• Women's Health Nursing
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• v.2 no.2
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• pp.298-331
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• 1996

Recent improvements in living standard and development in medical care led to an increased interest in life expectancy and personal health, and also led to a more demand for higher quality of life. Thus, the problem of women's health draw a fresh interest nowadays. Since late-middle aged women experience various physical and socio-psychological changes and tend to have chronic illnesses, these women have to take initiatives for their health control by realizing their own responsibility. The basic elements for a healthy life of these women are understanding of their physical and psychological changes and acceptance of these changes. Health promoting behaviors of an individual or a group are actions toward increasing the level of well-being and self-actualization, and are affected by various variables. In Pender's health promoting model, variables are categorized into cognitive factors(individual perceptions), modifying factors, and variables affecting the likelihood for actions, and the model assumes the health promoting behaviors are affected by cognitive factors which are again affected by demographic factors. Since Pender's model was proposed based on a tool broad conceptual frame, many studies done afterwards have included only a limited number of variables of Pender's model. Furthermore, Pender's model did not precisely explain the possibilities of direct and indirect paths effects. The objectives of this study are to evaluate Pender's model and thus propose a model that explains health promoting behaviors among late-middle aged women in order to facilitate nursing intervention for this group of population. The hypothetical model was developed based on the Pender's health promoting model and the findings from past studies on women's health. Data were collected by self-reported questionnaires from 417 women living in Seoul, between July and November 1994. Questionnaires were developed based on instruments of Walker and others' health promotion lifestyle profile, Wallston and others' multidimensional health locus of control, Maoz's menopausal symptom check list and Speake and others' health self-rating scale. IN addition, items measuring self-efficacy were made by the present author based on past studies. In a pretest, the questionnaire items were reliable with Cronbach's alpha ranging from .786 to .934. The models for health promoting behaviors were tested by using structural equation modelling technique with LISREL 7.20. The results were summarized as follows : 1. The overall fit of the hypothetical model to the data was good (chi-square=4.42, df=5, p=.490, GFI=.995, AGFI=.962, RMSR=.024). 2. Paths of the model were modified by considering both its theoretical implication and statistical significance of the parameter estimates. Compared to the hypothetical model, the revised model has become parsimonious and had a better fit to the data (chi-square =4.55, df=6, p=.602, GFI=.995, AGFI=.967, RMSR=.024). 3. The results of statistical testing were as follows : 1) Family function internal health locus of control, self-efficacy, and education level exerted significant effects on health promoting behaviors(${\gamma}_{43}$=.272, T=3.714; ${\beta}_[41}$=.211, T=2.797; ${\beta}_{42}$=.199, T=2.717; ${\gamma}_{41}$=.136, T=1.986). The effect of economic status, physical menopausal symptoms, and perceived health status on health promoting behavior were insignificant(${\gamma}_{42}$=.095, T=1.456; ${\gamma}_{44}$=.101, T=1.143; ${\gamma}_{43}$=.082, T=.967). 2) Family function had a significance direct effect on internal health locus of control (${\gamma}_{13}$=.307, T=3.784). The direct effect of education level on internal health locus of control was insignificant(${\gamma}_{11}$=-.006, T=-.081). 3) The directs effects of family functions & internal health locus of control on self-efficacy were significant(${\gamma}_{23}$=.208, T=2.607; ${\beta}_{21}$=.191, T=2.2693). But education level and economic status did not exert a significant effect on self-efficacy(${\gamma}_{21}$=.137, T=1.814; ${\beta}_{22}$=.137, T=1.814; ${\gamma}_{22}$=.112, T=1.499). 4) Education level had a direct and positive effect on perceived health status, but physical menopausal symptoms had a negative effect on perceived health status and these effects were all significant(${\gamma}_{31}$=.171, T=2.496; ${\gamma}_{34}$=.524, T=-7.120). Internal health locus and self-efficacy had an insignificant direct effect on perceived health status(${\beta}_{31}$=.028, T=.363; ${\beta}_{32}$=.041, T=.557). 5) All predictive variables of health promoting behaviors explained 51.8% of the total variance in the model. The above findings show that health promoting behaviors are explained by personal, environmental and perceptual factors : family function, internal health locus of control, self-efficacy, and education level had stronger effects on health promoting behaviors than predictors in the model. A significant effect of family function on health promoting behaviors reflects an important role of the Korean late-middle aged women in family relationships. Therefore, health professionals first need to have a proper evaluation of family function in order to reflect the family function style into nursing interventions and development of strategies. These interventions and strategies will enhance internal health locus of control and self-efficacy for promoting health behaviors. Possible strategies include management of health promoting programs, use of a health information booklets, and individual health counseling, which will enhance internal health locus of control and self-efficacy of the late-middle aged women by making them aware of health responsibilities and value for oneself. In this study, an insignificant effect of physical menopausal symptoms and perceived health status on health promoting behaviors implies that they are not motive factors for health promoting behaviors. Further analytic researches are required to clarify the influence of physical menopausal symptoms and perceived health status on health promoting behaviors with-middle aged women.

