• Title/Summary/Keyword: Age-structured model

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Subcortical Ischemic Change as a Predictor of Driving Cessation in the Elderly

  • Jang, Mi;Hong, Chang Hyung;Kim, Hyun-Chung;Choi, Seong Hye;Seo, Sang Won;Kim, Seong Yoon;Na, Duk L.;Lee, Yunhwan;Chang, Ki Jung;Roh, Hyun Woong;Son, Sang Joon
    • Psychiatry investigation
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    • v.15 no.12
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    • pp.1162-1167
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    • 2018
  • Objective Motor, perceptual, and cognitive functions are known to affect driving competence. Subcortical ischemic changes on brain magnetic resonance imaging (MRI) can reflect reduction in cognitive and motor performance. However, few studies have reported the relationship between subcortical ischemic changes and driving competence of the elderly. Thus, the objective of this study was to investigate the association between subcortical ischemic changes on MRI and driving abilities of the elderly. Methods Participants (n=540) were drawn from a nationwide, multicenter, hospital-based, longitudinal cohort. Each participant underwent MRI scan and interview for driving capacity categorized into 'now driving' and 'driving cessation (driven before, not driving now)'. Participants were divided into three groups (mild, n=389; moderate, n=116; and severe, n=35) depending on the degree of white matter hyperintensity (WMH) on MRI at baseline. Driving status was evaluated at follow-up. Statistical analyses were conducted using ${\chi}^2$ test, analysis of variance (ANOVA), structured equation model (SEM), and generalized estimating equation (GEE). Results In SEM, greater baseline degree of WMH was directly associated with driving cessation regardless of cognitive or motor dysfunction (${\beta}=-0.110$, p<0.001). In GEE models after controlling for age, sex, education, cognitive, and motor dysfunction, more severe change in the degree of WMH was associated with faster change from 'now driving' state to 'driving cessation' state over time in the elderly (${\beta}=-0.508$, p<0.001). Conclusion In both cross-sectional and longitudinal results, the degree of subcortical ischemic change on MRI might predict driving cessation in the elderly.

Development and application of a self-transcendence enhancement program for the well-being of elderly women living alone in Korea

  • Kim, Sun-Mi;Ahn, Sukhee
    • Women's Health Nursing
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    • v.27 no.2
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    • pp.128-140
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    • 2021
  • Purpose: The purpose of this study was to develop a self-transcendence enhancement program and examine its effect on self-transcendence, spiritual well-being, and psychological well-being in elderly women who live alone. Methods: A self-transcendence enhancement program was developed through theory, literature review, and in-depth interviews. The theoretical framework came from the Psychoeducational Approach to Transcendence and Health intervention model based on Reed's middle-range theory of self-transcendence. The program consisted of multiple modalities in a structured, theory-based program lasting for eight weekly sessions. Using a single-group pretest-posttest design, the program was tested on a group of 40 elderly women aged 75 to 84 years living alone in Daejeon, Korea. Participants completed self-reported study questionnaires before and after the program at the elderly welfare center. Data were analyzed using SPSS version 24.0, with significance level set at .05. Paired t-test was used to compare mean differences before and after the program. Results: The mean age of the study participants was 79.1 years. After completing the program, the participants showed higher levels of self-transcendence (t=8.78, p<.001), overall spiritual well-being (t=8.30, p=.002), religious spiritual well-being (t=1.79, p=.040), existential spiritual well-being (t=6.75, p=.002), and positive affect (t=3.77, p=.001) than they did before the program. They also reported lower levels of depression (t=-7.59, p<.001) and negative affect (t=-6.15, p<.001). Conclusion: The self-transcendence enhancement program developed in this study may be effective for improving the level of self-transcendence in elderly women living alone and helping them to attain spiritual and psychological well-being.

