Influence of perceived stress on health-promoting behaviors in patients with metabolic syndrome: the multiple mediating roles of adaptability and social support / 浙江大学学报·医学版

: To explore the potential associations between perceived stress and health-promoting behaviors based on the theoretical schema of the middle-range theory of adaptation to chronic illness. From January to May 2021, a convenience sampling method was used to recruit 230 young and middle-aged patients with metabolic syndrome who underwent physical examination in the inpatient center of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. The Health-Promoting Health Profile-Ⅱ, Chinese Perceived Stress Scale, Coping and Adaptation Processing Scale-Short Form, and Multi-dimensional Scale of Perceived Social Support were used in the cross-sectional study. The chain mediation effect procedure and bootstrap sampling test were used to examine the mediating role of adaptability and social support between perceived stress and health-promoting behaviors. The mean score of health-promoting behaviors was 100.0±14.6, the mean score of perceived stress was 22.0± 6.9, the mean score of adaptability was 47.0±6.1, and the mean score of social support was 63.8±10.8. Perceived stress had a negative impact on patients' health-promoting behaviors (=-0.309, <0.05). The adaptability (effect size= -0.112, 95%:-0.199~-0.038) and social support (effect size= -0.032, 95%:-0.083~played a mediating role and a chain mediating role in the process of perceived stress influencing patients' health-promoting behaviors (effect size= -0.045, 95%:-0.093~-0.020). Adaptability and social support play an intermediary role between perceived stress and health-promoting behaviors in young and middle-aged patients with metabolic syndrome. Healthcare professionals can motivate patients to develop healthy behaviors by developing intervention strategies on adaptability and social support.

Influence of Knowledge and Attitude of Cancer on Cancer Prevention Health Promoting Behavior in General Hospital Nurses

PURPOSE: The purpose of this study was to find factors affecting hospital nurses' cancer prevention health promoting behavior METHODS: The subjects were 308 nurses working in general hospitals with over 300 beds. Knowledge of cancer was assessed with 36 question items for six major cancers, and the attitude toward cancer was assessed with 10 items for cancer prevention and early detection. Cancer prevention health promotion behavior was assessed by 21 questions about diet, health life, and exercise. The collected data were analyzed using frequency and percentage, t-tests, one-way ANOVA, Pearson correlation coefficients, and stepwise multiple regression analysis. RESULTS: The score for knowledge of cancer was 25.12±3.33. The average score for attitude towards cancer was 30.41±4.08. The score of cancer prevention health promoting behaviors on cancer was 70.60±10.90. Cancer prevention health promoting behaviors were not correlated with cancer knowledge, and were positively correlated with cancer attitude (r=0.44, p < .001). There was a positive correlation with the cancer prevention attitude (r=0.49, p < .001) among the sub-areas of cancer attitude. CONCLUSION: The nurses' knowledge, attitude, and preventive health promotion behaviors of cancer were important for the health of individuals, patients and the general public, I think it is necessary to search for ways to actively promote cancer prevention health promoting behaviors in various directions and to confirm their effects.

Diabetes, Returning to Work, and Your Rights for Health / 임상당뇨병

Diabetes sufferers in their 30s to 50s are at an age must maintain their income-producing activities while also managing their health; however, maintaining this balance is not always easy due to their disease. Patients in their 30s to 50s who are actively engaged in work life may not experience workplace difficulties when their diagnosis is known and can be addressed with health-promoting behaviors or passive management. Patients have limitations in implementing the active self-management required by the educational scene in-house. The reason is because the working environment in Korea has not yet established a proper perception of diabetes and feels that allowing diabetes to manage diseases against fairness. The educators proudly reveal themselves as diabetes and cannot take into consideration or take responsibility the disadvantages they can experience when returning to work, we must consider what the patient “has to do to get back to work.” In addition, patients should think about how to manage their disease effectively through more than just a passive response. Moreover the Korean Diabetes Association should establish guidelines for the areas that need to be protected legally and on the defensive aspects that need to be better perceived.