• The Korean Journal of Health Service Management
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• v.9 no.1
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• pp.81-93
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• 2015

This study investigated the prevalence of unmet needs for health care among Korean adults and related factors. Using data from the 2012 Korea Health Panel, 1,896 adults aged 65 and over and two age groups(Young-Old(66-74) and Old-Old($65{\leq}$)) were analyzed to identify these factors. Logistic regression analysis was used to examine the main factors associated with unmet medical needs. According to the results of this study, the factors influencing unmet medical needs with regard to economic factors were Subjective Health Status(young-old), Disability(young-old), Activity Limitation(young-old), Education Level(old) and Economic Activity(old). The factors influencing unmet medical needs were factors of attitude, information, and disease. factors were Disability(young-old), Activity Limitation(young-old), Education Level(old) and Economic Activity(old). Therefore, further research that investigates unmet needs depending on age group in the elderly would suggest helpful policy implications.

• Women's Health Nursing
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• v.7 no.4
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• pp.486-498
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• 2001

The purpose of this study was to identify transition conditions, health behavior and indicators of healthy transitions among middle-aged women based on Schumacher & Meleis(1994) transition model for developing intervention program for their health promotion. A convenience sample of 221 women aged 40-60 was obtained in Jung-Gu, Seoul and they were asked to complete the questionnaires, which consisted of modified health-promoting lifestyle profile(HPLP), knowledge of menopause, physical well-being, emotional well-being, modified women's role integration protocol (WRIP), Beck's Depression Inventory(BDI), and indicators of healthy transition with subcategories such as subjective well-being, role mastery and well-being of interrelationship. The results were as follows: 1. Women had a mean age of 47.53 years. More than half(53.39%) of the women had jobs and 88.69 % had their spouses, Of 221 women, 51.13 % were premenopausal, 19.91% were perimenopausal, and 28.96% were postmenopausal. 2. Women scored lower on health responsibility and exercise than on self actualization, nutrition and interpersonal support among subcategories of health behavior measured the modified HPLP. Only 11.98% of respondents had breast-self examination and 42.66% had pap smear for screening cancer. 3. In transition conditions, women had poor knowledge about menopause and median level of physical well-being, emotional well-being and stress. 15.45% of the women had clinical depression. 4. As for the outcome index of the transition model, the mean of indicators of healthy transition was 3.69(possible range 1-5). 5. The levels of education and economic and the menstrual status were significantly related to physical well-being, depression and stress in the categories of transition conditions. The total score of health behavior correlated negatively with depression. The total score of indicators of healthy transition correlated with physical well-being, emotional well-being, stress, and depression in the categories of transition conditions. In conclusion, these findings suggested a profile of fragile middle-aged women and contributed to developing the community-based intervention program for health promotion.