Influencing Factors of Stress Response, Immediacy, Emotional Intelligence on Converged Nursing Performance of Nurses (간호사의 스트레스 반응, 즉시성, 감정지능이 융합적 간호업무수행에 미치는 영향요인)

  • Lee, Jung-Min;Park, Wan-Ju
    • Journal of the Korea Convergence Society
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    • v.12 no.1
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    • pp.305-315
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    • 2021
  • This study aimed to investigate the influencing factors of stress response, immediacy, emotional intelligence on converged nursing performance in Nurses. The Participants were 180 nurses who had worked at general hospitals without COVID-19 patients in B city. The data were collected by structured questionnaires of stress response, lack of premeditation, emotional intelligence, nursing performance. Data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, Pearson's correlation coefficients and multiple regression with SPSS 21.0 program. The results showed that use of emotion(β=.31~.39) is the highest significant influencing factors on nursing process skills, leadership, education and collaboration of nursing performance explaining 48.2% of the regression model in this study. And then age(β=-.29~.30), other's emotion appraisal(β=.17~.23) and current position(β=.19) are significant in order. Therefore, it is necessary to develop and apply the intervention programs that improve nurses' emotional intelligence for improving nursing performance.

Prevalence and Factors Associated With Adolescent Pregnancy Among an Indigenous Ethnic Group in Rural Nepal: A Community-based Cross-sectional Study

  • Kusumsheela Bhatta;Pratiksha Pathak;Madhusudan Subedi
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.3
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    • pp.269-278
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    • 2024
  • Objectives: The Chepang people, an indigenous ethnic group in Nepal, experience substantial marginalization and socioeconomic disadvantages, making their communities among the most vulnerable in the region. This study aimed to determine the prevalence and factors associated with adolescent pregnancy in the Chepang communities of Raksirang Rural Municipality, Makwanpur District, Bagmati Province, Nepal. Methods: A cross-sectional study was conducted from October 2022 to April 2023 among 231 Chepang women selected using simple random sampling from Raksirang Rural Municipality. A semi-structured questionnaire was used for interviewing the mothers. Bivariate and multivariate logistic regression analyses were performed, using odds ratios with 95% confidence intervals (CIs). Variables with a variation inflation factor of more than 2 and a p-value of more than 0.25 were excluded from the final model. Results: The study revealed that the prevalence rate of adolescent pregnancy among Chepang women was 71.4% (95% CI, 65.14 to 77.16). A large percentage of participants (72.7%) were married before the age of 18 years. Poor knowledge of adolescent pregnancy (adjusted odds ratio [aOR], 10.3; 95% CI, 8.42 to 14.87), unplanned pregnancy (aOR, 13.3; 95% CI, 10.76 to 19.2), and lack of sex education (aOR, 6.57; 95% CI, 3.85 to 11.27) were significantly associated with adolescent pregnancy. Conclusions: The prevalence of adolescent pregnancy among the Chepang community was high. These findings highlighted the importance of raising awareness about the potential consequences of adolescent pregnancy and implementing comprehensive sexuality education programs for preventing adolescent pregnancies within this community.

A Transcultural Study for Testing Models of the Treatment-seeking Behaviors in Patients with Rheumatoid Arthritis (류마티스 관절염 환자의 치료행위 모형 검증을 위한 횡문화적 비교연구)

  • Lee, In-Sook;Lee, Eun-Ok;Eun, Young;Wilkie, Diana J.;Belza, Basia
    • Journal of muscle and joint health
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    • v.6 no.2
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    • pp.253-277
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    • 1999
  • Patients with chronic disease have various treatment patterns because it shows a progressive degenerative feature. Especially various physical and emotional problems of the rheumatoid arthritis patients leave them shopping around various types of treatment. According to previous studies, over 70% of patients with arthritis experienced the traditional oriental medicine or folk remedies simultaneously with medical treatment within one year after the onset of disease. The purposes of this study are 1) to compare the patterns of treatment-seeking behaviors between Korean arthritis patients and Americans ; and 2) test two models of treatment-seeking behaviors by path analysis, one for early treatment-seeking behavior model(ETBM) and the other is chronic treatment-seeking behavior model (CTBM) in Korean sample. The interview survey was performed to 133 RA patients with structured questionnaire at out-patient clinic or public health center. Patients characteristics such as age, duration of disease were similar in two countries except higher educational background in Americans. There were no patients using only alternative therapies or no medical treatment in the US. Most of the American patients have chosen both medical treatment and alternative therapy, while the Koreans less than American. In Korea, combined treatment group usually consists of the people who are younger, more educated and higher economic status than the characters of other groups in early or chronic stages. In early stage, they tend to have strong belief of curing from the disease, satisfy the relationship with their physicians and comply with direction of the medical professional. The paths of two models were explained by 70% in ETBM and 33% in CTBM. When the models were modified, almost all paths of the CTBM were the same as the previous one, but direct determinant factor was changed from the relationship with physicians to the lay referral system in chronic model. These two models' explanation powers became 94% and 88%, respectively. The attitude or perception of disease, lay referral system and the relationship with medical personnel are the main determinants of treatment-seeking behaviors.

