The Journal of the Convergence on Culture Technology (문화기술의 융합)

The International Promotion Agency of Culture Technology (국제문화기술진흥원)
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Analysis of Psychosocial Factors Affecting Health Behavior Adherence among Community-dwelling Older Adults undergoing Percutaneous Coronary Intervention

관상동맥중재술을 받은 지역사회 거주 노인의 건강행위 이행에 영향 미치는 심리사회적 요인 분석

  • 전혜원 (경상대학교병원 권역심뇌혈관질환센터) ;
  • 장희경 (경상대학교 간호학과)
  • Received : 2020.09.07
  • Accepted : 2020.10.04
  • Published : 2020.11.30
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Abstract

This study is a descriptive research to analyze psychosocial factors affecting health behavior adherence among community-dwelling older adults undergoing Percutaneous Coronary Intervention. Data were collected with structured questionnaires from 126 patients discharged after hospitalization from a university hospital in J city, Gyeongnam, from July 15 to October 2 in 2018, and analyzed using SPSS/WIN 21.0. The result shows that the general characteristics, such as existence of spouse, education level, subjective health status, and subjective life satisfaction, have a significant influence on health behavior adherence. The research also identifies that medical support and resilience are positively correlated with health behavior adherence. In contrast, perceived stress, 3 sub-categories from perceived stress such as, family relations, anxiety and withdrawal, poverty and finance, and depression are negatively correlated. In the multiple regression analysis, resilience, perceived stress from poverty and finance, education level, and subjective life satisfaction explained 27.9% of health behavior adherence among older adults undergoing Percutaneous Coronary Intervention. Based on the results of this study, it is necessary to develop and apply a nursing intervention program to improve the health behavior adherence of local older adults who had Percutaneous Coronary Intervention.

본 연구는 관상동맥중재술을 받은 지역사회 거주 노인의 건강행위 이행에 영향을 미치는 심리사회적 요인을 분석하기 위해 수행된 서술적 조사연구이다. 경상남도 J시 G대학교병원에서 관상동맥중재술을 받고 외래를 내원한 환자 126명을 대상으로 2018년 7월 15일부터 10월 2일까지 구조화된 설문지를 사용하여 자료수집 후 SPSS/WIN 21.0으로 통계 분석하였다. 분석결과 대상자 특성에 따른 건강행위 이행은 배우자 유무, 교육수준, 주관적 건강상태, 주관적 삶 만족도에 따라 차이가 있었으며, 의료인 지지, 회복탄력성에서는 정적 상관관계가 있었고, 지각된 스트레스, 지각된 스트레스의 하위영역인 가족관계, 불안과 위축, 빈곤과 재정, 우울과는 부적 상관관계가 있었다. 다중회귀분석 결과 회복탄력성, 지각된 스트레스의 하위영역인 빈곤과 재정, 교육수준, 주관적 삶 만족도가 관상동맥중재술을 받은 노인의 건강행위 이행을 27.9% 설명하는 것으로 나타났다. 이러한 결과를 기반으로 관상동맥중재술을 받은 지역사회 거주 노인의 건강행위 이행을 향상시키기 위한 간호중재 프로그램 개발과 적용이 필요하다.

Keywords

References

  1. Health Insurance Review & Assessment Service, "100 line of disease statistics in life", 2018. http://www.hira.or.kr/sViewer/index.do?ebookSn=472
  2. Statistics Korea, "Causes of death statistics", 2018. http://kostat.go.kr/portal/korea/kor_nw/1/6/2/index.board?bmode=read&bSeq=&aSeq=377606&pageNo=1&rowNum=10&navCount=10&currPg=&searchInfo=&sTarg
  3. H.R. Kim, "Relationship between uncertainty, sick role behaviors, and quality of life of rehospitalized patients underwent percutaneous coronary intervention", Journal of Korean Clinical Nursing Research, Vol. 20, No. 3, pp. 279-289, 2014. https://doi.org/10.22650/JKCNR.2014.20.3.279
  4. M.J. Choi, M.H. Jeong, S.Y. Hwang, "Restenosis and compliance with self-care among acute coronary syndrome patients undergoing follow-up angiograms", Korean Journal of Health Promotion, Vol. 11, No. 1, pp. 34-41, 2011.