Body Esteem, Stress, and Health Promoting Behavior among Korean Adults in a Community / 재활간호학회지

PURPOSE: The purpose of this study was to examine the relationship between body esteem, stress, and health promoting behaviors among Korean adults in a community and to identify factors that influence health promoting behaviors. METHODS: This study was conducted using a questionnaire which included item for body esteem, stress and health promotion behaviors. Data were collected from 257 adults living in Jeollabuk-do in Korea from November to December, 2015. The collected data were analyzed through descriptive statistics, Pearson's correlation coefficient, and stepwise multiple regression using the SPSS/WIN 21.0 program. RESULTS: The mean score of body esteem was 2.73±0.43, stress was 1.89±0.68, and health promoting behaviors was 2.22±0.45. There was a significant positive correlation between body esteem and health promotion behaviors (r=.47, p<.001), whereas there was a significant negative correlation between stress and health promotion behaviors (r=-.47, p<.001). In stepwise multiple regression analysis, body esteem, religion, education explained approximately 30.1% of health promoting behaviors (F=37.73, p<.001). CONCLUSION: The results in this study indicate that body esteem is the most important factor in health promoting behaviors among Korean adults. Thus, body esteem contents should be included in developing programs for adults to enhance their health promoting behaviors.

Analysis of Factors Affecting the Need for Health Education Programs in Middle-aged Women

BACKGROUND: This study aimed to analyze the factors affecting health education program needs as defined by the World Health Organization (WHO) for promoting health in middle-aged women. METHODS: Study subjects included 203 middle-aged women ranging in ages between 40 and 59 years, living in S-city. Data were collected from September 10 to 24, 2011. Descriptive statistics, independent t-test, and one-way ANOVA were used to analyze general characteristics and the need for health education programs related to the general characteristics. Hierarchical multiple regression was used to access the factors influencing the need for health education programs. All data were analyzed by SPSS/WIN 17.0 program. RESULTS: The average score of the health promotion behaviors was 3.46 (+/-0.74). The average score of the need for health education programs (including physical, psychological, and social health education programs) was 3.88 (+/-0.13); and this was affected by age (psychological health education programs beta=-0.21), self-actualization (physical, psychological, social health education programs beta=0.28, beta=0.30, beta=0.30), health responsibility (social health education programs beta=0.21), interpersonal support (physical health education programs beta=0.18), and stress management (social health education programs beta=0.18). CONCLUSIONS: Based on the study results, health education for middle-aged women should be impacted less by monthly income and educational background, and should have more specialized, accessible contents considering not only programs that middle-aged women prefer but also the factors influencing the needs of health education.

Factors Affecting Nurse's Health Promoting Behavior: Focusing on Self-efficacy and Emotional Labor / 한국직업건강간호학회지

PURPOSE: This study examined self-efficacy, emotional labor, and health promoting behaviors. It also investigated factors affecting health promoting behaviors of nurses working for tertiary and general hospital. METHODS: Between June and July 2013, a convenience sample of 233 subjects was collected from 2 tertiary hospitals and 4 general hospitals. The data analysis was done with ANOVA, t-test and stepwise multiple regression. RESULTS: Emotional labor of the subjects was slightly lower than that of other nurses and the average level of health promoting behaviors was lower than the median. Health promoting behaviors were differentiated by education, hospital type, and monthly income. Self-efficacy showed positive correlation with HPLP-II, but emotional labor showed negative correlation with self-efficacy and HPLP-II. The most significant factor affecting health promoting behaviors was self regulation(16.3%). The combination of self regulation, attentiveness to required display rules, BSN, preference to task difficulty, and monthly income(> or =300) accounted for 25.4% of health promoting behavior. Attentiveness to required display rules was a negative factor of HPLP-II. CONCLUSION: When developing health promotion programs for nurses, self-efficacy should be considered and further research is needed to identify mediating variables between emotional labor and health promoting behaviors.

