Post-traumatic Growth and it’s associations with Deliberate Rumination, Self-disclosure, and Social Support among Intensive Care Unit Nurses / 중환자간호학회지

Purpose@#: This study aimed to identify intensive care units (ICU) nurses’ experience of traumatic events, deliberate rumination, self-disclosure, social support, and post-traumatic growth (PTG), and to explore relationships among the variables. @*Methods@#: Participants were 157 nurses who have provided direct patient care for six months or more in ICUs at a university hospital. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVAs, Pearson correlations, and multiple linear regressions using the SPSS/WIN version 23.0. @*Results@#: The PTG was found to be significantly associated with deliberate rumination (r=0.36, p<.001), self-disclosure (r=0.39, p<.001), and social support (r=0.54, p<.001). Factors that affect PTG significantly were found in the order of social support (β=0.40, p<.001), self-disclosure (β=0.25, p<.001), and deliberate rumination (β=0.24, p<.001). The final regression model explained 40.1% of the variance of PTG (F=26.33, p<.001). @*Conclusion@#: The influencing factors identified in this study on PTG, including social support, self-disclosure, and deliberate rumination should be included in programs to promote PTG for ICU nurses who may experience traumatic events repeatedly.

Psychometrics Properties of Ways of Coping Questionnaire-Korean among College Students

Background@#The purpose of this study was to investigate the validity and reliability of the Ways of Coping Questionnaire-Korean (WCQ-K) among college students. @*Methods@#A cross-sectional survey design was employed to validate psychometrics properties of the WCQ-K among 248 students from a university-affiliated health-care center in Suwon, Korea. Structured questionnaires were used for psychometric evaluation. Item analysis, exploratory factor analysis, and known-groups validity were performed for validity. The Cronbach’s alpha coefficient and Intraclass Correlation Coefficient (ICC) were used for reliability. @*Results@#A seven-factor model with 36 items explained 50.8% of the variance. The Cronbach’s alpha was 0.90; the ICC for 2-weeks test-retest reliability was 0.80. Students with stable ways of coping tended to have a lower score on the perceived stress and depressive symptoms than their counterparts (all P<0.05). @*Conclusions@#The findings of this study provide evidence for the adequate psychometric properties of the WCQ-K. The WCQ-K may be used in school or clinical settings to examine the potential role of stress-coping strategies in enhanced stress management among Korean college students.

Psychometrics Properties of Ways of Coping Questionnaire-Korean among College Students

Background@#The purpose of this study was to investigate the validity and reliability of the Ways of Coping Questionnaire-Korean (WCQ-K) among college students. @*Methods@#A cross-sectional survey design was employed to validate psychometrics properties of the WCQ-K among 248 students from a university-affiliated health-care center in Suwon, Korea. Structured questionnaires were used for psychometric evaluation. Item analysis, exploratory factor analysis, and known-groups validity were performed for validity. The Cronbach’s alpha coefficient and Intraclass Correlation Coefficient (ICC) were used for reliability. @*Results@#A seven-factor model with 36 items explained 50.8% of the variance. The Cronbach’s alpha was 0.90; the ICC for 2-weeks test-retest reliability was 0.80. Students with stable ways of coping tended to have a lower score on the perceived stress and depressive symptoms than their counterparts (all P<0.05). @*Conclusions@#The findings of this study provide evidence for the adequate psychometric properties of the WCQ-K. The WCQ-K may be used in school or clinical settings to examine the potential role of stress-coping strategies in enhanced stress management among Korean college students.

Effect of a Physical Activity Promoting Program Based on the IMB Model on Obese-Metabolic Health Outcomes among Obese Older Adults with Knee Osteoarthritis