  5. B. Silarova, I. Nagyova, J. Rosenberger, M. Studencan, D. Ondusova, S.A. Reijneveld, et al. "Sense of coherence as a predictor of health-related behaviours among patients with coronary heart disease", European Journal of Cardiovascular Nursing, Vol. 13, No. 4, pp. 345-356, 2013. https://doi.org/10.1177/1474515113497136
  6. W.J. Cho, M.N. Choi, S.S. Kim, E.H. Cho, "Effect of social support and depression on self-care of older adults receiving percutaneous coronary intervention", Korean Gerontological Nursing Society, Vol. 12, No. 2, pp. 119-130, 2010.
  7. L. Xiao, P. Wang, Q. Fang, Q. Zhao, "Health-promoting Lifestyle in Patients after Percutaneous Coronary Intervention", Korean Circulation Journal, Vol. 48, No. 6, pp. 507-515, 2018. https://doi.org/10.4070/kcj.2017.0312
  8. S.J. Jung, "The effect of depression and anxiety on health behavior of senior coronary artery disease patients under afterward management", Unpublished Master's Thesis. Seoul National University, Seoul, Korea, 2015.
  9. I.M. Kronish, N. Rieckmann, M.M. Burg, D. Edmondson, J.E. Schwartz, K.W. Davidson, "The effect of enhanced depression care on adherence to risk-reducing behaviors after acute coronary syndromes: findings from the COPES trial", American Heart Journal, Vol. 164, No. 4, pp. 524-529, 2012. https://doi.org/10.1016/j.ahj.2012.07.024
  10. N.Y. Shin, Y.H. Kang, "The Relationships among Health Locus of Control and Resilience, Social Support and Health Promoting Behavior in Patients with Newly Diagnosed Coronary Artery Diseases", Korean Journal of Adult Nursing, Vol. 27, No. 3, pp. 294-303, 2015. https://dx.doi.org/10.7475/kjan.2015.27.3.294
  11. M.J. Oh, K.O. Chang, S.H. Kim, "Effects of a Cerebrocardiovascular Disease Prevention Education Program on the Knowledge, Preventive Attitude, and Self-Esteem of Cerebrocardiovascular Disease for the elderly in the elderly welfare center", Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology, Vol. 7, No. 7, pp. 511-527, 2017. https://dx.doi.org/10.35873/ajmahs.2017.7.7.048
  12. K.N. Hwang, H.J. Won, I.S. Jang, J.Y. Lee, "Effects of Written Information for Coronary Artery Disease Depending on Patients' Health Literacy on Health Behavior Compliance Related Self-efficacy, Knowledge of Disease, Anxiety, and Educational Satisfaction", Korean J health Commun, Vol. 13, No. 2, pp. 233-241, 2018. https://dx.doi.org/10.15715/kjhcom.2018.13.2.233
  13. A.R. Park, "A Structural Model of Health Behavior Compliance in Patients with Percutaneous Coronary Intervention based on Self-Determination Theory", Journal of East-West Nursing Research, Vol. 24, No. 2, pp. 101-109, 2018. https://doi.org/10.14370/jewnr.2018.24.2.101
  14. S. Boo, E.S. Froelicher, "Cardiovascular risk factors and 10-year risk for coronary heart disease in Korean women", Asian Nursing Research, Vol. 6, No. 1, pp. 1-6, 2012. https://doi.org/10.1016/j.anr.2012.02.001
  15. C. Gonzalez, E. Rodilla, J.A. Costa, J. Justicia, J.M. Pascual, "Cardiovascular risk by Framingham and SCORE in patients 40-65 years old", Medicina Clinica, Vol. 126, No. 14, pp. 527-531, 2006. https://doi.org/10.1157/13087144
  16. A.R. Rahimi, J.A. Spertus, K.J. Reid, S.M. Bernheim, H.M. Krumholz, "Financial barriers to health care and outcomes after acute myocardial infarction", Journal of the American Medical Association, Vol. 297, No. 10, pp. 1063-1072, 2017. https://doi.org/10.1001/jama.297.10.1063
  17. E.Y. Cho, J.A. Kim, "The Effect of the Health Control Behavior of the Elderly on the Emotional Happiness", International Journal of Advanced Culture Technology, Vol. 6, No. 3, pp. 69-76, 2018. https://doi.org/10.17703//IJACT2018.6.3.69
  18. L. Ma, Y. Li, M. Feng, "Positive emotion and cardiovascular disease in elderly people", International Journal of Clinical and Experimental Medicine, Vol. 8, No. 5, pp. 6682-6686, 2015.