• Journal of Families and Better Life
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• v.23 no.3 s.75
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• pp.1-16
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• 2005

This study explored the elements, types, and determining factors of successful aging for the Korean elderly. In order to examine the expectations of the Korean elderly, a sample of 377 elderly aged 65 and over living in Seoul and Kyunggi areas was selected and interviewed. The elements of successful aging that the Korean elderly pointed out in the interviews were: 'peaceful and comfortable life', 'self-maintenance,' 'secure social support,' and 'ostentation.' The expected elements of successful aging were further classified into three types of successful aging: 'idealized expectation.' 'self-centered expectation,' 'balanced self-other expectation.' The elderly groups sorted by the types exhibited significant differences in terms of demographic characteristics, self-evaluated economic status, and self-evaluated health status. The variables that affected the expectations were age, level of education, marital status, gender, and self-evaluated health condition. However, further analysis revealed that the factors that affected the expectation for successful aging were different for male and female elderly. The results suggest that the successful aging of Korean elderly should be understood in the context of Korean society and culture. The results could be used to better understand varied and unique life of Korean elderly, as well as in establishing a basis of intervention that meets the specific demands of the Korean elderly.

• Journal of the Korean Home Economics Association
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• v.50 no.3
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• pp.95-109
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• 2012

The main purpose of this research is to analyze the variety of self-integration in accordance with the age of the elderly citizens and to verify the interactive effects of age groups and demographical characteristics on self-integration. For the purpose of this research, group of 603 elderly people who reside in Busan and are aged more than 65 were selected as participants. In this research, the elderly citizens were categorized into three age groups namely 65-74, 75-84, and above 85 years. From the results of the research we found out the following results: There were differences in self-integration across the various age groups; the age groups and the level of education had interactive effects on each other; there were differences in self-integration according to the level of education, marital status, type of co-living with children, economic status, and health status. The research showed significance in analyzing, positively the fact that public services which are designed for elder citizens need to be provided discriminatively and they should be suited for the various age groups.

• The Korean Journal of Health Service Management
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• v.8 no.2
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• pp.197-208
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• 2014

This study examined the relationship between social support and depressive symptom among the middle and old-aged people, using dataset of the Korean Longitudinal Study of Ageing(KLoSA 3rd). The subjects were 7,874 persons aged 45 and over. Using this data, social support variables and its relation to depressions was observed based on social network model. A multiple regression model was used to study an association between social support and depressive symptom, controlling for socio-economic characteristics, health status and behavior. Also, this paper run two subgroup regression models based on gender of subjects (male, female), controlling for confounding variables. Authors found that there was lower the number of meetings with friends (1~3 times in a week: b=0.597, p<0.0001; 1~2 times in a month: b=0.609, p<0.0001; 1~6 times in a year or under: b=1.598, p<0.0001) and negative relationship between spouse satisfaction (b=-0.007, p=0.0237), children satisfaction (b=-0.019, p<0.0001) and depressive symptom. Also quantitative effect differences were compared according to gender and its effect on depression. Compared to the male group, female group showed significant difference in quantitative effect with number of meetings with friends and spouse satisfaction, but children satisfaction didn't show clear differences according to gender. This study suggested the importance of social support for promoting mental health among the middle and old-aged people.

• The Korean Journal of Food And Nutrition
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• v.12 no.1
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• pp.13-19
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• 1999

To examine the relationship between the casual infection of gastric cancer and lifestyle and nutritional status we surveyed 169 persons 90 females and 79 males aged 40∼69 years from June 7 to June 14 1997 in Whachon area Kang-Won Do Korea. For this purpose we investigated Helicobacter pylori infec-tion and identified the effect of sex age, smoking alcohol consumption economic status occupation life-style and food intake on Helicobacter phlori infection. Helicobacter pylori status was evaluated using an en-zyme-linked immunosorbant assay(ELISA) for anti-Helicobacter pylori immunoglobulin G(IgG). Helicob-acter pylori infection was present in 66.3% of total subjects namely 67.7% of female and 64.4% of male and its prevalence increased with smoking low education level and low monthly income. Energy total protein calcium and vitamin C intakes in the negative Helicobacgter phlori infection group were higher than those in positive Helicobacter pylori infection group. However iron and niacin intakes were lower in the helicobacter pylori negative group than in the positive group.