Purpose@#This study examined the effects of a physical activity promoting program based on the Information-Motivation-Behavioral Skills (IMB) model on physical activity and health outcomes among obese older adults with knee osteoarthritis. @*Methods@#This study utilized a randomized controlled trial with a convenience sample of 75 obese older adults with knee osteoarthritis in a university hospital. The older adults in the intervention group participated in a 12-week program involving weekly group sessions and monitoring calls with education booklets and video clips for exercise dances, while those in the control group received an usual care. Outcomes were measured using self-report questionnaires, anthropometrics, and blood analyses. The intervention effects were analyzed using Mann-Whitney U test and ANCOVA. @*Results@#The mean age of participants was 74.9 years with 84.0% women. The intervention group at 12 weeks showed significantly greater improvements in self-efficacy for physical activity (F=81.92, p <.001), physical activity amounts (Z=-2.21, p =.044), knee joint function (F=15.88, p <.001), and health-related quality of life (F=14.89, p <.001) compared to the control group. Among obese-metabolic outcomes, the intervention group at 12 weeks showed a significant decrease in visceral fat mass (F=7.57, p =.008) and improvement in high-density level cholesterol (F=9.51, p =.003) compared to the control group. @*Conclusion@#Study findings support the need for an IMB based physical activity program for promoting physical activity, knee function and health outcomes in obese older adults with knee osteoarthritis. Longitudinal studies are warranted to confirm the persistence of obese-metabolic effects in clinical settings.

The Association Between Perceived Stress and Quality of Life in University Students: The Parallel Mediating Role of Depressive Symptoms and Health-Promoting Behaviors

PURPOSE: This study examined whether depressive symptoms and health-promoting lifestyle behaviors mediate the association between perceived stress and quality of life (QoL) in university students. METHODS: Using a cross-sectional survey, Korean university students (N = 187, Mage = 23.97 years; 54.0% Woman) completed structured questionnaires with psychometric adequacy. A parallel multiple mediation model was used to test the mediating effect of depressive symptoms and health-promoting lifestyle behaviors on the relationship between perceived stress and QoL. RESULTS: Total effect of perceived stress, depressive symptoms, and health-promoting lifestyle behaviors on QoL was −.55. Of these, total indirect mediating effect was −.50, whereas direct effect was only −.05 in the parallel mediation model. In particular, depressive symptoms (indirect effect = −.32) and healthpromoting lifestyle behaviors (indirect effect = −.18) completely mediated the relationship between perceived stress and QoL. CONCLUSION: The results suggest that effective strategies primarily focusing on improving depressive symptoms along with health behaviors are needed to decrease the negative effect of perceived stress on QoL.

Association of Job Stress with Health-promoting Behaviors and Health Status in Clinical Nurses / 한국직업건강간호학회지

PURPOSE: This study examined association of job stress with health-promoting behaviors and objective health status in 129 clinical nurses working at a university hospital. METHODS: A cross-sectional and descriptive design was used. Job stress and health behaviors were measured with Korean Occupational Stress Scale and Heath Promoting Lifestyle Profile-II, respectively. Health status measured with afternoon plasma cortisol, C-peptide, and lipid profiles. RESULTS: The level of job stress among clinical nurses was moderate with 51.41 on average. The mean for health-promoting behavior in the low stress group was significantly higher than that in the high or moderate stress groups (p<.001). The proportions of nurses with high C-peptide and cortisol levels, or low high-density lipoprotein levels, ranged from 14.0% to 35.7%. In particular, the percentage of nurses with high C-peptide levels was significantly higher in moderate and high stress groups than in the low stress group (24.1% versus 11.6%, p<.05). CONCLUSION: The study findings affirmed the associations of job stress with health-promoting behaviors as well as selected health status indicators such as C-peptide in clinical nurses. Job stress management intervention can help clinical nurses to improve their health-promoting behaviors and health status.

Measurement Properties of Self-report Questionnaires Published in Korean Nursing Journals

PURPOSE: The purpose of this study was to evaluate measurement properties of self-report questionnaires for studies published in Korean nursing journals. METHODS: Of 424 Korean nursing articles initially identified, 168 articles met the inclusion criteria. The methodological quality of the measurements used in the studies and interpretability were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. It consists of items on internal consistency, reliability, measurement error, content validity, construct validity including structural validity, hypothesis testing, cross-cultural validity, and criterion validity, and responsiveness. For each item of the COSMIN checklist, measurement properties are rated on a four-point scale: excellent, good, fair, and poor. Each measurement property is scored with worst score counts. RESULTS: All articles used the classical test theory for measurement properties. Internal consistency (72.6%), construct validity (56.5%), and content validity (38.2%) were most frequently reported properties being rated as 'excellent' by COSMIN checklist, whereas other measurement properties were rarely reported. CONCLUSION: A systematic review of measurement properties including interpretability of most instruments warrants further research and nursing-focused checklists assessing measurement properties should be developed to facilitate intervention outcomes across Korean studies.