  19. I. Liguori, G. Russo, F. Curcio, G. Sasso, D. Della-Morte, G. Gargiulo, et al. "Depression and chronic heart failure in the elderly: an intriguing relationship", Journal of Geriatric Cardiology, Vol. 15, No. 6, pp. 451-459, 2018. https://dx.doi.org/10.11909/j.issn.1671-5411.2018.06. 014
  20. J. Sipotz, O. Friedrich, S. Hofer, W. Benzer, T. Chatsakos, G. Gaul, "Health related quality of life and mental distress after PCI: restoring a state of equilibrium", Health and Quality of Life Outcomes, Vol. 11, No. 1, pp. 144, 2013. https://dx.doi.org/10.1186%2F1477-7525-11-144 https://doi.org/10.1186%2F1477-7525-11-144
  21. A.M. Roest, E.J. Martens, J. Denollet, P. De Jonge, "Prognostic association of anxiety post myocardial infarction with mortality and new cardiac events: a meta-analysis", Psychosomatic medicine, Vol. 72, No. 6, pp. 563-569, 2010. https://doi.org/10.1097/psy.0b013e3181dbff97
  22. H.J. Ju, H.K. Gong, "A Study on the Relationship Between the Variables Related to the Health Promoting Behavior of the Elderly", Journal of Digital Convergence, Vol. 17, No. 2, pp. 243-254, 2019. https://doi.org/10.14400/JDC.2019.17.2.243
  23. V. Storm, D.A. Reinwand, J. Wienert, S.L. Tan, S. Lippke, "The mediating role of perceived social support between physical activity habit strength and depressive symptoms in people seeking to decrease their cardiovascular risk: cross-sectional study." JMIR Mental Health, Vol. 5, No. 4, pp. e11124, 2018. https://doi.org/10.2196/11124
  24. G. Leon-Perez, K.A. Wallston, K.M. Goggins, H.M. Poppendeck, S. Kripalani, "Effects of stress, health competence, and social support on depressive symptoms after cardiac hospitalization", Journal of Behavioral Medicine, Vol. 39, No. 3, pp. 441-452, 2016. https://doi.org/10.1007/s10865-015-9702-x
  25. B.W. Smith, J. Dalen, K. Wiggins, E. Tooley, P. Christopher, et al. "The brief resilience scale: assessing the ability to bounce back", International Journal of Behavioral Medicine, Vol. 15, No. 3, pp. 194-200, 2008. https://doi.org/10.1080/10705500802222972
  26. S.J. Park, S.H. Kim. "The Effects of Social Support and Recovery Resilience on Self Care Behavior among the Elderly with Hypertension in the Senior Welfare Center", Journal of the Korea Academia-Industrial cooperation Society, Vol. 20, No. 7, pp. 182-191, 2019. https://doi.org/10.5762/KAIS.2019.20.7.182
  27. E.W. Yoo, Y.M. Lee, "Health Literacy and Self-care Activities of Older Patients with Type 2 Diabetes:The Mediating Effect of Resilience", Korean Journal of Adult Nursing, Vol. 30, No. 4, pp. 376-384, 2018. https://doi.org/10.7475/kjan.2018.30.4.376
  28. Y.O. Choi, "Comparison of factors influencing health behavior compliance by type D personality in the patients with coronary artery disease", Unpublished Master's Thesis. Chonnam National University, Chonnam, Korea, 2013.
