nursing students' problem solving abilities for the development and application of many teaching methods for improving nursing students' meta cognition, critical thinking and self-efficacy.

Development and Application of PBL Module Using Simulator: Focused on Simman / 기본간호학회지

PURPOSE: This research was done to identify how PBL education using a simulator affects nursing students' critical thinking, self-efficacy, and meta-cognition by applying and developing a PBL module using the Simman simulator. METHOD: With a one group pre-post test design, the research was conducted with a convenience sampling on 66 students in C College on Jeju Island for 8 weeks from August to October, 2005. The collected data on critical thinking, self-efficacy, and meta-cognition were analyzed using T-test. SPSS 10.0 was used to assist analysis. For study-related variables, means and standard deviations were used. RESULTS: The finding of the research showed that most of the students were in favor of use of PBL-in the curriculum with more than 50% of the scores indicating satisfaction with content of the teaching, the teaching method, and self-confidence in nursing. The results also showed that there was an increase in interest among the students regarding campus practical education. CONCLUSION: As the application of the PBL module using the Simman simulator elicited more interest and satisfaction from the students, it is worth using this simulator as a the teaching method to improve the practical education in nursing.

Comparison of Influential Variables for Smoking Temptation between Adolescent and Adult Smokers / 간호학회지

PURPOSE: This study attempted to identify influential variables on smoking temptation between groups: adolescent smokers and adult smokers. METHOD: A survey was conducted with 376 adolescent smokers in 4 high schools and 451 adult smokers in community settings in South Korea. Univariate statistics and regression were used for data analysis. RESULT: The most powerful predictor of smoking temptation for adolescent smokers was nicotine dependency. On the other hand, the most powerful predictor of smoking temptation for adult smokers was self-efficacy for smoking abstinence. In the high smoking temptation group, depression and nicotine dependency were the predictors for smoking temptation for adolescent smokers and nicotine dependency and pros for smoking were the predictors for smoking temptation for adult smokers. In the low smoking temptation group, cons for smoking and process of change for smoking abstinence were the predictors on smoking temptation for adolescent smokers and self-efficacy for smoking abstention and pros for smoking were the predictors on smoking temptation for adult smokers. CONCLUSION: There were different influential variables on smoking temptation according to age groups and level of smoking temptation. Smoking-cessation interventions should be tailored to the level of smoking temptation of the individual smokers.

A Study on the Variables that Influence Stages of Change in Smoking Cessation / 기본간호학회지

PURPOSE: The purpose of this study was to identify variables that influence smoking cessation based on the transtheoretical model . METHODS: Variables that influence the stages of change in smoking cessation were selected based on transtheoretical model. Data were collected from 176 men aged 30-64 who smoked. Data collection was done in community settings in Seoul and vicinity, Korea between December, 1999 and June, 2000. Data were analyzed by descriptive statistics and logistic analysis using the pc-SAS program. RESULTS: According to the logit model, the influence of significant variables on stage of change for smoking cessation suggest that; When the scores for Pros in decision making for smoking cessation are high, the possibility that the subjects are in the action, precontemplation and contemplation stage of change will be lower than the possibility that the subjects are in the maintenance stage of change. When the scores of habitual craving in smoking temptation is high, the possibility that the subjects are in the precontemplation and contemplation stage of change will be higher than the possibility that the subjects are in the maintenance stage of change. When the scores of smoking temptation in negative affect situations are high, the possibility that the subjects are in the contemplation stage of change will be higher than the possibility that the subjects are in the maintenance stage of change. When the scores of cognitive process in the process of change are high, the possibility that the subjects are in the contemplation stage of change will be higher than the possibility that the subjects are in the maintenance stage of change. CONCLUSIONS: The results provide evidence that physical and psychological dependence on smoking are main barriers to smoking cessation. Therefore nursing interventions based on stage that focus on increasing motivation and intention for smoking cessation need to be developed.

Analysis of Smoking Temptation, Nicotine Dependency, Perceived Health Status corresponding to Stage of Change in Smoking Cessation in Middle Aged Men / 기본간호학회지

This study was done to investigate the relation of smoking temptation, stage of change in smoking cessation, nicotine dependency and perceived health status in middle aged men. Convenience samples of 176 subjects who were either smoked or used to smoke, aged between 30 to 64, living in Seoul and Kyungi province area in Korea were selected for the study. The data was collected from December 1, 1999 to June 30, 2000. The research instrument were Stage of Change of Smoking Cessation Measure (DiClemente et al., 1991), Smoking Temptation Measure (Velicer, DiClemente, Rossi, Prochaska, 1990), Perceived Health Status Measure (McDowell & Newell, 1996), and Nicotine Dependency Scale (FTQ: Fagerstrom, 1978). The data were analyzed using the SAS Program. The result of the study are as follows: 1. The analysis of variance and multiple comparison showed that according to the stage of change, there were significant mean differences in the three sub-factors of smoking temptation; 'positive affect situation (F=12.64, p=.0001)', 'negative affect situation (F=16.01, p=.0001)', 'habitual craving situation (F=14.43, p=.0001)' and nicotine dependency (F=4.12, p=.0033) The mean score for smoking temptation for the subjects who were in the precontemplation stage outweighed the mean score for smoking temptation for subjects who were in the maintenance stage. 2. Through discriminant analysis, it was found that negative affect situation was the most influential variable of the smoking temptation sub-factors which can be used to discriminate stage of change. 3. The analysis of Pearson correlation coefficients showed that there was a significant positive relation between nicotine dependency and negative affect situation of smoking cessation((r=0.2182, p=0.0045) and a significant negative relation between nicotine dependency and perceived health status(r=-0.2115, p=0.0059).