Impact of Critical Thinking Disposition, General Self-Efficacy, and Leadership on Clinical Competence in Nursing Students / 한국의학교육

PURPOSE: The purpose of this study was to evaluate the relationships among critical thinking disposition, general self-efficacy, leadership and clinical competence, and identify the factors influencing clinical competence in nursing students. METHODS: In this descriptive study, 153 nursing students (from 2nd to 4th school year) of a university in South Korea were enrolled in December 2010. The instruments for this study were the Korean versions of the Critical Thinking Disposition Scale, General Self-Efficacy Scale, Leadership Inventory, and Clinical Competence Scale. Data were analyzed by descriptive statistics, t-test, MANOVA, Pearson correlation, and multiple linear regression with PASW 18.0 software. RESULTS: The mean scores (ranging from 1 to 5) in nursing students for critical thinking disposition, general self-efficacy, leadership, and clinical competence were 3.44, 3.51, 3.55, and 3.42, respectively. Positive correlations were found for clinical competence with critical thinking disposition, general self-efficacy, and leadership. The strongest predictor of clinical competence was leadership. In addition, leadership, nursing school year, and subjective academic achievement accounted for 34.5% of variance in clinical competence. CONCLUSION: This study revealed that developing leadership, critical thinking disposition, and self-efficacy in undergraduate nursing education is important to improve clinical competence of nursing students.

Monitoring the Use of Health-Related Quality of Life Measurements in Korean Studies of Patients with Diabetes

PURPOSE: The purpose of this study was to monitor the use of health-related quality of life (HRQOL) instruments in Korean studies of patients with diabetes. METHODS: Of 86 Korean studies initially identified, 17 studies met the inclusion criteria. For each study, a description of the instrument and its psychometric properties were monitored by the Instrument Review Criteria of the Scientific Advisory Committee. These criteria include conceptual definition, attributes, taxonomy, reliability, validity, responsiveness, administrative mode, and language adaptations. RESULTS: Five generic and one diabetes specific type questionnaires were identified from the 17 studies. Of those studies, conceptual definitions with the attributes of multi-dimension and subjectiveness were provided for 11 studies (71%). In the analysis of conceptual taxonomy, only 6 studies were classified as HRQOL, while other studies were done as QOL or health status. In monitoring of psychometric properties, reliability, validity, and responsiveness were reported for 88.2%, 64.7%, and 29.4%, respectively. One generic instrument was developed with a Korean population, while the other instruments were developed for Western countries. However, language adaptations were performed for only a few of the instruments. CONCLUSION: The psychometric properties including responsiveness of most instruments warrants further research, and the development of diabetes-specific HRQOL measurements should be sought to facilitate intervention outcomes across Korean studies of patients with diabetes.

Mental Health and Self-care Activities according to Perceived Stress Level in Type 2 Diabetic Patients with Metabolic Syndrome / 성인간호학회지

PURPOSE: This study was to identify the mental health and self-care activities according to perceived stress level in type 2 diabetic patients with metabolic syndrome. METHODS: The descriptive survey design was conducted using a convenient sample. One hundred and fifty-two diabetic participants with metabolic syndrome were recruited in a university hospital. The data were analyzed using descriptive statistics, Students' t-test, and ANOVA with SPSS/WIN 12.0. RESULTS: The high, moderate, and low stress groups according to perceived stress score consisted of 30.9%, 38.2%, and 30.9%, respectively. Differences of mental health and total self-care activities among the three groups were statistically significant. Depression (F=46.73, p<.001), trait anger (F=5.75, p<.01), and anger expression-in (F=4.60, p<.01) of participants in the high stress group were higher than other groups, whereas the total of self-care activities (F=2.85, p<.05) and exercise (F=3.49, p<.05) were lower than other groups. CONCLUSION: This study concluded that type 2 diabetic patients with metabolic syndrome with a high stress level were low in self-care activities along with elevated depression and anger.