Psychological Well-being, Perceived Health Status, and Health Promoting Behavior of Clinical Nurses / 간호행정학회지

PURPOSE: This study was designed to assess the degree of psychological well-being, perceived health status, and health promoting behavior of clinical nurses, and to identify correlations between variables. METHODS: Participants were 194 nurses working at S hospital, Seoul and data were analyzed using descriptive statistics, ANOVA, Duncan's test, Pearson correlation coefficient, and multiple regressions. RESULTS: Mean scores were 3.45 (5 point scale) for psychological well-being, 2.82(4 point scale) for perceived health status, and 2.30(4 point scale) for health promoting behavior. Psychological well-being correlated positively with perceived health status (r=.34, p<.001). Perceived health status showed a positive correlation with health promoting behavior (r=.30, p<.001). There was a positive correlation between psychological well-being and health promoting behavior (r=.52, p<.001). Personal growth(t=2.85, p=.005), purpose in life (t=2.30, p=.023) among subscales of psychological well-being, and perceived health status (t=2.13, p=.034) had a significant influence on health promoting behavior. These combinations explained 32.1% of health promoting behavior (F=12.58, p<.001). CONCLUSION: The results of this study suggest strategies to improve health promoting behavior by enhancing psychological well-being of nurses. Furthermore, a study to identify the effects of developed and applied psychological well-being promotion program should be conducted.

Factors Affecting on Health Promoting Behaviors among Teachers with Middle-aged Women Experiencing Menopause / 한국직업건강간호학회지

PURPOSE: This study examined the relationships among menopausal symptom, self-efficacy, health promoting behaviors, and investigated factors affecting health promoting behaviors of teachers with middle-aged women experiencing menopause. METHODS: From September to October 2012, a convenience sample of 252 subjects aged 40 to 60 years was recruited from 8 elementary schools, 3 middle schools and 5 high schools. The data analysis was done by ANOVA and stepwise multiple regression. RESULTS: Menopausal symptom of subjects was slightly lower than general middle aged women and the average level of health promoting behaviors was similar to general middle aged women. Health promoting behaviors were differentiated by severity of menopausal symptom, not by menstruation state. Menopausal symptom was negatively related to health promoting behaviors. The most significant factor affecting health promoting behaviors was self efficacy (14.3%). The combination of self efficacy, menopausal symptom, and elementary school teachers accounted for 20.1% of health promoting behavior. CONCLUSION: When developing health promotion program for teachers with middle-aged women, such program should consider self-efficacy, menopausal symptom, and school type.

Factors Influencing Health Promoting Behavior among Hospital Registered Nurses - Mood States, Resourcefulness, and Health Perception - / 간호행정학회지

PURPOSE: This study was done to examine the effects of mood state, resourcefulness, and health perception on health promoting behavior of hospital nurses. METHODS: Convenience sampling was conducted for nurses working at three University hospital and 336 nurses were selected. Data were analyzed using SPSS 18.0. RESULTS: The results of the analysis showed that the score for nurses' mood state was 41.76+/-18.90; for resourcefulness, 11.30+/-20.63; for health perception, 3.32+/-.77, and for health promoting behavior, 111.55+/-17.76. Mood state, resourcefulness, and health perception were significantly correlated with health promoting behavior. The overall explanatory power of the effects of nurses' mood state, resourcefulness, and health perception on health promoting behavior was 27.8%. CONCLUSION: Study results indicate that better mood state, higher resourcefulness, and higher health perception result in more health promoting behavior.

A Comparision on Frailty, Health Promotion Behavior, and Perceived Health Status in the Elderly according to the Type of Residency / 農村醫學 地域保健

OBJECTIVES: The purpose of this study was to classify frail and non-frail elderly and to investigate health promoting behaviors and perceived health status in the elderly according to the type of residency. METHODS: This was a descriptive study. Data collection was performed from June 15th, 2009 to August 2nd, 2009. The subjects were selected at D city in Korea. Data was analyzed by descriptive statistics, chi-square -test, and ANCOVA test with SPSS/Win 15.0 program. RESULTS: 20.8% of the elderly living at home and 49.2% of those living in institution were frail. Frailty of the elderly living in institution was severer than those living at home. Non-frail elderly according to the type of residency showed higher scores of health promotion behavior and perceived health status than frail elderly. The elderly living at home showed higher scores of health promotion behavior than those living in institution. CONCLUSIONS: In the comparison study between the elderly living at home and institution, ratio of frail elderly among the elderly living in institution is high and health promotion behaviors are deficient as well. Frail preventive program for the elderly is needed to develop and apply in consideration of these findings.