A study of the Stage of Change and Decisional balance: Exercise Acquisition, Smoking Cessation, Mammography Screening and Kegel's Exercise Acquisition in Korea / 간호학회지

This study was carried out to assess the perception of decisional balance of Korean subjects about 4 health behaviors and to identify the influencing factor of decisional balance for exercise acquisition, smoking cessation, mammography screening and Kegel's exercise acquisition. All are representative health behaviors nurses can intervene in Korea based on the Transtheoretical model. Convenient samples of 2,484 subjects (191; exercise, 169; smoking cessation, 1903; mammography screening and 221; Kegel's exercise) were selected from cities and counties over 9 provinces throughout Korea, and the data was collected from January 1, 1999 to February 29, 2000. The research instrument were the Decisional Balance Measure for Exercise (Marcus & Owen., 1992), Smoking Cessation (Velicer et al., 1985), Mammography Screening (Rakowski et al.,1992) and Kegel Exercise (Lim, 1999) and Stage of Change Measure for Exercise (Marcus et al, 1992), Smoking Cessation (DiClemente et al., 1991), Mammography Screening (Rakowski et al.,1992) and Kegel's Exercise (Lim, 1999). The data was analyzed by the SAS Program. The results are as follows; 1. According to the stage of change measure, 2,484 subjects were distributed in each stage of change for four health behaviors: 1,233 subjects (49.8%), 745 subjects (30.2%), 113 subjects (4.7%), 156 subjects (6.5%), and 216 (8.7%) belonged to the pre- contemplation stage, contemplation stage, preparation stage, action stage and maintenance stage. They were all series of stages of change in their efforts to do health behavior. 2. Factor analysis identified 3 factors (1 of Pros, 2 of Cons) for the exercise, 4 factors for smoking cessation (2 of Pros, 2 of Cons), 2 factors (1 of Pros, 1 of Cons) for the mammogram screening and 2 factors (1 of Pros, 1 of Cons) for Kegel's exercise of decisional balance. 3. The analysis of variance and multiple comparison analysis showed that for all 4 samples, the Cons of changing the problem behaviors outweighed the Pros for subjects who were in the pre- contemplation stage, The opposite was true for subjects in action and maintenance stage. 4. Through the discriminant analysis, it was found that one factor of Pros for exercise, one factor of Cons for smoking cessation, 1 factor of Cons for mammogram screening and one factor of Cons for Kegel's exercise were the more influencing factors, than others in discriminating the stages of change. Results are consistent with the applications of the Transtheoretical model, which have been used to understand how people change health behaviors. This results provide some evidence that subject's report of his/her health behavior corresponds to beliefs about usefulness of related health behaviors. The results of this study have implications for patients' health education and health intervention strategies. The findings of this study give useful information for nursing educators for 4 health behaviors, especially the factors relating to decision making in the different stages of change.

Decisional balance corresponding to the Stage of Change of Smoking Cessation in Middle Aged Men / 기본간호학회지

PURPOSE: This study was done to identify the factors of decisional balance for smoking cessation among middle aged men in Korea. This was composed of a set of variables at the level of decision making when middle aged men decide to stop smoking. It was used to classify and identify the characteristics of the stages of change for smoking cessation to which the middle aged men belong, and was used to identify the variables of decisional balance which influenced the stages of change for smoking cessation in middle aged men. METHODS: A convenience sample of 169 men who had smoked and were smoking, were between age 30 and 60 and lived in Seoul(mean age=44), were selected from the community. The data was collected from December 10, 1999 to February 28, 2000. The research instrument was the Decisional Balance Measure for Smoking Cessation (Velicer et al., 1985), and Stage of Change Measure(DiClemente et al., 1991). The data were analyzed using the SAS Program. RESULTS: 1. According to stage of change measure, the 169 subjects were distributed in each stage of change for smoking cessation: in the pre-contemplation stage 63 subjects (32.7%), contemplation stage 60 subjects (35.5%), preparation stage 17 subjects (10.1%), and maintenance stage 29 subjects(17.2%). 2. Factor analysis identified 4 factors of decisional balance as appropriate factors for smoking cessation of middle aged men. There were named by the researchers; 1)'Perceived Burden to Self', 2) 'Perceived Benefit to Others' 3)'Perceived Approval to Others', and 4)'Perceived Disapproval to Self'. 3. Analysis of variance showed that the three components, 1)'Perceived Burden to Self(F=8.50, P=0.0001)', 2) 'Perceived Benefit to Others(F=3.19, P=0.025)' and 3)'Perceived DisApproval to Self(F=2.87, P=0.038)were significantly associated with stage of change. 4. Through discriminant analysis, it was found that 'Perceived Burden to self' was the most influential variable in discriminating the four stages of change(pre-contemplation, contemplation, preparation, and maintenance). CONCLUSION: The results are consistent with the application of the Transtheoretical model, which has been used to understand how people change health behavior. Even though this study is a cross-sectional, not a longitudinal study, the findings of this study give useful information for smoking cessation intervention for the middle aged men.