Psychometric Evaluation of the Korean Version of the Adapted Illness Intrusiveness Rating Scale

PURPOSE: To examine the psychometric properties of the Korean version of the adapted Illness Intrusiveness Rating Scale (a-IIRS). The a-IIRS is a modified version of the original IIRS that measures illness-disruptions to daily life in patients with diverse diagnoses. While the psychometric properties of the original IIRS have been validated, no study has been conducted to validate the Korean version of a-IIRS. METHODS: After translation and back-translation processes, the Korean version of a-IIRS was developed. A pilot test was conducted with 10 patients with chronic diseases. A convenience sample of 380 patients with diabetes, hypertension, and/or arthritis was used. Exploratory and confirmatory factor analyses, known-group technique, hypothesized relationships, internal consistency, and item analysis were tested. RESULTS: Three factors were extracted from principal components analysis with varimax rotation: Relationships and Personal Development, Instrumental Life, and Intimacy. Confirmatory factor analysis corroborated the good fit of the three-factor model. Illness intrusiveness was significantly different among the study subjects categorized into three groups according to different health status: poor, fair and good. The instrument was positively correlated with the scales of fatigue and depression. The tool demonstrated high internal consistency with adequate item-total correlations. CONCLUSIONS: The findings are consistent with previous study results on IIRS and support the reliability and validity of the Korean version of a-IIRS. The instrument is culturally relevant for Korean patients with chronic diseases. Health care professionals need to consider illness intrusiveness when caring for patients with chronic diseases and promote their quality of life.

Sex differences in Risk of Cardiovascular Disease, Depression and Self-Care Activities in Type 2 Diabetes with Metabolic Syndrome / 성인간호학회지

PURPOSE: This study was to investigate the sex differences in risk of cardiovascular disease(CVD), depression and self-care activities in type 2 diabetes with metabolic syndrome. METHODS: The descriptive correlational design was conducted using a convenient sample. One hundred and twenty-nine diabetic patients with metabolic syndrome were recruited in a university hospital. The data were analyzed using descriptive statistics, the Pearson correlation coefficient, Students' t-test, one way ANOVA, and stepwise multiple regression with SPSS/WIN 12.0. RESULTS: The risk of CVD in diabetic patients with metabolic syndrome indicated a significantly negative correlation to self-care activities and age, and positive correlation to waist_C, SBP, DBP and TG. The metabolic syndrome is associated with an approximate 1.7-fold increase in the relative risk in CVD in diabetic women. The main significant predictors influencing CVD risk of diabetes with metabolic syndrome were age, waist_C, SBP and TG, which explained about 29.7%. CONCLUSION: These results indicate that patients with diabetes with metabolic syndrome with a high degree of waist_C, SBP and TG are likely to be high in risk of CVD.

The Relationship between Depression, Perceived Stress, Fatigue and Anger in Clinical Nurses / 간호학회지

PURPOSE: The purpose of this study was to identify the relationship between depression, perceived stress, fatigue and anger in clinical nurses. METHOD: A descriptive survey was conducted using a convenient sample. Data was collected by questionnaires from four hundred clinical nurses who worked at a university hospital. Radloff's CES-D for depression, Cohen, Kamarck & Mermelstein's Perceived Stress Scale, VAS for Fatigue, and Spielberger's STAXI for anger were used. The data was analyzed using the pearson correlation coefficient, students' t-test, ANOVA, and stepwise multiple regression with SPSS/WIN 12.0. RESULT: The depression of clinical nurses showed a significantly positive correlation to perceived stress(r=.360, p=.000), mental fatigue(r=.471, p=.000), physical fatigue(r=.350, p=.000), trait anger(r=.370, p=.000), anger-in expression(r=.231, p=.000), and anger-control expression(r=.120, p=.016). There was a negative correlation between depression and age(r=-.146, p=.003). The mean score of depression of nurses, 26, was a very high score and 40.8% of clinical nurses were included in a depression group. The main significant predictors influencing depression of clinical nurses were mental fatigue, trait anger, perceived stress, anger-in expression, and state anger, which explained about 32.7%. CONCLUSION: These results indicate that clinical nurses with a high degree of perceived stress, mental fatigue and anger-in expression are likely to be depressed.