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Therapeutic Compliance and Its Related Factors of Lung Cancer Patients (폐암환자의 치료순응도와 관련요인)

  • Kam, Sin;Park, Jae-Yong;Chae, Sang-Chul;Bae, Moon-Seob;Shin, Moo-Chul;Yeh, Min-Hae;Nam, Si-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.1
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    • pp.13-23
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    • 2002
  • Objectives : To investigate the therapeutic compliance and its related factors in lung cancer patients. Methods : The subjects of this study comprised 277 patients first diagnosed with lung cancer at Kyungpook National University Hospital between Jan 1999 and Sept 1999. Of these, 141(50.9%) participated in the study by properly replying to structured questionnaires. The data was analyzed using a simplified Health Decision Model. This model includes categories of variables covering therapeutic compliance, health beliefs, patient preferences, knowledge and experience, social interaction, sociodemographic and clinical characteristics. Results : The therapeutic compliance rate of the 141 study subjects was 78.0%. An analysis of health beliefs and patient preferences revealed health concern (p<0.05), dependency on medicine (p<0.05), perceived susceptibility and severity (p<0.05) as well as preferred treatment (p<0.01) as factors related to therapeutic compliance. Factors from the sociodemographic characteristics and clinical factors that were related to therapeutic compliance were age (p<0.01), monthly income (p<0.05), histological type (p<0.05) and clinical stage (p<0.05) of cancer. Conclusions : In order to improve therapeutic compliance in lung cancer patients it is necessary to educate the aged, low-income patients, or patients who have small cell lung cancer or lune cancer of an advanced stage for which surgery is not indicated. Additionally, it is essential for medical personnel to have a deep concern about patients who have poor lifestyles, a low dependency on medicine, or a high perceived susceptibility and severity. Practically, early diagnosis of lung cancer and thoughtful considerations of low-income patients are important. By means of population-based education in a community, we may promote attention to health and enhance the early diagnosis of lung cancer.

The Determinants of Health Promoting Behavior of Industrial Workers (산업장 근로자의 건강증진행위와 자아개념 및 건강의 중요성 인식에 관한 연구)

  • Kim, Chung Nam
    • Korean Journal of Occupational Health Nursing
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    • v.7 no.1
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    • pp.5-19
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    • 1998
  • This descriptive-correlational study was conducted to identify the major factors affecting health promoting behaviors. 344 workers who employed in four different manutacturing plants in Taegu and Kyungbuk area were selected by convenience sampling method. Data were collected from April let to April 18th, 1998 by ready structured questionaires. The purpose of this study was to offer the basic data for health promotion theory development and health promotion strategy planning. This study was based on Pender's Health Promotion Model and examined three variables health promoting behavior, self-concept and perceived importance of health. The Life Style and Health Habit Assessment scale(LHHA) developed by Pender(1982).The Self-concept scale developed by Choi(1972) and the Health Value scale developed by Wallston, Maides and Wallston(1980) were used for this study. Data was analyzed by percentage, mean. t-test. ANOVA, Pearson Correlation Coefficient, and Stepwise Multiple Regression. The major findings of this study are as follows ; 1. The average level of health promoting behavior practice was 63.2% and possible range was from 62 to 248 point. The mean score of respondent's positive self-concept was 75.8. 81.4% of respondents put a high priority on the importance of health. 2. There was a significant difference between the practice level in the category of general self care and less amount of working hours per day(P=0.000), less amount of working hours per week(P=0.000). There was a significant difference between the practice level in the category of nutrition and age(0.002), marital status(0.000), working hour per day(0.008), working hours per week(0.001), There was a significant difference between the practice level in the category of nutriton and sex(0.000), age(0.000), marital status(0.025), education level(0.000), working hours per day(0.002), working hours per week(0.006). There was a significant difference between the practice level in the category of sleep and rest and age(0.003), marital status(0.002), working hours per day(0.001), working hours per week(0.001). There was a significant difference between the practice level in the category of stress management and working hours per day(0.001), working hours per week(0.002). There was a significant difference between the practice level in the category of self-actualization and working hours per day(0.050). 3. General characteristics influencing the respodent's self-concept were level(P=0.009) and worksite(P=0.001). 4. The results of the hypothesis tests are as follows The first hypothesis, that "The respondent who have more positive self-concept will have higher scores in the practice of health promoting behavior." was supported(r=0.2973, P=0.0001). The second hypothesis that "The respondent who have higher perception level on importance of health will have higher scores in the practice health promoting behavior." was rejected(r=- 0665, P=0.2225). 5. The most important factor that affects health promoting behavior practice was working hours per week(6.0%). The combination of working hours per week, age, education level accounted for 10.0% of the variance in health promoting behavior. In conclusion, the results of this study on industrial workers supported Pender's health promotion model in partial and showed the relatedness between self concept and the practice of health promoting behavior. Further research is required to find factors influencing health promoting behaviors of industrial workers.