Factors Related to Health Promoting Behaviors of Young-Old and Old-Old Elderly in Rural Areas / 農村醫學 地域保健

OBJECTIVES: The purpose of this study was to investigate the level of health promoting behaviors and the significant factors in rural elderly(young-old vs old-old). METHODS: The data was collected using structured questionnaires from June 22th to Sep. 18th, 2009. A total of 556 elderly aged 65 years or over were selected from 14 rural districts in C province, South Korea. Age was divided into two groups as below 65-74 and 75 or older. A structured questionnaire was used to obtain information on the demographic characteristics, their perceived health status, the difficulty of activities of daily living, quality of life, self-efficacy and health promoting behaviors. The health promoting behaviors included nutrition, stress management, interpersonal support, exercise, health responsibility and self-actualization. The scores for health promoting behaviors were used mean and standard deviation. The data was analyzed using SPSS Win 12.0. RESULTS: Of the 556 subjects, we found that the young-old(65-74 aged) were 359 and the old-old elderly(over 75 aged) were 197. We found that the level of health promoting behavior was higher for young-old (2.75+/-0.374) compared to old-old elderly people (2.67+/-0.399). In multiple linear regression, quality of life, self-efficacy, living with spouse, and number of generation living together for the young-old, and quality of life for old-old elderly were significantly associated with health promoting behaviors. CONCLUSIONS: The study findings indicate that there are age differences in associated factor of health promoting behaviors. Therefore our findings may provide useful assistance in developing effective intervention programs to improve health promoting behavior of the elderly in rural areas according to their age differences.

Comparison of Health Promoting Behavior in Rural Elderly by Complementary Alternative Medicine Utilization / 성인간호학회지

PURPOSE: To compare the health promoting behavior in rural elderly people by complementary alternative medicine(CAM) utilization. METHODS: The data were collected from March 06th to May 26th, 2006. The participants were 207 rural elderly persons in Korea. Data were collected using structured questionnaires and analyzed with the SAS win 8.0 program. RESULTS: The rate of using CAM was 60.9%. Non-religious, perceived poor health and high concerns about health group used it more. The most common type was oriental medicine(35.7%), the most common motive was body protection(21.2%) and major source of information was other patients(35.9%). Almost all the subjects(90%) were satisfied with using CAM. The average score for the health promoting behavior was 2.67+/-.32(range 1.65-3.71). The average scores for each subscale were, personal communication 2.98, self-actualization 2.79, nutrition 2.78, health responsibility 2.58, exercise 2.40, stress management 2.38. Significant differences in health promoting behavior were found according to CAM utilization: personal communication ,self actualization. CONCLUSION: There were differences health promoting behavior between the elderly CAM utilization: Systemic guidelines of CAM use are needed.

Factors Influencing Health Promoting Behavior of the Low-income Elderly Women in Urban / 성인간호학회지

PURPOSE: This study was conducted to identify factors influencing health promotion behavior of the low-income elderly women in urban area. METHODS: The subjects of this study consisted of 389 the low-income Korean elderly women over 65 years. The data was analyzed using descriptive statistics, t-test, One-way ANOVA, Pearson Correlation Coefficients, Stepwise Multiple Regression with SPSS/Win 12.0. RESULTS: 1) Activity limitation was found to have a statistically significant negative correlation. But self-rated health, self-esteem, and social support were found to have a statistically significant positive correlation with health promotion behavior 2) The factors influencing health promotion behavior were self-esteem, social support, activity limitation, self-rated health, pocket money, and religion. They accounted for 36.8% of the variance for health promotion behavior in the low-income elderly women living in urban area. The most powerful predictor was self-esteem(28.1%). CONCLUSION: This study showed that making a thorough assessment of the predictors influencing health promotion behavior in the low-income elderly women who remain vulnerable in diverse aspects is very important to minimize their health issues and to contribute their positive health promotion.