Development and Validation of a Computerized Exercise Intervention Program for Patients with Type 2 Diabetes Mellitus in Korea

This study was designed to develop and validate a computerized exercise intervention program using the transtheoretical model (TTM) for Korean patients with type 2 diabetes mellitus (DM). This computerized program was web-based and developed by designing a flow chart. An expert group (n=24), who validated the content of the computerized program, produced a mean score for the evaluation scale of 4.25 (SD .56). Of the patients (n=28) with type 2 DM who participated in clinical validity testing of the program, the mean score for the satisfaction scale was 4.82 (SD .12). In the validation of the program, significant differences between baseline and after-intervention were observed in the stage of readiness for exercise (Z=-3.78, p < 0.001), physical activity (Z=-2.33, p < 0.05), blood glucose profiles [FBS (Z=-2.84, p < 0.01), pc 2hr. glucose (Z=-2.33, p < 0.05), HbA1c (Z=-2.77, p < 0.01) ], and VO2max (Z=-2.52, p < 0.01). The study confirmed that the computerized program could be used to construct a database and continue to provide follow-up intervention for patients in all stages.

Process of Change, Decisional Balance and Self-Efficacy Corresponding to the Stage of Exercise Behavior in Patients with Type 2 Diabetes Mellitus / 성인간호학회지

PURPOSE:Thisstudy 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 ofchangein contemplation stage. "Consciousness raising(CR)", "DR" were used higher than average in preparation stage. "Helpingrelationships(HR)","CR", "ER", "SR", "Social liberation(SL)", "Counter conditioning (CC)", "Reinforcement management(RM)", "Self liberation(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.

Development of a Exercise Intervention Program Based on Stage of Exercise Using the Transtheoretical Model in Patients with Type 2 Diabetes Mellitus / 기본간호학회지

PURPOSE: The purpose of this study was to develop an exercise intervention program based on stage of exercise using the Transtheoretical Model (TTM) for patients with type 2 diabetes mellitus (DM). METHOD: A methodological research design was used to develop the exercise intervention program based on stage of exercise using TTM. RESULT: The exercise intervention program consisted of theoretical background and goals of program, assessment tool for stage of change, and an exercise intervention program based on stage of exercise. Details for the exercise and a glossary are included. CONCLUSION: The exercise intervention based on stage of exercise can apply for DM patients who are in any stages properly.

The Effects of Planned Exercise Program on Metabolism, Cardiopulmonary Function and Exercise Compliance in Type 2 Diabetes Mellitus Patients / 간호학회지

This study was conducted to identify the effects of a planned exercise program based on Bandura's self efficacy model on metabolism, and the exercise compliance in type 2 diabetes mellitus patients. The study design was a nonequivalent pre-test post-test control design. Thirty four type 2 diabetes mellitus patients, who received follow-up care regularly through the diabetic out-patient clinic, were randomly sampled for this study. Twenty patients were assigned to the experimental group and fourteen patients were assigned to the control group. In the experimental group, a planned exercise program is composed of an individualized exercise prescription for 12 weeks, an individual education, and even a telephone coach program. In the case of the control group, they were instructed to continue with their usual schedules. The data collection period was from March 1999 to February 2000 Data were analyzed using SPSS/WINDOW 10.0program. The results were as follows. 1. In the experimental group, the level of fasting blood sugar has significantly decreased from 188.20 mg/dl to 155.55 mg/dl after planned exercise program (F= 16.86, p=.000). For lipid metabolism, body fat per cutaneous decreased from 27.16% to 26.57% after planned exercise program. The score of self efficacy has increased from 64.20 to 66.65 after planned exercise program and it was statistically significant (F=4.850, p=.040) The functional vital capacity has increased from 3.28 liter to 3.37 liter and it was statistically significant(F=7.300, p=.020). 2. In an after effect of a planned exercise program, 35 percent of the subjects who participated in a planned exercise program continued to exercise for another six months. In conclusion, the planned exercise program can improve cardiopulmonary function, glucose, and lipid metabolism. This program was show a positive effect on the self efficacy and exercise compliance.