Death Orientation of the Korean Adult: Data was focused on residents who were living in urban area / 기본간호학회지

Death and dying of human being is a comprehensive system, and death orientation, the subjective meaning related to every component of the death system is developed throughout life. this study was designed and carried out to identify, describe and classify the orientations of Korean adult toward the death system. In an attempt to measure the subjective meaning of death and dying, unstructured Q-methodology was used. The 65 Q-statements developed by Kim(1994), used by Kim(1994) and Park(1996) were adopted as Q-population and 39 Q-statements were selected by the three researchers for Q-items for this study. Thirty-three P-samples were sampled from P-population of literature Korean men and women, 35 and 55 years of age, lived in urban Korea for the last 10 years. Sorting of the 39 Q-items according to the level of personal agreement, and a forced normal distribution into the 9 levels were carried out by the P-samples. the Z-scores of the Q-sort data were computed, and the principal components factor analysis by PC-QUANL Program were carried out. the demographic, socio-cultural and health-related attributes of the P-samples were descriptively analysed. Eight types of death orientation were identified : Type I ; "naturalist". Six P-samples. Death is a natural phenomena, to be accepted as it is and to follow its natural course. Prefer to be informed of all facts and possibilities concerning the course of dying and death to occur to self. Type II ; "life-after-life negator". Three P-samples. Time and process of death is the destiny of each person. Death means 'darkness' and 'end to every thing, the absolute end'. Yet, wish physical integrity at the dying and after death. Type III ; "life-after-life believer". Six P-samples. Men are travellers passing by this life bound to the life-after-life. Priority concerns are on the activities. to prepare self for the eternal life ahead. Disregard premature and sudden death. Type IV ; "here-now believer". Five P-samples. Positive regard to the cremation of the body and donation of the organs on death. Regard religious and customary post-mortem rituals meaningless. Negate life-after life. Type V ; "believer of rituals". Five P-samples. Death being accepted as a part of a natural end to, and destiny of human life. Concerned to ensure a dignified end to personal life and dignified post-mortem rituals. Type VI ; "Realist"(derived from Type I). Tow P-samples. Life and death as universal reality. The abrupt death at golden age at the peak of happiness is favored to avoid inevitable physical and mental distress of self and the family. Agreed to the cremation of the body. disregard rituals. Type VII ; "Fatalist"(derived from Type II). Five P-samples. Not favored, yet, all man are destined to death, the inevitable end of all living beings. to ensure dignified end by personal consummation, information. on one's dying and imminent death are to be shared. Type VIII ; "reality avoider"(derived from Type III. One P-sample. Negative to longevity, artificial prolongation of, meaningless and distressful life. Highly positive to post-mortem organ donation.

A Classification of Death Orientation of Cancer Patient`s Family Members: A Q-Methodological Approach / 기본간호학회지

This study was designed to identify, describe and classify orientations of cancer patient's family members to death and to identify factors related to their attitudes on death. Death to the male is understood as a comprehensive system and believed to be highly subjective experience. Therefore attitude on death is affected by personalities. As an attempt to measure the subjective meaning toward death, the unstructured Q-methodology was used. Korean Death Orientation Questionnaire prepared by Kim was used. Item-reliability and Sorting reliability were tested. Forty five cancer patient's family members hospitalized in one university medical center in Seoul were sampled. Sorting the 65 Q-items according to the level of personal agreement; A forced normal distribution into the 11 levels, were carried out by the 45 P-samples. The demographic data and information related to death orientation of the P-sample was collected through face to face in depth interviews. Data was gathered from August 30 till September 22, 1995. The Z-scores of the Q-items were computed and principal component factor analysis was carried out by PC-QUANL Program. Three unique types of the death orientation were identified and labeled. Type I consists of twenty P-samples. Life and death was accepted as people's destiny. They firmly believed the existence of life after life. They kept aloof from death and their concern was facing the end of the life with dignity. They were in favor of organ donation. Type II consists of Nine P-samples. They considered that death was the end of everything and did not believed the life after life. They were very concerned about the present life. Type III consists of Sixteen P-samples. They regarded the death as a natural phenomena. And they considered that the man is just a traveller and is bound to head for the next life which is believed to be free of agony, pain or darkness. They neither feared death nor its process. Their concerns were on the activities to prepare themselves for the eternal-life after death. Thus, it was concluded that there were three distinctive type of attitudes on death among cancer patient family members, and their death attitudes were affected by demographic and socio-cultural factors such as sex, education, and religion.