  29. Y.O. Choi, J.S. Kim, "Development of a stress scale for elderly patients with coronary artery disease", Journal of Korean Academy of Nursing, Vol. 44, No. 6, pp. 630-638, 2014. http://dx.doi.org/10.4040/jkan.2014.44.6.630
  30. R.L. Spitze, K. Kroenke, J.B. Williams, "Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study", JAMA, Vol. 282, No. 18, pp. 1737-1744, 1999. http://dx.doi.org/10.1001/jama.282.18.1737
  31. J.Y. An, E.R. Seo, K.H. Lim, J.H. Shin, J.B. Kim, "Standardization of the korean version of screening tool for depression(Patient Health Questionnaire-9, PHQ-9)", Journal of the Korean Society of Biological Therapies in Psychiatry, Vol. 19, No. 1, pp. 47-56, 2013.
  32. Y.S. Tae, "Study on the correlation between perceived social support and depression of the cancer patients", Unpublished Master's Thesis. Ewha Womans University, Seoul, Korea, 1985.
  33. S.R. Um, "The Coping effect of self-resilience on the stress process of older adult from mobility: focusing on the stress-coping-adaptation model", Unpublished Master's Thesis. Kyunghee University, Gyeonggi, Korea, 2018.
  34. S.J. Kim, "Influences of stress, social support, and disease knowledge on health behavior of elderly patients with coronary artery disese", Unpublished Master's Thesis. Sungkyunkwan University, Gyeonggi, Korea, 2017.
  35. S.J. Yu, K.C. Lim, H.M. Seo, E.H. Kong, J.H. Kim, "Powerlessness in Community-dwelling Older Korean Adults: Association of Depression, Stress, Social Support, Health Promotion Behavior & Activities of Daily Living", Journal Korean Gerontological Nursing Society, Vol. 15, No. 2, pp. 103-111, 2013.
  36. Y.H. Pang, O.S. Kim. "Powerlessness, Family Support and Health Promoting Behavior in Elders Using Home Service under Korean Long-term Care Insurance", Journal Korean Gerontological Nursing Society, Vol. 19, No. 3, pp. 184-193, 2017. https://doi.org/10.17079/jkgn.2017.19.3.184
  37. J.U. Kim, Y.K. Kim, "The Effect of Happiness Enhancement Program based upon Character Strengths on Resilience, Trait Anxiety and Self-efficacy of Single Mothers", Journal of Learner-Centered Curriculum and Instruction, Vol. 18, No. 18, pp. 515-537, 2018. http://dx.doi.org/10.22251/jlcci.2018.18.18.515
  38. H.J. Kim, J.H. Lim, J.W. Jung, "The Effect of Positive Psychology Group Art Therapy on Resilience of Middle Aged Women and their Coping Ability with Stress", Journal of Clinical Art Psychotherapy, Vol. 8, No. 3, pp. 71-100, 2018. http://dx.doi.org/10.34167/cliart.8.3.201812.71
  39. H.W. Nam, K.S. Kim, "The Effects of the Character Strengths Enhancement Program using Mindfulness on Children's Resilience", The Korea Journal of Youth Counseling, Vol. 23, No. 2, pp. 105-134, 2015. http://dx.doi.org/10.35151/kyci.2015.23.2.006
  40. Y.J. Lee, J.S. Ko, "The Effect of Recreational Exercise Program on Resilience of Female Elderly in Nursing Home", The Korean Journal of Sport, Vol. 15, No. 1, pp. 69-77, 2017.