The Development of Exercise Therapy Protocol Applied to an Efficacy Expectation Promoting Program in Type 2 Diabetes Mellitus Patients / 기본간호학회지

Type 2 Diabetes Mellitus patients have chronic metabolic disorder and they need self care for their lifetime. But most Diabetes Mellitus patients don't know how to do a self care due to the lack of adequate support from health care professionals. It has been reported that lack of exercise therapy compliance guide is very important one. This study was conducted to develop an exercise therapy protocol applied to an efficacy expectation promoting program based on Bandura's self efficacy model for type 2 Diabetes Mellitus patients. Firstly, a conceptual framework was developed through efficacy expectation promoting program based on Bandura's self efficacy model. In order to identify the contents of program and to design a preliminary protocol, a with the consultation experts was made. A clinical validity was tested using twenty type 2 Diabetes Mellitus patients who received follow-up care regularly through the diabetic out-patient clinic from October, 1998 to May, 2000. After this process, the final protocol was developed. The results of this study are summarized as bellows : The final exercise therapy protocol applied to an efficacy expectation promoting program for type 2 Diabetes Mellitus patients consists of individualized exercise test and prescription, a small booklet relating personal experience with Diabetes Mellitus and a telephone coaching program for 12 weeks on performance accomplishment, vicarious experience and verbal persuasion, which are all induction modes of efficacy expectation. It is concluded that the exercise therapy protocol applied to an efficacy expectation promoting program is applicable to type 2 diabetes mellitus. And this exercise therapy protocol could show a positive effect on the exercise compliance of Diabetes Mellitus patients.

The Effects of Exercise Therapy Applied in an Efficacy Expectation Promoting Program on Self-Efficacy and Metabolism: in NIDDM(Non-Insulin Dependent Diabetes Mellitus) Patients / 간호학회지

This study was conducted to investigate whether exercise therapy applied in an efficacy expectation promoting program based on the self-efficacy theory of Bandura(1977) would increase self-efficacy and metabolism in NIDDM patients. The study design was a nonequivalent control group pre-test post-test quasi-experimental design. The exercise therapy applied in the efficacy expectation promoting program was composed of a staged exercise program, a small booklet relating personal experience with diabetes mellitus and a telephone coaching program on performance accomplishment, vicarious experience and verbal persuasion, which are all induction modes of efficacy expectation. The subjects of the study were twenty eight NIDDM patients who received follow-up care regularly through the out-patient department of endocrine medicine in one general hospital which had a diabetic clinic. Fourteen were assigned to the experimental group and fourteen to the control group. The experimental group participated in the exercise therapy applied in the efficacy expectation promoting program from three to five times per week for four weeks and the control group did not have the program. The collected data were analyzed using the x2-test, t-test, paired t-test, and Cronbach's Alpha using SPSS/PC+. The results are summarized as follows : 1. Experimental group had higher efficacy score than control group(t=5.98, p=.00). And, There was a significant different in the efficacy score before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(t=-6.42, p=.00). 2. Experimental group did not have lower level of glucose metabolism than control group(FBS : t=.32, p=.75, HbA1C : t=.60, p=.55, pc 2hrs. glucose : t=-.29, p=.78). But, There was a significant different in the amount of glucose metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(FBS : t=3.63, p=.003, HbA1C : t=4.20, p=.00 2hrs . glucose : t=1.93, p=.001). 3. Levels of lipid metabolism were partly a significant different between Experimental group and control group(triglyceride : t=-1.87, p=.07, HDL cholesterol : t=-.29, p=.77, body weight : t=1.78, p=.09, Total cholesterol : t=-2.17, p=.04). And, There was partly a significant different in the amount of lipid metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(triglyceride : t=2.50, p=.03, HDL cholesterol : t=-.43, p=.67, body weight : t=5.34, p=.00, Total cholesterol : t=2.26, p=.04). In conclusion, it was found that exercise therapy applied in an efficacy expectation promoting program was an effective nursing intervention for increasing self-efficacy and metabolism.