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The Factors Related to Health Promoting Behaviors of the Late Middle Aged (중년후기 성인의 건강증진행위 관련요인)

  • Lim, Eun Ju;Noh, Jun Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.10
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    • pp.4694-4702
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    • 2012
  • The purpose of this study was a descriptive research that identified the levels of health-promoting behaviors, previous related behavior, perceived benefits/barriers, self-efficacy, and social support. In addition, it was to establish the relations among the variables, and determine the factors affecting the health-promoting behaviors. Study participants were 311 middle aged between 55-64 in urban areas, and the data were collected through self-reported structured questionnair. According to the results, the mean score for the levels of health-promoting behaviors of the late middle aged was 2.64. Also, among the variables related to health-promoting behaviors, perceived benefits were the highest score (30.7), and perceived barriers were the lowest one (2.08). Meaningful positive correlations were found among health-promoting behaviors and previous related behavior, social support, perceived benefits, and self-efficacy, but perceived barriers showed weakly negative correlations. In addition, the factors affecting health promoting behaviors were revealed in order as following: Previous health related behavior(${\beta}$=.35, p<.001), perceived benefits(${\beta}$=.32, p<.001), social support(${\beta}$=.28, p<.001), and life satisfaction(${\beta}$=.13, p<.001), and this model's explanatory power was 68.8%(F=166.71, p<.001). Based on the findings from the study, in order for the late middle aged to have a well-being old age, an health promoting education program including exercises and stress management should be provided to maintain and improve proper health promoting behaviors. The network with the same age groups also should be supported to share useful information and back up one another.

A Study on The Influence Factors of Self-Efficacy, Job Performance, and Job Satisfaction of University Hospital Nurses (대학병원간호사의 자기효능감, 업무수행능력이 직무만족도에 미치는 영향요인)

  • Kim, Mi-Young;Lee, Hye-Kyung
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.3
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    • pp.726-736
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    • 2019
  • The purpose of this study is to investigate the effect of University hospital nurses' self-efficacy and job performance on job satisfaction. The subjects of this study were 130 nurses working at a university hospital in C city and collected data using structured questionnaires. The collected data were analyzed using mean, standard deviation, t-test, ANOVA, Pearson's correlation and multiple regression analysis using spss 25.0. The results showed that the self-efficacy was 3.24 points for the average score, 2.74 points for the job performance, and 3.10 points for the job satisfaction. Self-efficacy, job performance, and job satisfaction were statistically correlated. The factors affecting job satisfaction were self-efficacy (${\beta}=.39$, p<.001), age at 30~34 years (${\beta}=-.27$, p=.001), Operating Room(${\beta}=-.17$, p=.029), Medical ward (${\beta}=-.17$, p=.025) and unmarried (${\beta}=-.20$, p=.012) and the explanatory power of the model was 30.4%. Based on the results of this study, it is necessary to develop a program to improve the job satisfaction considering the self-efficacy, age, working department of hospital nurse.