• Journal of Korean Public Health Nursing
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• v.28 no.1
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• pp.71-86
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• 2014

Purpose: This study was conducted in order to identify factors that predict suicidal ideation and depression according to gender among Korean adults. Method: From the data base of the fifth Korean National Health and Nutritional Examination Survey(KNHANESV-1, 2010), data on 4,894 adults aged 19~64 were used. Data were analyzed by application of the Rao-Scott Chi-Square test and logistic analysis with SAS 9.2. Results: Overall, 8.5% of men and 18.1% of women had suicidal ideation during the last year; 7.5% of men and 17.0% of women had depression during the last two weeks. Risk factors for suicidal ideation include perceived high stress(OR male 3.649, female 2.941), depression(OR male 10.109, female 6.033), poor cognition of health status(OR male 8.115, female 6.664), low economic status(OR male 1.898), and low educational status(OR female 1.631). Risk factors for depression include perceived high stress(OR male 2.678, female 3.686), suicidal ideation(OR male 9.925, female 6.022), non-employed(OR female 1.525), married(OR female 2.392), and physical discomfort(OR female 1.545). Conclusions: Based on the above mentioned results, risk factors of suicidal ideation and depression differed according to gender. Development of various policies and appropriate intervention programs according to gender, that lessen the risk of suicidal ideation and depression for adults is needed.

• Journal of Family Resource Management and Policy Review
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• v.20 no.1
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• pp.89-108
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• 2016

The purpose of this study is to examine the demographic, economic, and psychological factors that influence the quality of life (QoL) of the elderly. The data in the 'Survey on the Elderly in 2011', were collected from The Ministry of Health & Welfare and the Korea Institute for Health and Social Affairs. The samples included 3,312 out of the total of 15,146 elderly people aged from 65 to 70 years. Multiple regression analysis and path analysis were used to analyze the research model. The findings are as follows. First, the most critical factor that affected the QoL of the elderly was "subjective standard of living" with other factors including "subjective physical condition level", "depression", "total annual income", "the number of chronic disease", "self-esteem", "economic supports from their adult children", "education level", "living with their adult children or not", "sex", and "home ownership", in that order. Second, based on the path analysis results, the QoL of the elderly was influenced by "subjective physical condition level", "subjective standard of living", "depression", "self-esteem", "total annual income", "education level", and "the number of chronic disease", in that order. In particular, "depression" had a negative direct effect and an indirect effect on the QoL of the elderly, whereas "self-esteem" had a positive direct effect and indirect effect on their QoL. Third, "labor force participation status" did not affect the QoL of the elderly. However, it implied the mediating effect of "self-esteem" and "depression" on their QoL. These results show that demographic, economic, and psychological factors heavily influence the QoL of the elderly. Specifically, "depression" and "self-esteem" turn out to be mediating variables that strongly influence the QoL of the elderly. Also, "labor force participation status" does not have a positive direct effect on the QoL of the elderly but has a positive mediating effect of "depression" and "self-esteem" on their QoL.

• Korean Journal of Community Nutrition
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• v.23 no.5
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• pp.385-396
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• 2018

Objectives: This study aims to evaluate the economic efficiency of a nutrition management program for children under 5 years of age in Kenge, Kwango District, Democratic Republic of the Congo (DR Congo) from 2014 to 2016. Methods: The economic efficiency of a nutrition management program for children under 5 years of age who have recovered from malnutrition status was evaluated using a cost-benefit analysis. The costs were analyzed according to the executed budget incurred during the project period. The benefits were estimated as the monetary value of the saved lives of children under 5 years of age. The economic efficiency of the program was determined by the Benefit-Cost Ratio (BCR). The BCR was calculated by dividing the total discounted benefit by the total discounted costs. The project is economically efficient when the BCR is greater than 1. Results: The costs of the nutrition management program were calculated as 1,677,609,648 Korean Won (KRW). A total of 2,466 children survived with improved malnutrition status through this program. The benefit for the reduction of mortality for children under 5 years of age was estimated to be 6,814,354,467 KRW, the estimated value of life for 2,466 children. The BCR was 4.06. Conclusions: The nutrition management program for children under 5 years of age in DR Congo was found to be a cost-effective project. Successful and efficient Official Development Assistance (ODA) for a health project requires integrated and comprehensive strategies and specialized international development consulting to improve efficiency. Future nutrition management programs should take into account the national health program to maintain the sustainability of the project.