A Study on the Relation of BMI to Lipid Metabolism and Health Promoting Behavior in Middle-Aged Women

PURPOSE: This study examined the relation of BMI to lipid metabolism and health promoting behavior in middle-aged women. METHODS: The subjects were 113 women between 40 to 60 years of age. The data was collected from April 2003 to July 2004. BMI was measured using body composition analyzer and lipid metabolism were measured using automatic biochemical analyzer. Health promoting behavior was collected using a structured questionnaire. The SPSSWIN(10.0 version) program was used to analyze the data and get the descriptive statistics and Pearson's correlation coefficients. RESULTS: BMI was negatively correlated with HDL-c and positively correlated with triglyceride, but there was no significance between BMI and total cholesterol. There was no significance of correlation between BMI and total health-promoting behavior. CONCLUSION: This study showed that BMI is meaningful in the identification of the high risk women to prevent HDL-c & triglyceride metabolism disturbance, but additional research is needed to study the correlation between BMI and health promoting behaviors in middle-aged women.

Factors Effecting Health Promoting Behaviors in Middle-Aged Women / 간호학회지

PURPOSE: This study was to evaluate the casual relationship between the factors in the Pender's model and to explain health promoting behaviors among middle-aged women in order to facilitate nursing interventions for this population group. METHOD: 116 women between 40~60 years old living in Incheon were asked to complete a questionnaire about their health. The data was collected between March and November, 2003. The data was analyzed by descriptive statistics and the correctional analysis SPSSWIN 11.5 program. The LISREL 8.12 program was used to find the best fit model which explained a causal relationship of the variables. RESULTS: The climacteric symptoms of middle-aged women negatively correlated with health promoting behaviors. However, marital satisfaction positively correlated with health promoting behaviors. CONCLUSION: Marital satisfaction and climacteric symptoms had an effect on health promoting behaviors. Therefore, based on this study, we plan to develop a health education program to decrease climacteric symptoms and to promote marital satisfaction for health promotion.

The Relationship between Health Promoting Behaviors and Anger in Middle-Aged Men / 기본간호학회지

PURPOSE: The purpose of this study was to identify health promoting behaviors and the relationship between health promoting behaviors and state and trait anger in middle-aged men. METHOD: In this descriptive correlational study, the participants were 143 middle-aged men who lived in D city. Data were collected from November, 2004 to January. 2005. Personal interviews with a structured questionnaire were used. The data were analyzed using descriptive statistics, and Pearson correlation coefficients with SPSS Win 11.0 program. RESULTS: The score for health promoting behavior in the middle-aged men was above the mean score, The highest dimension was self-actualization and the lowest dimension of health promoting behaviors was exercise. A significant negative correlation was found between health promoting behaviors and state anger in middle-aged men. But there was no significant correlation between health promoting behaviors and trait anger. CONCLUSION: These results suggest that state anger should be considered as an important factor when nurses develop educational programs to enhance health promoting behavior in middle-aged men.

The Relationship of Individual Characteristics, Perceived Health Status, Body Image, and Health Promoting Behavior in Hospital Nurses / 성인간호학회지

OBJECTIVE: The purpose of this study were to: (1) describe the individual characteristics, perceived health status, body image, and health promoting behaviors of staff nurses working in a metropolitan hospital and (2) determine the relationship of perceived health status, body image, and health promoting behaviors. METHODS: Data were collected from 311 staff nurses working at one of university affiliated hospitals using a self-administered questionnaire for perceived health status(SF 36 V2), body image(BAQ), and health promoting behaviors (HPLP-II) and using the report of year 2002 employee physical check-up results for health related characteristics. RESULTS: Most of nurses were within the normal range of BMI, total cholesterol, and liver enzymes but 42.2% had systolic BP above 120mmHg and 37.3% hemoglobin below 12g/dL. Although 96.4% of BMI score indicated 'underweight' or 'normal', 'feeling fat' showed the highest. Among health promoting behaviors the most frequently reported one was spiritual growth and the least one was engagement in physical activity. In the correlational analysis, health promoting behaviors had the positive relationships with perceived health status, vitality, mental health, attractiveness, strength and fitness (p=.000 - .004). CONCLUSION: These findings provide information that is relevant in designing interventions to enhance health promoting behaviors among nurses working in a hospital.