A Study on the Market Structure Analysis for Durable Goods Using Consideration Set:An Exploratory Approach for Automotive Market (고려상표군을 이용한 내구재 시장구조 분석에 관한 연구: 자동차 시장에 대한 탐색적 분석방법)

  • Lee, Seokoo
    • Asia Marketing Journal
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    • v.14 no.2
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    • pp.157-176
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    • 2012
  • Brand switching data frequently used in market structure analysis is adequate to analyze non- durable goods, because it can capture competition between specific two brands. But brand switching data sometimes can not be used to analyze goods like automobiles having long term duration because one of main assumptions that consumer preference toward brand attributes is not changed against time can be violated. Therefore a new type of data which can precisely capture competition among durable goods is needed. Another problem of using brand switching data collected from actual purchase behavior is short of explanation why consumers consider different set of brands. Considering above problems, main purpose of this study is to analyze market structure for durable goods with consideration set. The author uses exploratory approach and latent class clustering to identify market structure based on heterogeneous consideration set among consumers. Then the relationship between some factors and consideration set formation is analyzed. Some benefits and two demographic variables - age and income - are selected as factors based on consumer behavior theory. The author analyzed USA automotive market with top 11 brands using exploratory approach and latent class clustering. 2,500 respondents are randomly selected from the total sample and used for analysis. Six models concerning market structure are established to test. Model 1 means non-structured market and model 6 means market structure composed of six sub-markets. It is exploratory approach because any hypothetical market structure is not defined. The result showed that model 1 is insufficient to fit data. It implies that USA automotive market is a structured market. Model 3 with three market structures is significant and identified as the optimal market structure in USA automotive market. Three sub markets are named as USA brands, Asian Brands, and European Brands. And it implies that country of origin effect may exist in USA automotive market. Comparison between modal classification by derived market structures and probabilistic classification by research model was conducted to test how model 3 can correctly classify respondents. The model classify 97% of respondents exactly. The result of this study is different from those of previous research. Previous research used confirmatory approach. Car type and price were chosen as criteria for market structuring and car type-price structure was revealed as the optimal structure for USA automotive market. But this research used exploratory approach without hypothetical market structures. It is not concluded yet which approach is superior. For confirmatory approach, hypothetical market structures should be established exhaustively, because the optimal market structure is selected among hypothetical structures. On the other hand, exploratory approach has a potential problem that validity for derived optimal market structure is somewhat difficult to verify. There also exist market boundary difference between this research and previous research. While previous research analyzed seven car brands, this research analyzed eleven car brands. Both researches seemed to represent entire car market, because cumulative market shares for analyzed brands exceeds 50%. But market boundary difference might affect the different results. Though both researches showed different results, it is obvious that country of origin effect among brands should be considered as important criteria to analyze USA automotive market structure. This research tried to explain heterogeneity of consideration sets among consumers using benefits and two demographic factors, sex and income. Benefit works as a key variable for consumer decision process, and also works as an important criterion in market segmentation. Three factors - trust/safety, image/fun to drive, and economy - are identified among nine benefit related measure. Then the relationship between market structures and independent variables is analyzed using multinomial regression. Independent variables are three benefit factors and two demographic factors. The result showed that all independent variables can be used to explain why there exist different market structures in USA automotive market. For example, a male consumer who perceives all benefits important and has lower income tends to consider domestic brands more than European brands. And the result also showed benefits, sex, and income have an effect to consideration set formation. Though it is generally perceived that a consumer who has higher income is likely to purchase a high priced car, it is notable that American consumers perceived benefits of domestic brands much positive regardless of income. Male consumers especially showed higher loyalty for domestic brands. Managerial implications of this research are as follow. Though implication may be confined to the USA automotive market, the effect of sex on automotive buying behavior should be analyzed. The automotive market is traditionally conceived as male consumers oriented market. But the proportion of female consumers has grown over the years in the automotive market. It is natural outcome that Volvo and Hyundai motors recently developed new cars which are targeted for women market. Secondly, the model used in this research can be applied easier than that of previous researches. Exploratory approach has many advantages except difficulty to apply for practice, because it tends to accompany with complicated model and to require various types of data. The data needed for the model in this research are a few items such as purchased brands, consideration set, some benefits, and some demographic factors and easy to collect from consumers.

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