Prediction of pain outcomes in Korean older adults: use of a structural equation model.

OBJECTIVE: To construct a structural equation model of pain adjustment outcomes (e.g., depression and fatigue) in Korean older adults based on the cognitive-behavioral model of chronic pain. METHODS: Nonexperimental research design. Data were collected by questionnaires from 271 Korean older adults. Data analysis was conducted with SPSS 10.1 for descriptive statistics and a PC-LISREL program for covariance structural analysis. RESULTS: In this study, based on the modifications, chi-square statistics were changed, the goodness-of-fit index was 0.97, the adjusted goodness-of-fit index was 0.93, the root mean square residual was 0.04, the normal fit index was 0.98, and the non-normed fit index was 0.98. Path coefficients and their statistical significance for the revised model were as follows: pain adjustment and pain beliefs were found to have a significant direct effect on pain coping. The variable directly related to pain beliefs was pain adjustment, and variables directly influencing fatigue were pain coping and pain beliefs. Lastly, pain adjustment, pain coping, and fatigue were found to have a significant direct effect on depression. Also, pain adjustment, pain coping, and pain beliefs were found to have a significant indirect effect on depression. In conclusion, pain adjustment, pain coping, pain beliefs, and fatigue all contributed to depression. Fifty-four percent of depression could be explained by these variables. CONCLUSIONS: This modified model is considered appropriate for explaining and predicting pain adjustment outcomes in Korean older adults. Also, the findings support the development of an intervention strategy to improve pain coping, negative pain beliefs, fatigue, and depression caused by poor pain adjustment.

[A meta-analysis of the effects of a self-efficacy promoting program].

PURPOSE: This meta-analysis was conducted to evaluate the effects of a self-efficacy promoting program and analyze its components. METHOD: The material used for this study were 18 self-efficacy promoting program studies carried out from Jan. 1980 to Oct. 2003. The studies were analyzed in different categories: 1) types of dependent variables 2) sample characteristics 3) types of experimental treatment conditions 4) types of self-efficacy source and 5) total amount of time RESULT: 1) The weighted mean of a self-efficacy promoting program ranged from 1.383 to 0.015 2) for the experimental treatment condition, exercise had a much larger effect in increasing general self-efficacy and self-care than education 3) the studies using 3 sources had a much larger effect in increasing self-care than the studies using 4 sources 4) a time period longer than 900 minutes had a much larger effect in increasing specific self-efficacy, general self-efficacy and self-care than in a time period shorter than 900 minutes. 5) effect size of specific self-efficacy was significantly higher than general self-efficacy. CONCLUSION: These results can be used to guide the development of a self-efficacy promoting program for nursing practice.

[Influencing factors of climacteric women's depression].

PURPOSE: This study was conducted to define the main factors influencing depression of climacteric women. METHOD: The data was analyzed using a SAS 6.12 PC+ program for descriptive statistics, Pearson correlation coefficients and stepwise multiple regression. Two hundred seventy climacteric women between 40 and 59 years old were recruited from 6 areas in Korea from Oct. 5, 2002 to Dec. 13, 2002. The reliability of the 7 instruments were tested with Cronbach's alpha which ranged from.82 to.95. RESULT: The results were as follows : The mean depression score was 14.17, which was slightly high. The depression was influenced significantly by occupation, economic status, and menopause status. There were significant correlations between all the predictive variables and the depression(r=.73~ -.17, p <.05). Stepwise multiple regression analysis showed that 59% of the variance in depression was significantly accounted by stress(53%), climacteric symptoms(3%), marital adjustment (2%), and health promotion behavior(1%). CONCLUSION: In reducing the climacteric women's depression, the above major influencing factors should be considered.