  41. J.H. Jung, "A Systematic Review of Forest Therapy Program on Older Adults", The Journal of Humanities and Social science, Vol. 10, No. 4, pp. 1017-1032, 2019. http://dx.doi.org/10.22143/HSS21.10.4.72
  42. H.J. Kim, "Effects of Group Arts Therapy on the Resilience with Older Women of Resident", The Korean Journal of Arts Therapy, Vol. 14, No. 1, pp. 255-275, 2014.
  43. J.H. Bak, H.M. Jo, "Effects of Simsang(imaginary-oriented)-Poetry Therapy Program on the Mental Health of the Elderly", Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology, Vol. 9, No. 8, pp. 423-432, 2019. http://dx.doi.org/10.35873/ajmahs.2019.9.8.037
  44. K.S. Han, J.S. Chae, J.H. Park, S. Park, "Effects of Voluntary Resistance Training on Health Improvement in Elderly Woman taking Lifelong Eduction Program", The Korean Society of Sports Science, Vol. 28, No. 4, pp. 1239-1249, 2019. http://dx.doi.org/10.35159/kjss.2019.08.28.4.1239
  45. E.Y. Jung, S.K. Hwang, "Health Literacy and Health Behavior Compliance in Patients with Coronary Artery Disease", Korean Journal of Adult Nursing, Vol. 27, No. 3, pp. 251-261, 2015. http://dx.doi.org/10.7475/kjan.2015.27.3.251
  46. K.W. Sung, J.H. Park, M.K. Park, "Influences of Social Support, Self-esteem and Hope on Health Conservation of the Vulnerable Elderly with Diabetes", Journal of korean academy of community health nursing, Vol. 28, No. 4, pp. 386-396, 2017. https://doi.org/10.12799/jkachn.2017.28.4.386
  47. J.C. Lee, J.S. Park, G.H. Kim, "Factors Associated with the Health Promotion Activities of the Korean Elderly", Korean Journal of Health Education and Promotion, Vol. 27, No. 2, pp. 121-139, 2010.
  48. H.J. Kim. "Health Promotion Behaviors of Rural Elderly Women Living Alone and Their Life Satisfaction", Journal of korean academy of community health nursing, Vol. 27, No. 3, pp. 254-261, 2016. http://dx.doi.org/10.12799/jkachn.2016.27.3.254
  49. L.J. Xu, S.M. Ryu, H.S. Goong, "Gender Differences in Predictors of Health Behaviors Modification among Patients with Cardiovascular Disease", The Korea Contents Association, Vol. 15, No. 3, pp. 281-289, 2015. http://dx.doi.org/10.5392/JKCA.2015.15.03.280
  50. Y.J. Lee, "Influence of Self-Rated Health Status, Self-Efficacy and Social Support on Health Behavior in Urban Elderly People Living Alone", The Journal of the Convergence on Culture Technology, Vol. 4, No. 2, pp. 81-87, 2018. http://dx.doi.org/10.17703/JCCT.2018.4.2.81
  51. Y.S. Jang, S.H. Mo, "The Effects of Depression, Death Anxiety, and Social Support on Psychological Well-Being of Elderly Living Alone: Mediating Effect of Resilience", Journal of the Korea Gerontological Society, Vol. 37, No. 3, pp. 527-547, 2017.
  52. J.H. Kong, H.H. Hong, E.Y. Jung, "The Effect of Health Behavior, Resilience, and Recognition of Well-dying on the Depression of Elderly with Chronic Disease", Journal of the Korea Academia-Industrial cooperation Society, Vol. 16, No. 10, pp. 7146-7156, 2015. http://dx.doi.org/10.5762/KAIS.2015.16.10.7146