A Study on the Relationship between Perceived Health State, Personality, Situational Barrier, Health Promoting Behavior in Students / 성인간호학회지

PURPOSE: The purpose of this study was to examine the relationship between perceived health state, personality, situational barrier, health promoting behavior, to provide the basic data for health promoting intervention. METHOD: This study was designed as a descriptive correlation study. Data were 396 undergraduate students of one university in Chung-Buk. The instruments for this study were the modified health promoting behavior scale developed by Bak, Insuk(1995), and the modified perceived health state scale developed by Im, Meeyoung (1998), the modified personality scale developed by Park, Youngbae(1998), the modified situational barrier scale developed by Im, Meeyoung(1998). RESULT: The results of this study showed that the mean score for perceived health state 2.72, personality 3.35, situational barrier 2.72 and health promoting behavior 2.67. The health promoting behavior categories, scores for 'sanitary life'(3.08), 'self-actualization and interrelationship'(2.93) were higher than the mean score, whereas scores for 'healthy diet'(2.64), 'rest and sleep'(2.62), 'exercise and stress management'(2.49), and 'diet management' (2.25) were lower than the mean score. This study revealed the negative correlation between perceived health state, personality, situational barrier and health promoting behavior in undergraduate students. CONCLUSION: Perceived health state accounted for 16% and personality accounted for 21.3% of the variance in health promoting behavior in students. Therefore, health promoting programs that increase health state and personality should be developed to promote health behavior and to diminish situational barrier for students in Korea.

Model Development of an Elderly Health Promotion Center: The Effect of a Social Support Program at a Community Health Center / 간호학회지

PURPOSE: The purpose of this study was to develop a model of an elderly health promotion center after witnessing the effect of a social support program on dependent variables in older adults at a local community health center. METHOD: The subjects were 60 female adults over 65 years dwelling in a rural area, and they were divided into experimental and control groups each with 30 people. A social support program was implemented 6 hours a day, 3 times a week, for 4 months in the experimental group. Included was health assessment, health education, counseling, consultation, exercise, physical & occupational therapy, primary care, recreation, lunch & transfer service. Data was collected from May 1stto September 14th, 2002 by questionnaires, and analyzed by x2-test, t-test, Pearson's correlation coefficient and stepwise multiple regression using SAS. RESULT: The social support program in the elderly was very effective on all dependent variables of physical health (t= 4.68, p= .001), health knowledge (t= 3.60, p= .001), life satisfaction (t= 8.65, p= .001), and health promoting behaviors (t= 5.23, p= .001). CONCLUSION: The Social Support Program at a Community Health Center was effective on health promoting behaviors in the elderly.

A Study on the Relationship among Climacteric Symptoms, Knowledge of Menopause and Health Promoting Behavior in Middle-Aged Women / 여성건강간호학회지

PURPOSE: This study was to identify the correlations among climacteric symptoms, knowledge of menopause and health promoting behavior in middle-aged women. METHOD: 1,360 women between 40-60 years of age living in Incheon, were asked to complete a questionnaire on their health. The data was collected between October 10th and October 30th, 2002. The data was analyzed using T-test, ANOVA and Pearson's correlation coefficients with SPSS/pc program. RESULT: The variables significantly affecting climacteric symptoms, knowledge of menopause and health promoting behavior were education, perceived health status and family health problems. The relationship between knowledge of menopause and health promoting behavior was statistically significant with a positive correlation. CONCLUSION: The knowledge of menopause by middle aged women was in positively correlated with health promoting behavior. Therefore, based on this study, we plan to develop a health education program to promote knowledge of menopause and health promoting behavior.